Question about missing teeth and orthodontics

December 8, 2021 5:52 AM

Went for a dental checkup recently and asked the dentist about options for some missing molars. The dentist suggested I could get orthodontics to shift my teeth back into the correct position and then perhaps get implants to replace the missing molars. My question is, is this process something that orthodontists actually do/are familiar with? More details inside.

So, I had two molars extracted a while back (maybe even too late now to have implants).

My teeth have shifted, so now the gap where those molars used to be has shrunk and the implants wouldn't be able to fit.

The dentist said that one option I could explore would be to see an orthodontist to get all my teeth back into the correct place, and once that is done, see about getting implants.

I am now wondering, if I went to see an orthodontist about this, would they know what I was talking about? Do lots of people have this sort of thing done?

I am thinking about seeing an orthodontist about this but I am a little anxious about being laughed out of the office or something, hence why I am asking on here first.

posted by iamsuper to Health & Fitness (7 answers total)

Depending on how much space you have left, you could ask about the possibility of using a smaller implant. I had the same issue and they used a premolar implant instead of a molar; nine years later, I haven't any issues.

But my understanding is, yes, this is a thing orthodontists do.
posted by toastedcheese at 6:09 AM on December 8, 2021

Nope, super common for the ortho to be asked about. Were xrays taken recently? This will show how much bone level is available for implants before doing any teeth realignment. This will be a multi-months treatment just for the teeth realignment.

I had this done to actually close gaps that had evolved over time due to loss of a back tooth. Not only did the gaps did close but they re-tilted a back tooth so it was more upright and not angling (like the tower of Pisa!). In my case my ortho suggested Invisaligns, 22 hours a day, 6 months of wearing them, then at minimum another year with 16 hours a day with the last set.
posted by tipsyBumblebee at 6:12 AM on December 8, 2021

Yes... I am (genetically) missing a bottom tooth on each side (the one in front of the molar?) and when I had braces as a teen, they shifted my bottom molars forward to fill the space. Any orthodontist worth their salt should be able to go over options during a consultation.
posted by DoubleLune at 6:24 AM on December 8, 2021

My daughter has a baby tooth without a permanent one beneath it, and we went to three (four?) different orthodontists to hear how they would address braces and what happens if/when she looses that tooth.

We came away with basically two basic plans, but none of them had doubts or seemed fazed by the issue.
posted by wenestvedt at 7:09 AM on December 8, 2021

Yep, from personal experience this is what orthodontists do, you hear more about the cosmetic reasons but they really do focus on the structural issues before the aesthetic.

Anecdotal evidence: My teeth are a little too big for my mouth and I ended up with both canines and one bottom tooth emerging pointing outward, towards my lips/checks. So they had to make a decision and pull four molars. This was back in the 80's before there was invisalign, so it took 5 years of braces (including external headgear to add more tension) to shift everything around and straighten everything out. A couple years after that was done my wisdom teeth started emerging and they had to pull those too, because there just was no room. My teeth are still a bit crooked, but I can chew, and shut my lips without straining, so it's an improvement.

It does weird out every new dental hygienist when they go to chart my teeth, I'm missing not only my wisdom teeth but four more than that, and they get all confused on the count,. Yet my teeth are so tightly packed that flossing is nearly impossible and it doesn't look like anything could possibly be missing.
posted by buildmyworld at 7:34 AM on December 8, 2021

Yes, as a dentist who has referred patients many times for this, I can confidently say that your Orthodontist will know exactly what is being asked. Sometimes we want the tooth behind the space to stand upright again (we call this, naturally, molar uprighting) and sometimes we just want the appropriate space for the size of tooth we want to add. Either approach can be managed with braces, but almost certainly brackets and wires, not "invisalign" type appliances.
posted by OHenryPacey at 8:06 AM on December 8, 2021 [2 favorites]

I am about 3/4 of the way through that process and yes, my wonderful dentist and my orthodontist worked together on it.

1. Removed any teeth that had to go (like 1 or 2)
2. Got braces first to address the overbite and shifts. (3 years) and now wear a retainer
3. Step 1 of 2 with implants - add the posts and wait 3-4 months
4. Step 2 of 2: implants themselves.

It's a long and costly process. However, the other option was pull all my teeth and get dentures and nope, nope, nope. I am grateful I got a second option from my (then new!) dentist who has a broader spectrum of training than my local family dentist.
posted by Mysticalchick at 9:00 AM on December 8, 2021