The comments

Dr Sylvain Chamberland, Orthodontiste says:

Chances are it would have been a better decision to extract 4 premolars (the 1st or the 2nd) to reduce your bimax protrusion rather than extracting the 4 second molars hoping it will favour eruption of the 3rd molars. It occurs oftent that a bimax prothusion get 4 premolars extracted at the start of treatment and 4 3rd molar extracted at the end ot the treatment.

If you feel that your teeth are sticking out, that you have difficulty to close your lips, it is still time to extract 4 premolars. I can't tell if it would be preferable to remove the 1st or the 2nd without seeing you.
A non estraction innvisalign will not help.
I thinks braces and extraction may likely be the best solution for you.

Dr Sylvain Chamberland, Orthodontiste says:

Many orthodontist will not try to a mandibular impacted canine into occlusion. It takes times and it may be difficult mechanically. It is also possible that the canine position that it may not be possible to manage a forced eruption.You can send the panogram via my professional FB page facebook.com/drsylchamberland

Mrs Lamia AlMidfa says:

Good afternoon Dr Sylvain

I really need your help and your advise for my 11 years old daughter who have an impacted lower canine laying horizontal under middle teeth. Plus the top center tooth issue that did not fall yet.
I went 4 doctors in Dubai - UAE and they told me that the lower impacted canine must extracted asap :’(
Please provide me with your email to send you my daughters recent Xray, as i am really concerned :(

Patricia Lam says:

Hi Dr. Sylvain,

I am 24 year old female in Ontario.
Back in highschool, I sought treatment for what I think is bimaxillary portrusion (my lips don’t close at rest & my front and lower teeth stick out). They took x-rays and eventually, my dentist had my four 2nd molars extracted in order to have my 4 wisdom teeth grow in naturally. It was after the extraction of the four 2nd molars (backmost teeth), that I got my braces put on. I had them on for about 2 years, but still noticed my teeth were sticking out, and my lips still don’t close at rest after they were taken off.

My teeth apparently have Class 1 alignment or something like that, but I can’t help but be unsatisfied about the overall aesthetic look of my teeth and mouth area of my face as it still portrudes.

I was wondering if the best approach would be the extraction of the 2nd premolars/braces again or if no extraction/Invisalign would work, as I would rather not get braces again, at my age especially.
Would pictures help demonstrate my situation?

Best Regards,
Patricia

Beth Newenhof says:

This information on your website regarding stimulating lower jaw growth in adolescents is very interesting to me. My daughter will be 14 in December. She is missing half of her permanent teeth. She has reduced upper and lower jaw growth. We have consulted several specialists over the past years including a maxillofacial specialist who states she could have lower jaw surgery sometime after the age of 16. I want to make sure we are doing everything we can to stimulate jaw growth while she is younger. One orthodontist mentioned placing braces that will then cause ‘mini’ breaks in the jaw that encourage bone growth. I am a Speech Pathologist and work with patients on feeding and speech exercise including jaw strength and other areas and am curious if chewing exercises can stimulate more growth (see also Diane Bahr, SLP or Sara Rosenfeld-Johnson, SLP websites and info.). I have read articles regarding stimulating jaw growth with devices such as a Crozat, MARA, Herbst, headgear, etc. Any advice is greatly appreciated!

Dr Sylvain Chamberland, Orthodontiste says:

It will depends on the ability of your orthodontist, but such case usually adult case take 24-30 months in general.

Prabodh says:

How long will it take to treat bimaxillary protrusion given that the patient has front teeth vertical (not flared) and normal occlusion?

Dr Sylvain Chamberland, Orthodontiste says:

Yes.

Dr Sylvain Chamberland, Orthodontiste says:

He probaly took a panoramic xray and there was no tooth buds of the wisdom teeth.

Dr Sylvain Chamberland, Orthodontiste says:

Extraction of 4 premolars does not favour obstructive sleep apnea.

Dr Sylvain Chamberland, Orthodontiste says:

If you can't do orthodontic treatment and want to do something that will favour canine erution, You MUST remove the primary canine ASAP.

Dr Sylvain Chamberland, Orthodontiste says:

I would place a lower lingual arch to maintain arch space and make annual recall. I would not do comprehensive interceptive treatment at this age.

See example below:

Dr Sylvain Chamberland, Orthodontiste says:

Bringing an impacted canine into occlusion takes time. It is not a reason to not try. Rome was not built in one day.
It will be worth the effort to get your canine in occlusion.

Jasmine says:

I have two gold teeth. They are on the left and right side of my two front teeth. Can I get braces or Invisalign’s over them???

Stephanie Lynn Weaks says:

I was told today that my daughter wouldn't have wisdom teeth. How does the dentist know?

Prabodh says:

Hi Dr. Sylvain,

Is there any way to find out whether an adult will suffer from obstructive sleep apnea before the extraction of first 4 premolars for treating bimaxillary protrusion?

Gogu says:

I would generally prefer to avoid orthodontic treatment at this time as I work full time in a very demanding job. I may not be able to make regular appointments for adjustments. What would you recommend other than orthodontic treatment?

M. Michaelidis says:

Hello Dr. Chamerland, My son is almost 8 years old and he lost his lower canine prematurely because his lower lateral adult incisor ate into the root of his baby canine. It does not appear that he currently has enough room for the adult canine to erupt. Should this be treated early with phase 1 orthodontics to minimize complications with the adult teeth or can we wait until he is older. His insurance won't pay for interceptive orthodontics unless it is proven that the adult teeth will not be able to emerge without treatment. Attached are a couple of pictures. Thank you!!
https://imgur.com/vrb3hjg
https://imgur.com/XLk1EMm

Gogu says:

I was told by my ortho that it is a difficult case esp at my current age, because of the horizontal aspect of the impacted canine and the proximity to the roots. If done, how long do you expect this to take to get the canine into position?

Dr Sylvain Chamberland, Orthodontiste says:

I would recommend extraction of the primary canine and traction of the permanent canine in occlusion. It is not that difficult. The direction of pull should be vertical and distal to begin.