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Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

• Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

• Tooth and Jaw Structure

Dr. Daniel Very and the team at Very Orthodontics carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

• Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

• Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Dr. Daniel Very will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

• discuss the extraction procedure with you, including sedation options
• numb the area 
• gently loosen and then extract the tooth
• provide options for pain management after the procedure
• give you detailed instructions for aftercare
• work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Very Orthodontics in Boardman or Niles will coordinate a treatment plan to create your best—and healthiest—smile.

You’ve been told that you have a malocclusion called an “underbite.” Let’s look at just what this diagnosis means, and what it means for you.

Just what is an “underbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a typical bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth.

An underbite, on the other hand, results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

What causes an underbite?

Underbites tend to be genetic, and run in families, so, most often, an underbite is something you’re born with. The size of your jaws, the shape of your teeth, or both will affect your bite.

A smaller number of underbites develop because of injuries or early oral habits, such as prolonged and vigorous thumb sucking or tongue thrusting.

How do we treat an underbite?

Your treatment will depend on the type and severity of your underbite, and your age when treatment occurs.

• Braces and Aligners

If your underbite is a slight one, caused, for example, by crowded or overly large teeth, braces or clear aligners can help move the teeth into proper alignment.

• Functional Appliances

If the underbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still growing and forming.

If you’re a young patient, two appliances commonly used to help correct an underbite are palatal expanders, which gradually widen the upper jaw if it’s too narrow, and reverse pull headgear, which fits both inside the mouth and outside on the face, and provides a steady, gentle pull to encourage the forward growth of the upper jaw.

• Surgical treatment

In some severe cases, surgical treatment can correct an underbite by reshaping the jawbone itself and positioning it further back to align properly with the upper jaw.

Why treat your underbite?

A serious underbite can cause damaged teeth and enamel, painful problems with the temporomandibular joint, headaches and facial pain, sleep apnea, difficulty chewing, eating, and speaking, and can affect confidence and self-esteem.

By following your treatment plan, you’ll not only prevent these consequences, but you’ll achieve major benefits—a healthy, comfortable bite, and an attractive, confident smile. Want to know more? Talk it over with Dr. Daniel Very at our Boardman or Niles office for all the information you’ll need!

Proper mouth protection is recommended by Very Orthodontics when you participate in any sports activities. If you wear braces, this protection becomes essential. Injuries to your mouth can not only damage your teeth, but your braces could break and cut open your lip.

Full Facial Guards

Full facial guards are often used in football and offer protection to your mouth from most injuries. Even with full facial protection, you may benefit from additional mouth protection. While your face is protected from outside impact, you could still suffer from cuts or damage to your braces from internal impact.

Mouthguards

Mouthguards referred to as boil-and-bites can be purchased at many retail stores. As the name implies, these guards are boiled in water to heat and soften the material. While the guard is still warm, you place it in your mouth and bite down gently. This causes the guard to form to the shape of your mouth. Unfortunately, these guards do not necessarily offer the best protection or fit.

Dr. Daniel Very can make custom mouthguards specifically for you. The custom fitting ensures you of better protection and a comfortable fit. Custom guards are also built in layers for durability. The American Dental Association recommends custom guards for orthodontic patients. Your mouthguard will be designed to provide proper protection for both your teeth and your braces.

No matter what type of sport you participate in, a mouthguard can protect your braces. Even an activity as seemingly harmless as table tennis can result in a contact injury. The Academy for Sports Dentistry states that a properly fitted mouthguard should not interfere with any athletic activity.

Very Orthodontics will provide you with properly-fitting mouth protection to ensure the safety of your braces and your teeth. We will be glad to answer any questions you have so you can continue the activities you enjoy with little concern. If you do suffer any injuries to your mouth or braces during sporting activities, please contact us immediately. The sooner we can care for your mouth, the better the results will be.

Braces are an investment in your smile. When your teeth reach a desired straightness, you’ll have a beautiful smile, but it’s important to keep it that way! You can accomplish this with a retainer provided by Very Orthodontics.

A retainer is a small, custom-fit device that reinforces the new position of your teeth after your braces are removed. But for many patients, especially the youngest ones, wearing a retainer may seem like an annoyance. So exactly how long after your braces come off should you wear your retainer?

Graduation of Wear Time

When we remove your braces, Dr. Daniel Very will evaluate the condition of the bone structure surrounding your teeth and determine how well it is adjusting to the new position of your teeth. For the first few months, we may require you to wear your retainer both day and night, except during meal times and for brushing and flossing.

As the bone and gum tissues adjust to your new smile, we may determine that you need to wear your retainer only at night. After about one year of wearing the retainer every night, you may be able to take a couple of nights off each week.

However, we do not recommend ever stopping permanently. To best secure the position of the teeth, especially through future extractions and oral health changes, wearing your retainer a few nights a week will be necessary for many years.

Considerations

If you are concerned about your appearance when you wear a retainer, there are many that can be worn discreetly. You could choose a clear plastic one that is less obvious during the months immediately following removal of your braces. When you change to night wear only, clear wire retainers are available for minimal visibility as well.

Another option is a lingual retainer. It is placed on the back sides of your teeth so no one will ever know it is there! Lingual retainers are also permanent, so there’s no risk of losing them.

Remember, wearing your retainer is an investment in your smile. If you fail to wear it consistently, the tissues that support your teeth will be unsupported, and you may begin to experience noticeable shifting. You’ve worked hard to get that beautiful smile — your retainer will let you keep it! Remember to call our Boardman or Niles office if you have any questions about your retainer!