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Dentistry/Extraction for braces


I'm 21 years old male. I got my braces 3 months ago. My orthodontist trying to move front teeth backwards because i have a full upper lip but i don't have enough space therefore she wants to extract 4 bicuspid(one each side). she gave me a choice between extraction and non extraction.
I have read that such extraction will cause SLEEP APNEA, TMJ, pre mature sagging of the face, narrow smile.... so many things and many people said that they regretted doing it. Then i opted for a non extraction plan and then she did stripping in some selected upper front teeth to create space and use a elastic to keep it straight. Now she told me that it is the final shape and also no need to put braces in lower jaw. My teeth looks straight but my profile did not improve. When i have my mouth closed from the front, it looks somewhat like a monkey's mouth from the protrusion. I haven't noticed a difference in my face shape, it looks same as before the treatment. I hated the end result.
I heard the stories of people getting their treatment without extraction successfully.

In case of extraction, it creats excess of space because i have NO CROWDING, to close the gap front teeth pushed too far back then what about the TONGUE ?
Should i go for the extraction or not ?

Your help will be appreciated.
Thank you.

I'm going to start right away by saying that it is just not possible for me or any orthodontist to provide you with a treatment plan without careful and thorough consideration of a clinical examination and xrays.  I can, however, make some general comments regarding orthodontic treatment.

In a case where there is crowding along with a prominence of the upper teeth, so much so that there is excessive fullness of the upper lip, very often the only way to correct both the crowding and the prominence is to remove at least two teeth in the upper arch and carefully retract the upper front teeth to improve the lip posture and align the teeth.  When this is done properly there is no "sunken in" appearance, nor is there "sagging of the face", nor is there a "narrow smile".  What results is an esthetic lip posture and a nice, straight smile.

You ask about future treatment options.  These need to be explored after a thorough re-evaluation of your particular situation, which has been complicated by the reduction in size of the upper front teeth.  This could include taking all new x-rays, impressions and photographs.  Any treatment plan involving the upper teeth must also consider the lower teeth and how your bite lines up.  Of course, a very important consideration must be made regarding the effect of treatment on your facial esthetics, especially since that is your main reason for seeking treatment.

I would suggest that you prepare yourself to consider all options including extractions, full braces on upper and lower teeth, and having to make some compromise in some treatment goals.  You've asked me some good questions that I can't answer because I haven't made the proper examinations.  Be prepared to ask those same questions when you face the next orthodontist.  


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Dr. Randolph Myerson


Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.


I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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