The issue that orthodontists most commonly deal with is crowded teeth. If a patient's dental arches are too small and narrow to accommodate their teeth, the teeth end up bunched together. In cases where the dental arches are especially small, braces alone simply aren't enough. While braces may straighten the teeth and correct the overcrowding issue, they cannot enlarge dental arches. That means more space must be created before you can start wearing braces.
Space Can Be Created in a Number of Ways
When a patient's dental arches are so small that space must be created prior to braces, there are several methods that can be used. 'Slenderizing' is the shaving of the sides of teeth in order to reduce their size and therefore create more room. Dental arches can also be widened using an orthodontic appliance called a palatal expander.
Some family dentists and orthodontists will also recommend the removal of one or more teeth in order to make more space. One such method is referred to as bicuspid extraction therapy and involves the removal of the first or second premolars. However, one major worry that many patients have prior to having this treatment done is the effect it will have on their facial shape.
There May Be a Slight Change in Your Facial Structure
In most cases, orthodontic treatment results in a better and more attractive facial profile for patients. However, there is a perfectly understandable worry that extracting the bicuspids in order to create more room may make a face longer and narrower. A recent study found that after first premolar extraction, there was little to no change in facial height or length. Another study that examined the effects on profile of removing the second premolars revealed similar results in that the change in facial profile was minimal at most.
However, with that said, some patients may notice a change in the length and width of their face post-premolar extraction. Though any changes to your profile may be minimal, you may notice them much more than others do. If this is the case, speak to your orthodontist about your feelings. You may be able to alter any changes by widening your dental arches with a palatal expander.
While orthodontists do understand your concerns, if your dental arches are exceptionally small or narrow, the extraction of at least one tooth may drastically improve the appearance of your teeth. Make sure to bring up any concerns you have about facial profile changes with your orthodontist prior to starting your treatment. A good orthodontist can improve a smile in a number of ways, some of which do not require the extraction of teeth.