You are here:

Dentistry/extractions

Advertisement

Expert: - 4/4/2007


Question
QUESTION: The orthodontist my 10-year old sees recommends extracting 6 teeth as part of his orthodontic plan.  This will remove 4 permanent pre-molars and 2 baby molars. The goal is to create space for the other permanent teeth as they emerge.  The remaining permanent teeth will be moved into these spaces through orthodontia. I am wondering if this is common orthodontic practice. It makes me a bit jittery to remove permanent teeth.  His pediatric dentist and my dentist have both commented that his teeth are crowded. Thanks for your insight.
ANSWER: Dear Tom,

I well understand your concern.
This is not a question that I feel comfortable answering without examining
your son.

My experience is that most times orthodontic treatment can be completed without removal of four permanent teeth. I generally would recommend that since your son is only 10 years you wait two more years and then look again.  Remember there is no rush to start treatment. There is  little data  that shows, starting early shortens treatment, or puts it into an age that doesn't interfere with his social development.

In this instance, lack of X-rays and models etc, leave me only one reasonable
suggestion, please get another independent opinion.

Dr. Moss

---------- FOLLOW-UP ----------

QUESTION: Dr. Moss:  Thanks again for your answer. A quick follow-up if I may, I failed to mention that his permanent pre-molars are erupting. Could this cause the 2 baby molars to potentially not come out on their own?  Also, in getting a 2nd opinion this would obviously involve X--rays.  My son has had several x-rays over the years for another, unrelated medical condition in addition to dental and orthodontic x-rays.  Are the cumulative affects of dental x-rays a concern? I understand they are very low power.  Thanks.  

Answer
Dear Tom,
Even  though X-rays today are quite safe. You should take x-rays from the first dentist, with you for the second opinion. Although the  X-rays belong to the dentist that takes them. any good dentist will be happy to make copies for you.
I  still believe that you should wait two years, especially since you told me the premolars are erupting. your son will grow and there is a good chance the treatment plan will change. Also the length of treatment time will be surprisingly LESS.
Sorry I cant help more at this distance.
Dr. moss

Dentistry

All Answers

Answers by Expert:

Ask Experts

Volunteer

Stephen J. Moss

Expertise

I am a professor emeritus at New York University, with a background that includes extensive research, scientific writing and biology. I also am an international consultant in health education, particularly in developing education on new science for health professionals and consumers. I am a past president of the American Academy of Pediatric Dentistry, former head of the NYU Division of Oral Biology and I represent the World Dental Federation at the United Nations. I travel around the world to provide health education to professionals and consumers.

Experience

Having retired from New York Universit, where I directed the pediatric dentistry training program, a walk-in dental clinic and research on oral biology, I formalized my professional and consumer health education initiative in the form of Health Education Enterprises. This entity consults and provides information on new science pertaining to oral and general health, particularly leading edge concepts that can be employed in the health professions to improve the public's health. As such, I am an expert in communicating new science and its usefulness to professional and lay audiences alike. I also had a pediatric dentistry practice in New York City for nearly 30 years.

Organizations
I am affiliated with the American Dental Association, the World Dental Federation, the International Association of Pediatric Dentistry and the American Association of Pediatric Dentistry among other formal organizations. My experience has included a research fellowship at the National Institutes of Health and work at the Forsythe Dental Research Center

Publications
lpha Omegan USA, Nowa Stomatologia Poland, Journal of Public Health Dentistry, The Journal of the Southeastern Society of Pediatric Dentistry USA, News Bulletin Japan, Journal of Marmara University Dental Faculty Turkey, Italian Journal of Paediatric Dentistry Italy, Asian Dentist Singapore, The Journal of the Israel Dental Association Israel, ROBRAC Brazil, Italian Journal of Paediatric Dentistry
Italy, FDI World, STOMA Portugal, Pediatric Dentistry The Philippines, Modern Stomatology Bulgaria, Journal of the Indian Society of Pedodontics and Preventive Dentistry India

Education/Credentials
I obtained a doctor of dental science (DDS) degree, a master of science degree and am a board certified pediatric dentist.

©2012 About.com, a part of The New York Times Company. All rights reserved.