Impacts of Delayed Orthodontic Treatment After Tooth Extraction

What are the effects of not immediately correcting supernumerary teeth after their extraction?

Hello Doctor, I will be going abroad for work for two years starting on February 28, so I originally scheduled an intensive extraction of my wisdom teeth and supernumerary teeth, followed by orthodontic treatment.
However, after consulting many people's experiences with orthodontics, I have several questions and considerations, and I hope you can provide some advice.
My supernumerary teeth are located above the roots of my two front teeth and slightly encroach into the nasal cavity, causing my left front tooth to be misaligned at an angle of 15 to 45 degrees, resting on the right front tooth.
Five years ago, the dentist helped me correct the misaligned teeth and fitted braces to make them look neat, but the two front teeth are bonded together, which has made cleaning difficult.
I cannot use dental floss, and since the braces are metal, I cannot tell if there are cavities inside.
1.
The oral surgeon said that the supernumerary tooth currently appears to be fine, and if I do not plan to undergo orthodontics, I might consider not extracting it for now and to address it when I return home.
2.
The orthodontist wants to extract the tooth on February 5, remove the old braces on February 24, create a temporary retainer, and immediately place brackets on four teeth to straighten the roots of the front teeth.
Doctor, should I follow the oral surgeon's advice and wait to undergo orthodontics when I return home, or should I adhere to the orthodontist's plan? I asked the orthodontist about my inability to return for monthly adjustments, as I might only be able to visit every six months.
She said that would be fine and that she would teach me how to handle emergencies and how to remove the braces.
However, I am still concerned that rushing into treatment might backfire.
On the other hand, if I follow the oral surgeon's approach, I worry that my dental condition might worsen over the two years, and being 30 years old, will orthodontic treatment be more difficult?
Additionally, if I proceed with the extraction of the supernumerary tooth but do not immediately get braces within the same month, and instead wait six months to a year before getting braces abroad, is that feasible? Will my front teeth fall out due to the lack of support from the supernumerary teeth? Thank you for your patience in reading this.

Cai Yingying, 20~29 year old female. Ask Date: 2016/01/31

Dr. Zeng Guanghui reply Dentistry

The misalignment of the incisors is due to the presence of supernumerary teeth.
Initially, the plan was to correct the crooked incisors and place crowns to make them appear straight.
However, the supernumerary teeth are impinging on the adjacent teeth.
If considering re-orthodontic treatment, it is advisable to first consult an oral surgeon to surgically remove the supernumerary teeth.
After allowing 1 to 2 months for the surgical site to heal, it is safer to proceed with orthodontic treatment.
This is because the surrounding alveolar bone will have healed, reducing the risk of periodontal tissue damage during the movement of the incisors due to incomplete healing of the extraction site.
It is recommended to seek further treatment from both an oral surgeon and an orthodontist.

Reply Date: 2016/01/31

More Info

When considering the impacts of delayed orthodontic treatment after tooth extraction, particularly in your case involving the removal of wisdom teeth and supernumerary teeth, several factors come into play that can affect both the alignment of your teeth and the overall health of your oral cavity.

Firstly, it is essential to understand that the timing of orthodontic treatment following tooth extraction is crucial. After a tooth is extracted, the surrounding bone and gum tissue undergo a healing process. If orthodontic treatment is initiated too soon, before the extraction site has fully healed, it can lead to complications such as inadequate bone support for the adjacent teeth, which may result in tooth mobility or misalignment. In your situation, since you have a supernumerary tooth that is affecting the alignment of your incisors, it is advisable to wait until the extraction site has healed properly before starting orthodontic treatment.

Moreover, if you choose to delay orthodontic treatment for an extended period, such as the two years you mentioned due to your work abroad, there are potential risks. The longer the teeth remain misaligned, the more likely they are to shift further out of position. This can lead to increased difficulty in achieving the desired alignment later on. Additionally, as you age, the bone density and elasticity of your periodontal tissues may change, potentially making orthodontic treatment more challenging and prolonged.

Regarding your concern about the supernumerary tooth providing support to your incisors, it is important to note that while the supernumerary tooth may seem to offer some structural support, it can also contribute to misalignment and complicate oral hygiene. If it is not removed, it may continue to exert pressure on the adjacent teeth, exacerbating the misalignment. Once the supernumerary tooth is extracted, the adjacent teeth may initially shift slightly, but with proper orthodontic treatment afterward, they can be realigned effectively.

If you decide to follow the oral surgeon's advice and delay the extraction and subsequent orthodontic treatment, it is crucial to maintain regular dental check-ups to monitor the condition of your teeth and gums. This will help ensure that any potential issues, such as cavities or gum disease, are addressed promptly.

In conclusion, while it is possible to delay orthodontic treatment after tooth extraction, it is generally advisable to proceed with the extraction and follow up with orthodontic treatment as soon as the extraction site has healed. This approach minimizes the risk of further misalignment and ensures that your teeth can be properly aligned with the least amount of complication. If you are concerned about the timing and logistics of your treatment while abroad, consider discussing your options with both your oral surgeon and orthodontist to create a plan that accommodates your situation while prioritizing your dental health.

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