8 Years in Braces: Addressing Dental Space Issues and Concerns

I have been wearing braces for 8 years?

Hello, I got braces in my second year of junior high (now I'm in my third year of college).
At that time, I had two extra teeth extracted.
Last year, the doctor said there wasn't enough space in my upper teeth and recommended extracting two premolars.
After that extraction, this year the doctor mentioned there wasn't enough space in my lower teeth and suggested removing my right wisdom tooth (which has been extracted) to create space.
Just this month, the doctor said there is a severe lack of space in my lower teeth and recommended extracting two lower premolars.

Question 1: I've had the braces for quite a while, and my bite hasn't improved.
Would you recommend changing the braces?
Question 2: Why wasn't everything extracted at once when I first got the braces, and is it correct to suggest extractions afterward?

BB, 20~29 year old female. Ask Date: 2015/09/05

Dr. Zeng Guanghui reply Dentistry

Due to insufficient space for tooth alignment, it is generally necessary to extract four premolars (two from the upper jaw and two from the lower jaw) to achieve proper alignment.
If there are impacted wisdom teeth, they should also be extracted.
After that, orthodontic brackets and wires are placed to align the teeth, which typically takes about one and a half to two years.
If there is no improvement in occlusion during the treatment period, it is advisable to consult a dentist for further evaluation and treatment.

Reply Date: 2015/09/05

More Info

Wearing braces for eight years can be a frustrating experience, especially when it feels like progress is slow or when additional extractions are suggested. Let's address your concerns regarding dental space issues and the prolonged orthodontic treatment.

Understanding the Need for Extractions
1. Why Additional Extractions?
When you initially started your orthodontic treatment, your dentist may have assessed your dental structure and determined that extracting two teeth was sufficient at that time. However, as treatment progresses, the orthodontist continually evaluates the alignment and spacing of your teeth. If they notice that there is still insufficient space for proper alignment, they may recommend further extractions. This is not uncommon in orthodontics, as the dynamics of tooth movement can change over time.
2. Sequential vs. Simultaneous Extractions:
The decision to extract teeth in stages rather than all at once can depend on various factors, including the specific alignment issues, the growth patterns of your jaw, and the overall treatment plan. Sometimes, orthodontists prefer to monitor how teeth respond to initial extractions before proceeding with additional ones. This approach allows for a more tailored treatment plan based on how your teeth are moving and the space that becomes available.

Addressing Your Concerns
1. Duration of Treatment and Lack of Improvement:
If you feel that your bite has not improved after eight years, it is essential to communicate this concern with your orthodontist. They may need to reassess your treatment plan, which could include changing the type of braces or considering other orthodontic appliances. In some cases, if the treatment is not yielding the desired results, your orthodontist might suggest a referral to a specialist for a second opinion.

2. Considering a Change in Orthodontist:
If you are feeling dissatisfied with the progress of your treatment, it is reasonable to seek a consultation with another orthodontist. A fresh perspective can provide insights into your treatment plan and whether adjustments are necessary. It is crucial to feel comfortable and confident in your orthodontic care, especially after such a long duration of treatment.

Additional Considerations
- Orthodontic Treatment Duration:
The average duration for orthodontic treatment can vary widely, typically ranging from 18 months to 3 years. However, complex cases may require longer treatment times. Factors influencing treatment duration include the severity of misalignment, the age of the patient, and the specific orthodontic techniques used.

- Post-Treatment Retention:
After the removal of braces, wearing a retainer is crucial to maintain the new position of your teeth. This phase is often overlooked but is essential to prevent teeth from shifting back to their original positions.

- Potential for Jaw Issues:
Prolonged orthodontic treatment can sometimes lead to issues with the jaw or temporomandibular joint (TMJ). If you experience discomfort or pain in your jaw, it is essential to discuss this with your orthodontist or a dental specialist.

Conclusion
In summary, while it can be disheartening to face additional extractions and prolonged treatment, it is essential to maintain open communication with your orthodontist. If you feel that your concerns are not being adequately addressed, seeking a second opinion can provide clarity and reassurance. Remember, the goal of orthodontic treatment is not just to achieve straight teeth but to ensure a functional bite and overall oral health.

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