Oral Surgery for Orthodontic Patients

Can I get my wisdom teeth removed with braces?

young girl with braces wisdom teethOrthodontists often refer their patients to an oral surgeon for specific procedures before treatment with braces or aligners. When a patient have teeth that need to be removed before braces can be applied, an oral surgeon often performs the operation. There are a variety of procedures an oral surgeon can perform to maximize the effectiveness of orthodontic treatment.

Braces or aligners straighten your teeth by applying constant pressure to the teeth to gently move them into new positions. Some patients have teeth that are crowded or severely misaligned. In these circumstances, oral surgery may be needed to remove one or more teeth before applying braces. Some patients have extra teeth or teeth trapped in the jaw and may need the teeth extracted to allow room for the remaining teeth to be moved into proper alignment.

Removing Teeth

The bicuspid teeth are located between the canine teeth and molars. If a patients jaw is too small to hold all the teeth which forces them out of alignment, an orthodontist may recommend removing the bicuspids to make room. Once the bicuspids are removed, and the area has healed, the orthodontist attaches braces and power chains to guide the remaining teeth into a better alignment, filling the gaps where the bicuspids once were. Occasionally, one or more molars may be removed instead of the bicuspids.

If the primary reason to remove teeth is to provide additional space because of overcrowding, the orthodontist may suggest removing either two or four teeth, maintaining balance on either side of the jawbone. Braces pull the remaining teeth into the empty spaces left by the pulled teeth while maintaining symmetry.

When teeth are asymmetrical, with one tooth pushing the others to one side, an individual tooth may be extracted so the orthodontist can use braces and other appliances to guide the teeth back into proper alignment. Without the extraction, it is almost impossible to align the teeth so that the upper and lower teeth meet properly for chewing and speaking.

Impacted Teeth

An impacted tooth is a tooth that cannot erupt or emerge from the gum properly. Most impacted teeth are wisdom teeth that the oral surgeon can remove to prevent tooth decay due to issues with proper hygiene and pericoronitis, which is a type of inflammation and infection of the gum tissue.  In addition, impacted maxillary canines or other teeth can be treated orthodontically. Braces will reposition the teeth and make room for the impacted tooth. Oral surgery will be necessary to remove gum tissue and bone around the impacted tooth to expose the tooth. A

bracket with a chain is then placed on the impacted tooth and attached to your orthodontic work. This way the orthodontist can gradually pull the impacted tooth into its proper position.

Occasionally, the lower second molars are impacted, and unlikely to erupt on their own. In this case a surgical up righting of the second molar can be performed. This is something your oral surgeon can do. Ideally, the second molars should be surgically elevated before the roots finish forming to maximize the success of the procedure. Your orthodontist will work with the oral surgeon to coordinate the treatment. The surgical treatment will often include removal of the developing wisdom tooth, some minor contouring of the bone around the second molar, and a surgical elevation on the impacted second molar. 

When oral surgery is needed in conjunction with orthodontic treatment, Dr. Valiente collaborates closely with your orthodontist to create an appropriate treatment plan. Most patients will work with their orthodontist before and after oral surgery to correct their dental alignment problems completely.

If you have questions about oral surgery relating to your orthodontic treatment, Dr. Valiente is happy to answer your questions. Please contact us at 813-968-5400 to schedule a consultation.