To Pull or Not to Pull

That is the question — or
4 on the floor and 24

For nearly a century- orthodontists have suggested the removal of four bicuspids when straightening teeth. Thus the phrase 4 extracted teeth on the floor and 24 months of banding. Today the trend is away from extractions. The results are usually more esthetic without extractions. Quite frankly- the smiles are gorgeous. I have referred adult patients back to the orthodontist to move the teeth back? I urge caution when it is suggested to remove permanent/adult teeth. Sometimes it might be necessary.

40 plus years of practice has prompted me to question patients who have had ortho in the past. In fact, it is like a big yellow flag waving to me. Oftentimes patients who have had ortho are experiencing pain, popping, and locking of jaw joints. i.e. temporal mandibular joint.. The jaw bone is the only one that articulates in two places simultaneously. Somehow the two joints are to align with each other and the teeth at the same time. This rarely occurs in nature but can be exacerbated in patient with past teeth straightening.

When ortho is completed, they need to have their bite checked for balance. I have a computerized device that helps us to first determine if a balance job is warranted and second to adjust. (Like tires)

If your one that is experiencing popping of the jaw, locking of the jaw and or pain just in front of your ear – I suggest an exam to determine if you bite needs to be balanced.