Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Orthodontist Shaved My Son’s Teeth

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I’m fuming after a visit to the orthodontist. I took my 12-year-old son in to get started with orthodontic treatment. The doctor said it would be a longer visit because they were getting everything set up, but didn’t really elaborate on everything they’d be doing. It may be on me, but I didn’t clarify. I just thought he was getting braces put on. Come to find out, AFTER the appointment no less, that the dentist shaved his teeth. I had to hear about the procedure from my son. I thought he was mistaken when he came out and told me what they’d done, so I corrected him, and the assistant then told me what my son was saying was accurate. She said it was normal for treatment and that they do it with all their patients. Now, on top of everything else, I’m worried about the long-term damage the orthodontist may have caused. Why did he do this and can it be fixed?

Signed,

Not Ok in OK

Dear Not Ok,

Smiling young woman with braces

Why Did the Orthodontist “Shave Teeth?”

This is done to make space. Once the dentist measures out how much space is there and how much space is necessary for all the teeth once they’re in alignment, it becomes apparent if more space needs to be made. There are several ways to make space, such as palatal expanders and tooth extractions, but reducing the width of teeth is common as well. In short, if the dentist removes just the tiniest amount of structure on the sides of each tooth, it adds up to a fair amount of space overall. This may have been the easiest and least invasive method for your son. It’s referred to as “interproximal reduction.”

Interproximal Reduction is Safe

Although each dentist has his own toolkit he draws upon for various cases, interproximal reduction often earns a place in the toolkit because it is a safe and fast choice. True, some of your son’s enamel is gone now. Nothing will bring it back. However, if the reduction was such that your son would be at an increased risk for decay now, the dentist would have protected the surface with dental bonding. You can confirm if this was necessary with the dentist.

The Dentist Should Have Spoken with You

Despite the fact that this is a safe and trusted procedure, the dentist should have explained it to you in advance. He’s required to get “informed consent” before procedures are carried out, and if he didn’t fully inform you, then you didn’t give consent. That’s not ok. It’s possible he glossed over it or the detail was lost amid all the new information you were being given at the time, but if you’re 100% certain he didn’t discuss it, or even think he should have been more direct about it, then you should mention it to him. Again, it doesn’t sound like his practice was off, but if he’s missing the mark in communication, he needs to address that.

This post was sponsored by Dr. Ryan Noah, a Tulsa orthodontic treatment provider.

Does My Orthodontist Have to Pull My Teeth?

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My orthodontist wants to pull a couple of my teeth. He says it’s the only way he can make all my teeth straight and keep them that way. I disagree. I’ve never heard of this and I don’t understand why he would want to remove good teeth. Aren’t dentists supposed to be in the business of saving teeth, not pulling them? What should I do? Is this normal and something I have to go along with or is the guy a little off his rocker?

Jeremiah

Dear Jeremiah,

Yes, orthodontists commonly remove teeth as part of treatment. There are a number of reasons why they do, but a lot of time it comes down to not having enough space. If you have a narrow arch and a full set of teeth, there may not be enough room for them to be straightened out and fit properly. This likely is the cause of you having less than straight teeth to begin with. When an orthodontist catches cases like this early on, before the top of a child’s mouth is fused, a metal expander can be used to gradually widen the arch. At a certain age, usually around age 12 or so, the palate becomes hard and can’t adjust, so the only way to make room for everything is to remove some teeth.

There are other reasons why it might be necessary as well, such as to correct an overbite or to prevent the roots of the teeth from becoming exposed during treatment in some cases, but a lot of the time it simply comes down to making room.

Having straight teeth makes it much easier to keep them clean and to clean between them, which in turn helps prevent decay. So, although those teeth are healthy now, keeping them could indirectly affect the health of all your other teeth in the long run. When an orthodontist considers your treatment plan, he takes time to weigh the value of performing extractions. They’re not the easy way out, but they can help produce the results you need.

Should you go along with it? Only you can decide that. However, If you’re on the fence about it, find another orthodontist and have him provide an assessment. You don’t even need to mention your concerns about the extractions- just ask him what the best way to get the results you want is. If he suggests extractions, then you know it’s probably a solid choice. If he doesn’t, then you can see how he feels about it. Best of luck to you.

The blog is brought to you by Dr. Ryan Noah.