Tooth extraction

[wx1]

I've got nothing to lose by asking here since we've been back and forth trying to get information.

Our 8yo son had his baby second molars extracted two weeks ago. They were removed because his first molars were large and caused damage. His first molars are erupted but must have been squeezing in too tight. We were told by the dentist to have them removed by an oral surgeon. She wasn't comfortable doing it herself but she reassured us when we couldn't get a surgery appointment until over a month later. I know Dr. Google is frowned upon but I gave into the urge. Every source about early loss of baby teeth said that space maintainers are required and urgent after extractions. Nobody said anything about this to us. Our dentist casually mentioned seeing an orthodontist "at some point" after his extraction. So we asked the oral surgeon directly after the surgery and he said no rush and to make an appointment within 6 months.

What do you do when you research something that urges the opposite of what your provider is saying?

My worry is that space maintainers allegedly hold space for the permanent tooth to erupt in proper position. Losing that space could cause impaction and subsequent need for more extractions.

We can't even get seen by an orthodontist until June anyway but I wonder what the worst case scenario of space loss is. I'm really stressing because I want to believe what the oral surgeon said but can't get over how every other dental resource says immediate space maintenence is critical. I'm very disappointed in our dentist because she truly didn't prepare us for any further assessment after the surgery.

Thanks so much!!

 

[Skippy918]

He already has his adult first molars? I had a bunch of baby teeth pulled while I had braces on and never had spacers put in.

 

[wx1]

He already has his adult first molars? I had a bunch of baby teeth pulled while I had braces on and never had spacers put in.

Thanks for your reply. First molars erupt between 6 and 8 years old.

I can only guess that maybe you didn't need spacers because you had braces on already that can realign your teeth. Our son hasn't had any orthodontic treatment thus far.

 

[kymom99]

My grandson had a tooth pulled and they put in a spacer. He’s 7

 

[cvjw]

My son had to have early braces in elementary school because he had 2 baby teeth knocked out while playing on the trampoline. They put the braces on to keep the spacing correct in his mouth to allow his adult teeth to come in properly. Evidently, the teeth can move around when there is open space in the mouth.

I would see an orthodontist. Even if his teeth have moved some before you get an appointment, they can move them back.

 

[Minnie1222]

Is there a waitlist at the orthodontist office for you to come sooner if there's a cancelation?

 

[Sleepy425]

That tooth will not erupt (typically) until 10-12 years old. So yes a space maintainer is important. In our office at the extraction we take the impression and have the patient back within a couple weeks to have it cemented. Honestly waiting until June most likely wouldn't be the end of the world. But if you could get a referral to a pediatric dentist sooner that would be ideal, especially if your child doesn't have a need to start ortho yet.

 

[princesscinderella]

I second the see a pediatric dentist, they are equipped to handle extractions on children and will know if he need a spacer. Sometimes there’s not enough room in the mouth and you need an expander put in by an orthodontist to expand the jaw for all the adult teeth to grow in with proper space. My kids all had to have them and it’s amazing how quickly it expanded. His age is perfect to see if he’s a candidate for this as the palate is not fully fused yet and bones are still growing. It’s a 2 phase orthodontics.

 

[DLgal]

I second the see a pediatric dentist, they are equipped to handle extractions on children and will know if he need a spacer. Sometimes there’s not enough room in the mouth and you need an expander put in by an orthodontist to expand the jaw for all the adult teeth to grow in with proper space. My kids all had to have them and it’s amazing how quickly it expanded. His age is perfect to see if he’s a candidate for this as the palate is not fully fused yet and bones are still growing. It’s a 2 phase orthodontics.

And some people's mouths are just too small even with the use of an expander. I had 8 permanent teeth pulled. As an adult, I have only 24 teeth. I had an expander placed at age 8 and then extensive braces. I had 4 adult molars pulled and then my wisdom teeth as well. My mouth is TINY.

So, if there was already a crowding issue, there may just continue to be one and all the adult teeth won't end up fitting anyway. I never had any spacers put in, because I didn't have any actual space.

 

[Cheburashka]

I've got nothing to lose by asking here since we've been back and forth trying to get information.

Our 8yo son had his baby second molars extracted two weeks ago. They were removed because his first molars were large and caused damage. His first molars are erupted but must have been squeezing in too tight. We were told by the dentist to have them removed by an oral surgeon. She wasn't comfortable doing it herself but she reassured us when we couldn't get a surgery appointment until over a month later. I know Dr. Google is frowned upon but I gave into the urge. Every source about early loss of baby teeth said that space maintainers are required and urgent after extractions. Nobody said anything about this to us. Our dentist casually mentioned seeing an orthodontist "at some point" after his extraction. So we asked the oral surgeon directly after the surgery and he said no rush and to make an appointment within 6 months.

What do you do when you research something that urges the opposite of what your provider is saying?

My worry is that space maintainers allegedly hold space for the permanent tooth to erupt in proper position. Losing that space could cause impaction and subsequent need for more extractions.

We can't even get seen by an orthodontist until June anyway but I wonder what the worst case scenario of space loss is. I'm really stressing because I want to believe what the oral surgeon said but can't get over how every other dental resource says immediate space maintenence is critical. I'm very disappointed in our dentist because she truly didn't prepare us for any further assessment after the surgery.

Thanks so much!!

I'm sorry you're dealing with this. I definitely recommend getting a second opinion before removing teeth (or doing any other type of surgery). Dentists are not typically the ones recommending tooth removal, unless it's due to decay. Orthodontists are the ones you want to see for those recommendations, and you still want second and third opinions even with them, when tooth removal is involved.

Fortunately, these are only baby teeth. Take this event as a warning before you pull any of your child's permanent teeth on a single orthodontist's advice. Also, do get an orthodontist consultation immediately (should be easy as there are so many of them- it doesn't tend to take long to get in), and get answers about spacing. An orthodontist, not dentist or oral surgeon, is the expert on spacing.

 

[leahgoogle]

I agree with consulting with an orthodontist before extracting more teeth. When my son was about 10 years old, our dentist wanted to pull a front baby tooth (it wasn't loose so he wasn't going to lose it on his own) that was in front of a permanent tooth that had come in behind it. I took him to an orthodontist and the orthodontist actually wanted to leave the baby tooth there until braces to maintain bone integrity because the adult tooth was not going to have room to move up anyway. He said pulling that one baby tooth would have led to needing to pull more teeth as time went on. We had the baby tooth pulled right before he got braces so the other teeth could be moved around. I know it is not your exact situation, but had I listened to our dentist without getting an orthodontic consult my son would have been worse off.

 

[wx1]

Thank you all so much for your kindness and responses. We were considering a palate expander for his crowding anyway so that might help us get any space back if he does lose some. It's amazing how much faith you have to put in different doctors when they say opposing things. I'm thankful he's young and there are more options because his jaw isn't done growing yet.

 

[seashoreCM]

You said that DS already had his second baby molars extracted. The second baby molars were the last teeth in the row so I would question whether a spacer is needed for the respective second adult molars that will appear in 5 or so years. Since the first adult molars are now the last teeth in the row today, there should not be a space problem for the adult seconds. Those first adult molars, as all the adult (permanent) teeth, need proper care since they have to last until age 99 or whatever,

The palate expander might still be needed;. Consult with your orthodontist on this one.