Generally, premolar extraction is directed to solve the tooth size arch discrepancy, reduce the face’s vertical height, and allow correction of the axial inclination of anterior teeth. However, the bicuspid extraction philosophy for facial height reduction does not give any noticeable changes for patients after treatment.
The reason for this can be the vast extrusive effect of most tooth movement modalities, which can significantly compensate for facial height reduction. Other reasons for premolar extraction are listed below.
1. Bimaxillary Dentoalveolar Protrusion
The bimaxillary dentoalveolar protrusion has become much more acceptable in today’s esthetic and functional viewpoint. This appearance is more desirable, especially by looking at celebrities and fashion magazines.
However, this extraction remains the best orthodontic treatment for someone whose teeth are too protrusive. It will not treat protrusion, but it will reduce the issue. This has become more common in young adolescents who want what they see in celebrities.
2. Teeth Crowding
In simple terms, this is when there are too many teeth for the size of dental arches which causes insufficient space to align them. The most common solution is to create the needed space by removing some teeth and aligning the rest correctly. The first phase is to determine what must be done in orthodontic treatment. It is hence essential to take a record and conduct a study to develop a suitable treatment plan.
However, not all cases require extractions; they are not necessary. If it is possible to align all the existing teeth in the correct position and a healthy bite, the work will be done without removing teeth. Still, dental extraction is the most effective way for certain patients to obtain straight teeth that last long.
3. Vertical Reduction
Facial aesthetics are an essential part of all orthodontic treatment. In most cases, premolars are extracted to resolve the crowding and change the facial profile. The extraction of premolars gives a particular vertical reduction. This is more of a plastic issue than a health issue. It would be best if you talked to your orthodontist for them to guide you on which approach best suits you. In some cases, they recommend non-extraction methods.
4. Skeletal Disharmony And Camouflage Treatment
In most adults and older adolescents, premolar extraction remains a mechanotherapy to solve maxillary protrusion. In other cases, an orthodontist will extract teeth to contribute to future health issues in some patients who might already have breathing issues. However, your orthodontist will have to go through all possible options that can help resolve the issue. Where non-extraction methods are bound to work, it is what orthodontists go for.
5. Treatment Or Efficiency?
In some cases, extracting premolars in line with pursuing the non-extraction treatment plan might benefit the patient and the orthodontist. This can be done by creating a space by distalizing premolars, expanding arches, and flaring incisors.
If all three things are done, some patients might be in the bimaxillary dentoalveolar protrusion scenario, and some patients do not necessarily respond to the non-extraction methods that are provided. Despite that, you can make room for the bicuspids; the non-extraction treatment plan could add months or years to the case.
I have to have mine taken out soon because of the way they are growing 😬 I am not excited! Lol