Desperately need advice about a dental issue

fobwatch

13 yr old DD recently had teeth extracted, went to Orthodontist yesterday and it has now come to light that between orthodontist and sedation clinic they have mistakenly taken one too many bottom adult teeth out. She is now missing lower R4 and lower R5 and they have informed us that her back molars will move forward to the side of the mouth to close the gap. At this point they appear more concerned about the trouble they are potentially in, but my main concern is getting my daughter's teeth and smile back to how they should be and I'm receiving little information on how we move forward with correcting this error. I will be in contact with them again shortly, however, would welcome any advice from a dentist/professional to give me a few options on the best way forward for my DD.

Toothsmith

My feeling - without seeing this - is that a couple of teeth missing on one side might be a bit too much to hope natural closure will do the job. But I can't see it!

Teeth needed to be taken out, and chances are that's because of crowding, and so it could easily be that natural closure will take place.

I think they have just gone defensive because that's the default position in this country nowadays. Litigation is at an all time high, and so covering your behind is an essential part of medical practice.

I think you need to make it clear to them that although you realise that a mistake has been made, you appreciate that sometimes these things happen, and that your primary concern is that your daughter ends up with a nice smile rather than some money in the bank.

Hopefully that will help to get things going the right way.

fobwatch

Thanks Toothsmith - what I am worried about is that the gap will be filled by the teeth at the back coming forward, is there a procedure that the gap could instead be filled with a false tooth and if so how would this work - I appreciate your reply - my main concern is getting my daughters smile and bite back properly. I would add that the same orthodontist has done a fantastic job on my son's teeth in recent years and was extremely apologetic for the mistake that has occured.

McKneff

13 year olds are pretty grown up these days, have you asked her what she wants. Is the gap visible when she smiles.

I'm not a dentist and so dont understand the numbers you have quoted.

fobwatch

Although I am trying to play down what has happened, she is aware that the only suggestion offered so far is to bring the back teeth forward without guaranteed success.

brook2jack

This depends on so many factors like are there wisdom teeth present that may come through in future that without seeing your daughter and x rays its impossible to say.

However as a general rule it is much better to move a natural tooth into a gap than to fill it with an artificial tooth as an artificial tooth , however good, is never as good as your own tooth.

After such a mistake everyone concerned will be desperate to get the best result and as braces take around 18 months to 2 years anyway to work this problem may take some time before it's sorted.

On a positive side the extra tooth taken out was not a molar , it's a much smaller tooth so the space problems are not as drastic as if a molar had been taken out by mistake. I am sure the practice is very concerned to get the best out of this for your daughter.

fobwatch

Thanks for your reply brook2jack - do you know how her bite would be affected though with these two (I believe premolars) missing?

brook2jack

Without seeing her impossible to say. However in terms of bite the canines and molars are most important. She presumably needed one of these premolars out anyway so the extra space created by taking the other out may be fairly easily closed up. however it's impossible to tell without seeing her.

At 13 she will be doing a fair amount of growing and her problems which necessitated orthodontics in the first place will influence things. These are all questions you need to be asking the orthodontist.

fobwatch

Update from dentist yesterday evening - as I still have the tooth that they mistakenly pulled, they have made a suggestion, that perhaps this tooth could be bonded to her molar to keep the space open and then when she is 16-18 that they will do an implant.
Is this feasible? Appropriate?
They have also suggested that they as a practice could organise an independent specialist to assess appropriate action.
I appreciate any guidance as having little dentistry knowledge feel out of my depth.

Toothsmith

It's fesible, but we can't comment on how appropriate it is, because we can't see the problem.

Plus - I'm not an orthodontist anyway.

It does sound like they're trying their best, so I would go with their advice.

Just to say though that implants have not been around for that long - so no-one really knows their survival rates beyond 10-15 years. (Although so far, up to 10-15 years they're very good. If looked after). So that will put the in her early 30s. Still a lot of lifetime to go.

They are not 'fit and forget' though, and will have ongoing maintenance needs.

If there is an option that didn't require an implant - even if it's more complex, longer lasting ortho treatment, then I would be tempted to go with that.

But if any ortho options would leave her with some underlying future problem - then go with the implant.

It's impossible to advise without much more information though. And even then, it's a bit like predicting the lottery results!

fobwatch

Thanks for all your help - will post again when I have an update as appreciate any advice. It does appear that they are keen at this stage to do the best for her, but as you discuss Toothsmith, this is an ongoing lifetime issue. Once again many thanks for all advice given.