Any orthodontists on here?
Discussion
I'm not a dentist..
..but from a (if it were me) point of view, I'd agree with you and have it taken out. Prevention is better than cure, right?
I 'ignored' my wisdom teeth (and the dentist) in my early twenties and it caused issues with three of them (two upper, one lower). One was slightly impacted which made it difficult to clean properly and it decided to commit dental suicide and tried to take me with it. With hindsight I'd have had them all out BEFORE they started causing problems as the removal and healing process is a walk-in-the-park compared to what a bad tooth can do to you
..but from a (if it were me) point of view, I'd agree with you and have it taken out. Prevention is better than cure, right?
I 'ignored' my wisdom teeth (and the dentist) in my early twenties and it caused issues with three of them (two upper, one lower). One was slightly impacted which made it difficult to clean properly and it decided to commit dental suicide and tried to take me with it. With hindsight I'd have had them all out BEFORE they started causing problems as the removal and healing process is a walk-in-the-park compared to what a bad tooth can do to you
UncleRic said:
had them all out BEFORE they started causing problems
Basically, we can't do that. Risks v benefits and various guidelines have our hands more or less tied on that one.There needs to be some sign of trouble or impending trouble in most cases before they can come out.
Little more flexibility when treatment is not the NHS, but really not that much more.
I'm not a specialist ortho, but like others here, I dabble occasionally.
You are right to want ortho, because if nothing else, that tooth you point to is creating a bounded area thats difficult to clean effectively and is going to be happily retaining plaque putting you at risk of gingivitis/perio disease & caries. Also, neatly lined up lower front teeth will be much easier to keep free of gum problems over your lifetime.
From the impression, both your lower wisdoms appear to be mesially impacted and crucially, part erupted. If an x-ray confirms that the front part of the wisdom tooth/teeth are in contact with the lower 2nd molar than that can be an indication for removal, as the chance of caries is significant. Different hospitals interpret (NICE) guidelines differently, eg Guy's Hospital will definitely take those out, even with no caries evident, whereas King George's Hospital would not.
Mesial drift won't occur in everyone, if your teeth tightly lock together when you bite (good intercuspation) then it is less likely.
I also agree that they look very unlikely to spontaneously correct if you take the premolar out. If you're going to do it, do it properly and do it now. Younger=Easier.
If you're averse to visible braces it looks like you might be a good candidate for 'invisible' ortho treatment via removable retainers. Research Clearstep & Invisalign.
P.s. You are missing a tooth on the left side. Is it congenitally missing, buried or have you had it out already?
You are right to want ortho, because if nothing else, that tooth you point to is creating a bounded area thats difficult to clean effectively and is going to be happily retaining plaque putting you at risk of gingivitis/perio disease & caries. Also, neatly lined up lower front teeth will be much easier to keep free of gum problems over your lifetime.
From the impression, both your lower wisdoms appear to be mesially impacted and crucially, part erupted. If an x-ray confirms that the front part of the wisdom tooth/teeth are in contact with the lower 2nd molar than that can be an indication for removal, as the chance of caries is significant. Different hospitals interpret (NICE) guidelines differently, eg Guy's Hospital will definitely take those out, even with no caries evident, whereas King George's Hospital would not.
Mesial drift won't occur in everyone, if your teeth tightly lock together when you bite (good intercuspation) then it is less likely.
I also agree that they look very unlikely to spontaneously correct if you take the premolar out. If you're going to do it, do it properly and do it now. Younger=Easier.
If you're averse to visible braces it looks like you might be a good candidate for 'invisible' ortho treatment via removable retainers. Research Clearstep & Invisalign.
P.s. You are missing a tooth on the left side. Is it congenitally missing, buried or have you had it out already?
Edited by -Z- on Thursday 14th July 14:53
Your ortho is very unlikely to take your tooth out - they will ask your normal dentist to do it in most cases.
Teeth can move back after orthodontic treatment, even after years. Most initial movement is due to retainers not being worn correctly. Rotations of the tooth are the most difficult to correct.
It is very rare for teeth to move when a retainer is being worn correctly. Initially, just after the braces come off, they need to be in pretty much permanently. So if you had left the retainer out for even a few hours at a time, it is possible. It is also possible if the retainer was not shaped correctly around that tooth - fairly unlikely.
Teeth can move back after orthodontic treatment, even after years. Most initial movement is due to retainers not being worn correctly. Rotations of the tooth are the most difficult to correct.
It is very rare for teeth to move when a retainer is being worn correctly. Initially, just after the braces come off, they need to be in pretty much permanently. So if you had left the retainer out for even a few hours at a time, it is possible. It is also possible if the retainer was not shaped correctly around that tooth - fairly unlikely.
Trevor McDonald said:
Hi, its a bonded retainer that was fitted immediately after the brace was removed.
The retainer may have debonded from that particular tooth which rotated. It sometimes happens.Trevor McDonald said:
Also the ortho is private, removal is £120 which I dont mind paying, though thats twice the price someone else quoted.
If you have selected the specialist to do the work for you, why do you keep mentioning the price ?Edited by sinizter on Thursday 14th July 20:28
I was at Bristol uni when they concluded research showing no link between impacted wisdoms and lower incisor crowding.
Truth is that the lower teeth will always crowd with time for numerous reasons, mainly because the tapered profile means they do not lock together and natural forces that push towards the centre line cause the crossing over.
This is why it essential to have fixed LIFE time retention (bonded wire) as you'll get relapse (as with all ortho) back to the crowded form.
With out extraction you'll need a lot of enamel removal to make the space not worth it. Simple extraction definitely best choice.
Of course other ideas out there
Truth is that the lower teeth will always crowd with time for numerous reasons, mainly because the tapered profile means they do not lock together and natural forces that push towards the centre line cause the crossing over.
This is why it essential to have fixed LIFE time retention (bonded wire) as you'll get relapse (as with all ortho) back to the crowded form.
With out extraction you'll need a lot of enamel removal to make the space not worth it. Simple extraction definitely best choice.
Of course other ideas out there
Trevor McDonald said:
Hi there,
The bond has not broke, but it would appear my teeth have bent the metal. As for the price, well I preferred your pre-edit response - I only mentioned it hoping for some feedback i.e. not to get ripped off.
Unless they've used a piece of floss masquerading as metal, your teeth will not have bent the metal.The bond has not broke, but it would appear my teeth have bent the metal. As for the price, well I preferred your pre-edit response - I only mentioned it hoping for some feedback i.e. not to get ripped off.
If it truly hasn't debonded (you wouldn't be able to tell this yourself) then what is likely to have happened is that the wire was not sufficiently adapted to the tooth when it was fitted and has sprung back to the shape it wants to be, dragging the tooth with it.
Price is fair enough, they're probably building in leeway in case it's a surgical extraction, although in my experience teeth angled like that practically leap out of the socket.
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