Is it safe to have only 24 teeth for a 37 year old adult?


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Hello I am considering getting invisalign with 4 premolars extracted for the purpose of reducing my protruding mouth. That will leave me with 24 teeth, I just wondered is it generally safe to have that amount of teeth for a 37 year old? Could I possibly experience future problems? I asked my dentist this question but he just gave a broad answer saying there are always jaw risks when undergoing orthodontics.

The size of my arches in the after pics of my clin check look a lot smaller which concerns me. Does anyone think its absolutely necessary to have teeth extractions to reduce the protrusion or can I go without?
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Hope you can help answer my question
 
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You will look very different but isn't that what you want? You do know that you normally have to wear a retainer the rest of your life and that there is the risk of root resorption?
 
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Thanks for responding. Yes I do want to reduce my protrusion but I'm just worried that I will potentially be opening up future health problems with having a smaller mouth. And what do you mean there is a risk of root reabsorption?
Yes I realise that I have to wear retainers for the rest of my life but isn't that the same with everyone undergoing orthodontistry ?
 
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With orthodontic procedures there is a risk.that roots will be shorter after treatment. It's a risk for anyone undergoing orthodontic treatment. Your dentist mentioned jaw risks. But you don't feel you can communicate with him about this? It's really important that you feel comfortable with your dentist when you are undergoing such radical work. Your dentist should be able to address all your concerns and fully explain what you should expect afterwards and the risks.
 
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The dentist just gave me broad answers. He didn't give me any explanations to any possible risks he just said there are potential risks to all orthodontic treatment. Do you think I should consult with someone else?


I'm just in the process now of going through and checking the 3d imaging that invisalign/dentist prescribed for me, he is just waiting for me to give the final all clear so they can send it off to make the aligners.
 
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There is no harm in seeking a second opinion. This is radical treatment and you should feel totally comfortable with your dentist and fully understand the risks and expected outcome. You may be unhappy with the way you look now, but some people are unhappy with the way they look after treatment.
 
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I did have a consultation for the same treatment with a specialist orthodontist, he also teaches orthodontistry at university, published books on it etc so he seems like a very qualified person to ask advice.
He just explain the risks to my other teeth (because I've got 5 restoration teeth crowns/root canal filling) and he said it is possible to extract the 4 teeth but he doesn't think that it will make much difference to my profile. I can't remember exactly if he said there would be risks to my jaw etc, Ive emailed his admin team.
 

MattKW

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If the specialist orthodontist said he doesn't think it will make much difference to your profile, then you have to seriously take that on board. From a GP point of view, I also think it will not help your profile; I think you look just fine. In any case, to retract your chin profile, you'd really only remove 2 upper teeth to pull your upper front teeth back and give the illusion of a straighter profile.
Computer simulations from Invisalign for cases like yours (jaw discrepancy) are a concern. I certainly wouldn't use Invisalign after extracting premolars; you really have to use braces, but your dentist, Dr A, probably isn't qualified for braces so he's not informing you of that option, ... or has he? Invisalign cannot move molars forward.
It is very rare nowadays (in Aust.) to have 4 premolars removed. It used to be a common procedure, but it tends to make people's faces look smaller and sunken. If unsure, then spend a little bit of money and get another specialist orthodontist opinion. It could save you a lot of tears.
 
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So why did you decide to go to the dentist you are with now rather than the specialist?
 
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Yes as I have explained in the first comment that I would like my side profile to look smaller and more sunken because right now my mouth is protruding and sticking out so yes that is the effect I want. I have also had genioplasty which is why the lower mouth doesn't look as bad, but my original chin was receding. I decided to go with the dentist because he offered me a better deal for invisalign along with extractions. I would have gone to the specialist but their price is 10 xs more and what would be the point if the specialist doesn't do extractions but just offers me the same product which is invisalign. I wanted metal braces but because I have 2 front crowns the brackets could potentially come off therefore I can't get metal braces. Actually there are different invisalign models that you can get, I've seen them online such as the g6 invisalign which is designed to use with teeth extractions.
Here is the link:

This is me before genioplasty and rhinoplasty
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This is after genioplasty and rhinoplasty
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The temptation with trying to achieve a certain look is that you keep having work done and you are still not satisfied. It can be an endless cycle and in the meantime you make irreversible changes.
 

MattKW

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Well, it's your money and your face. If you don't seek a specialist opinion, then it's on your head (literally). As you say, you've had a genioplasty, but now you want to pull your upper and lower front teeth backwards - how will that make the effect of the genioplasty better? I think it'll be a poor result. Bye...
 
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Yes I think people do become obsessed with trying to achieve a certain look especially within the plastic surgery industry but I had quite a few problems with my facial features beforehand that's why I opted for plastic surgery and teeth extractions/orthodontics, so it wasn't about vanity more trying to look what society deems as normal/average.
 
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With your teeth you should try to achieve the change with as little work as possible. The proposed work could achieve the opposite of what you are seeking. It may make your face look wider but your cheeks and neck to sag rather than look more delicate. I'm sure there are more conservative routes to getting where you want to be. Don't rush into this. Possibly a combination of orthodontics and cosmetic work. Get as many opinions as you can.
 
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Well, it's your money and your face. If you don't seek a specialist opinion, then it's on your head (literally). As you say, you've had a genioplasty, but now you want to pull your upper and lower front teeth backwards - how will that make the effect of the genioplasty better? I think it'll be a poor result. Bye...
I did say that I have consulted with a orthodontic specialist already
 
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With your teeth you should try to achieve the change with as little work as possible. The proposed work could achieve the opposite of what you are seeking. It may make your face look wider but your cheeks and neck to sag rather than look more delicate. I'm sure there are more conservative routes to getting where you want to be. Don't rush into this. Possibly a combination of orthodontics and cosmetic work. Get as many opinions as you can.
I've already had a face lift and bone contouring around my face so I'm not really that concerned about my face looking wider or my cheeks and neck to sag. I am trying to get my protruding mouth to become smaller there aren't any other options really. Ive seen other people do it for the same purpose of reducing the protrusion and it seem to work out good for them. Thanks for your concern though.
 

honestdoc

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Thanks for responding. Yes I do want to reduce my protrusion but I'm just worried that I will potentially be opening up future health problems with having a smaller mouth. And what do you mean there is a risk of root reabsorption?
Yes I realise that I have to wear retainers for the rest of my life but isn't that the same with everyone undergoing orthodontistry ?
When you move teeth, there are risks of root damage and bone damage. A board certified orthodontist will be very knowledgeable and prevent this from happening.
 
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