Braces/orthodontics for premolar extraction gap

kayeb

I've got to have a premolar removed (upper 15). I've really upped my hygiene & diet recently.

I saw an implantologist, referred by my regular dentist. He mentioned that whilst he could do an implant, my mouth is crowded & orthodontics might be able to close the gap.

Has anyone had a success with braces to fill an extraction gap? An implant will cost up to £4K with the maybes (scans grafts sinus lifts).

It's not just cost, I want to do the right option, & I do struggle to floss due to tight gaps.

I had braces when I was a teenager, with 4 premolars being removed at that time, unfortunately they went crooked over the years after the braces came off.

Any idea of the cost of braces to close an extraction gap?

Toothsmith

Braces often close extraction gaps - as teeth are often extracted pre-ortho in order to create space. This is what happened to you when you were younger.

The implantologist is, quite correctly, discussing all possible options with you and allowing you to weigh up the pros & cons of each.

Was the implantologist also an orthodontist, or did he recommend you to a different person for an orthodontic opinion?

It's impossible for anyone on here to say which option would be best for you. It takes quite a bit of analysis of the positions of your teeth, the health of each of those teeth, your diet and OH, and the sort of result you would like. The result of the analysis of these factors will give you the best indication of which option is best for you. The other people reading this will all have slightly different factors affecting what would be best for them, so other people's experiences can't really be an indication of what's best for you.

A course of orthodontic treatment would be in the ball park of £2-2.5k depending on what sort of systems were suitable for you, and which you chose. Straightforward train-tracks would be cheapest, the fancy less visible systems would be more expensive.

Cleaning your teeth thoroughly will be very important if you go for orthodontics. Plaque builds up around the appliances and could harm your teeth if you don't clean them well. But by the same token, an implant will also fail if you are not diligent with cleaning around it.

Get the opinions you need from both the implantologist, and the orthodontist, and base your decisions mostly on what they advise you.

kayeb

Thanks very much for your comprehensive advice Toothsmith. The implantologist wasn't an orthodontist, he was throwing the idea "in the ring".

I am seeing my regular dentist next week, & I am going to ask for a consultation to their visiting orthodontist so I can weigh up the pros & cons. It's another £75 but will at least give me the info I need to make an informed choice. I do have many big fillings, a veneer, 4 root canals & a crown; so I do worry whether they are braceable. But as you say, the orthodontist should be able to advise my suitability.

Incidentally when my regular dentist was unable to complete the root canal (canals too calcified) on the soon to be extracted tooth, she did mention a click in little denture (without a plate), & that no one would ever know. I was a bit upset at the time so I didn't really take it in. I think she was probably referring to a Valplas denture. The Implantologist mentioned this option in his advice letter, but said they can build up a lot of placque. I have really upped my game & spend about 15 mins at night carefully flossing & using the interdental brushes. My husband tells me flossing isn't good for my teeth but I ignore him!

brook2jack

Valplast dentures have their place but there are disadvantages ,

They stain quickly and need special cleaning solutions

They cannot be added to

They have a relatively short life , around five years and are more expensive than conventional dentures


They can cause the bone underneath to shrink which may be a problem if you are thinking of implants in the future.

However they are small,discrete and in the right place stay in very well.

If you don't floss and use interdental brushes you are not cleaning 40% of the gums and teeth , so you are right to ignore your husband on this. Many people notice their gums bleeding when they first floss but this is not because they are damaging them, the gums bleed because they are so inflamed and proper cleaning will sort that out.

Have you seen a hygienist to have demonstrated the correct way to use and correct size of tepe brush to use ?

Have you also addressed your diet and are keeping to the three sugar attacks a day rule? Eg no sugar in tea coffee, no snacks containing sugar in between meals etc

kayeb

Thanks for your reply Brook. Thanks for the info re Valplast, really helpful.

I have really grasped the nettle with diet these last few months. I never liked sweet drinks anyway but was a grazer of chocolate & biscuits between my 3 healthy meals. It has required a lot of will power but I've cut out eating between meals & virtually all chocolate & biscuits; restricting treats to weekends. I've found the longer I've been doing this new regime I've been losing the craving for sweet things. The waistline has gained too; I've lost nearly a stone despite eating bigger (savoury) meals. Sadly I've also had to cut out the (raw) nuts too as I had 2 or 3 broken teeth.

I've been going to my practice for 45 years, they went private about 10 years ago but they never had a hygienist until recently (my old dentist, now retired, said patients used to complain a temporary hygienist they got in was too rough). I will ask my current dentist if she thinks I would benefit from an appointment with this new hygienist. My new dentist says my gums are good but I know how important interdental hygiene is. Reading this forum recently has been very informative & I thank both you & Toothsmith for replying to our posts as they give really useful reference material re dental care & hygiene.