"four on the floor" any input

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#1 Post by **roost22** » Tue Jul 22, 2008 6:34 pm

My ortho has suggested I have 2 upper and 1 lower premolar extracted my other lower was extracted as a teenager. anybody out there with some insight on this, as in treatment time, treatment appliances. Iam a 45yo man going in for my sentence.

#2 Post by **iBorg** » Tue Jul 22, 2008 8:12 pm

Been there...done that.

DON"T

I had this when I was 18. I went almost thirty years ashamed of my lack of a smile as a result of this treatment. You can check my blog and see how disgusted I was with the end result.

Is it always wrong, no. BUT, prior to committing to it get not one but at least three second opinions. If they all suggest the same thing, then odds are it is the right treatment. If they all offer different opinions, decide which method feels the most right to you.

Good luck....deciding which ortho and the treatment method you wish to use is one of the hardest parts of the entire experience.

Mike

#3 Post by **joney** » Wed Jul 23, 2008 3:54 am

Hi roost22

I know it didn't work out for Mike but it has worked out for me.

I had one upper removed as a teenager. Recently I had the matching upper premolar removed and one lower premolar removed so you would be in the same position as me.

It probably depends on jaw size and I am very petite. However my smile definitely not disappeared. I have my top brace off now and I am very pleased with the result, a wider arch and straight teeth.

It is something you have to decide for yourself but if you're having doubts then best to think it over and get other opinions.

Regards
Joney

#4 Post by **TumbleDryLow** » Wed Jul 23, 2008 8:17 am

Yes, definitely get some other opinions. I went to 4 consults. All 4 orthos said I had 2 choices: upper jaw surgery and expander (SARPE) in addition to either 1 lower incisor or 2 lower bicuspids removed.
Or a (possible) compromised result having 4 teeth removed--2 lower and 2 upper bicuspids.

I didn't want to do surgery...but that was my personal decision. I'm only 8 month in, but so far, I've been happy with the result. I was told my treatment time would be 24-30 months.

I just asked my ortho the last time I was in if she thought she was going to be able to fix my cross bite (that was the possible compromise I made not doing the surgery). She said that indeed it would be fixed by the end. So I took a chance and it worked out for me.

As for my smile....I don't think that my smile is smaller, and even if it is, I'm OK with that. My teeth are straight!

Good luck.

#5 Post by **Lisa65** » Wed Jul 23, 2008 8:38 am

I had "four on the floor" done as a teen, 30 years ago. But back then only very rich people got fixed braces as each tooth had to be banded, so instead I got a removable appliance a bit like a Hawley to drag my front teeth back. It kind of worked, but my ortho has now had to re-open those old gaps in order to sort out my teeth. Having said that, there would not have been room in my mouth for all my teeth if present, and had those premolars not been extracted when I was a teen, my ortho would've done extractions as part of my treatment this time. I definitely don't have a narrow smile now, and I'm not particularly petite.

It depends on the nature of your problem. In some cases, extractions are the only way to get straight teeth because there simply isn't enough space in the jaw, but in other cases (like Mikes), extractions are not the right option.

#6 Post by **Emerald** » Fri Jul 25, 2008 3:35 am

Before my braces were fitted I had my two upper pre-molars extracted and my two lower wisdom teeth.

My lower wisdom teeth were removed for more space for my then crowded teeth to have room to spread and my top pre-molars were removed to make space for a missing adualt incisor which I lost when I was 8.

This hasn't made my smile narrow as I have quite a small mouth, but I needed these extractions to make space.

My bottom teeth are now nicely spread out and the space at the top allowed my orthodontist to create room for the temporary false tooth I have at the moment which will eventually be replaced by an implant.

I had no choice in treatment plans as my treatment is through the NHS but as you have a choice I suggest you seek different opinions before deciding on what is best for you.

#7 Post by **roost22** » Fri Jul 25, 2008 6:49 am

Thanks for the input everybody, I did get a second opinion and it wasn't the same as the first, he did not suggest doing anything with the upper arch and said if I went with the upper extractions it would take 3 years. I did not mention that i already had one upper premolar ext. and a bridge put in about four years ago that i don't really care for. So it wouldnt be an extraction but the brdge would be sectioned. It would be same result though. (space created) I went ahead and got records taken to hear a detailed plan and will have a appt in august to discuss that with ortho. I do have a third consult but not until nov. 6 and it sounds like everybody thinks I should wait to here that. (me too) If anybody has had upper premolars extracted to fix an overjet I would like to here from them. My questions to them would be 1. how long before they started to retract the canines? 2. how long did it take to retract canines? 3. did you have tpa or headgear? thank you for any responses, Bob