Introduction to the Impact of Premolar Extractions on Overbite

I had two premolar extractions to correct my overbite, but now I am concerned that my face might appear more sunken than before. I'm also questioning whether my dental professional is truly qualified. Here's what I've learned about the process and some advice on what to do next.

The Role of Premolar Extractions in Orthodontic Treatment

When you undergo orthodontic treatment for an overbite, the goal is to reposition your teeth to improve your bite and overall oral health. However, removing these premolars can significantly impact your facial structure. These teeth, along with the alveolar bone where they are rooted, play a crucial role in supporting your facial structure. The loss of these supporting structures can lead to a sensation of facial sinking, especially when combined with teeth retraction.

Facial Changes and Mandible Size

According to Dr. Paul Coceancig, often overbites are due to a small mandible. When the upper teeth are retracted to match an already retracted mandible, both jaws can appear recessed. This can make your face look more sunken, as the supporting structures are diminished.

Consult Your Dentist for Adjustments

One option is to communicate with your dentist about maintaining a degree of overbite and not closing the entire 1.6 cm of space achieved by the premolar extractions. Instead, ask them to close the gaps forward, preserving some of the overbite. Retaining a bit of overbite is better than a pushed-back mouth, as it allows for more space in your mouth and enhanced vocal range.

Freddie Mercury, a famous singer, famously stated that more space in his mouth meant more vocal range. His statement is factually correct, highlighting the importance of maintaining facial structure and dental support for both oral health and aesthetic appearance.

Other Dental Perspectives and Solutions

It's important to be aware that orthodontic treatments can sometimes result in negative changes to facial appearance, even without extractions. I had a negative change to my face from orthodontics without extractions, and I wish I had never undergone the procedure. If you're unsure about your current treatment, consider getting multiple second opinions. Not all orthodontists may want to extract your teeth, and some may have different recommendations.

Living with Your Current Smile

If you're already satisfied with your facial features and smile, you might consider keeping your teeth as they are. The key is to ensure that your overall oral health and proper alignment are maintained, even if the aesthetic changes are minimal.

Conclusion

While premolar extractions can be beneficial for orthodontic correction, it's essential to be informed about the potential impacts on your facial appearance. By discussing your concerns with your dentist and seeking second opinions, you can make an informed decision about your orthodontic treatment and ensure the best possible outcomes for both your oral health and appearance.