Guide to Premolar Extraction in Orthodontics

Premolar extraction may be a necessary step to take during a preparation for an orthodontic procedure. Namely, removing premolars may be necessary and even inevitable in order to preserve and optimize the overall function of a patient’s teeth and jaw. 

So if you need to undergo a premolar extraction for an orthodontic treatment, what can you expect? When is this type of extraction a logical next step? Read our brief guide to extractions in orthodontics in Murrieta in general and premolar extractions done for orthodontic reasons in particular.

Why are premolars extracted?

It is common for an orthodontic treatment to involve the extraction of a tooth or a serial extraction, especially that of premolars. 

Below is a list of the most important considerations to be mindful of:  

• The procedure may be the only way to gain space for the correction of crowding or proclined teeth.
• There may be a severe, immediately visible discrepancy in arch length (a discrepancy between teeth size and jaw size) and a premolar extraction may be the optimal way to resolve the issue. 
• The degree of dental discrepancy or dental crowding and the age of the patient will have an effect on how your doctor may decide to treat your poor bite: with or without the extraction of permanent, healthy teeth. 
• In certain situations, the upper front teeth may need to be retracted to reduce the horizontal space (overjet) between the upper and lower front teeth.
• A premolar extraction may also be needed to correct axial inclination of anterior teeth or reduce facial vertical height. 

Is it bad to have premolars removed?

Asking yourself “Can I live without a premolar?” You certainly can. While having a premolar removed isn’t always ideal, it’s not necessarily a bad thing, as long as you consult with your dentist or orthodontist to make sure it’s the right choice for you. Here are potential drawbacks you should know about:

• Changes in facial structure: With premolar extraction you can notice a subtle face change, particularly if multiple teeth are removed.
• Bite changes: If not done properly, it can alter your bite, causing discomfort or even functional problems.
• Shifting of teeth: Teeth can gradually shift if the space left by the extraction isn’t handled with appropriate orthodontic solutions.

It’s always best to talk it over with your dentist, who can help you weigh the benefits and risks to determine if extraction is the right path for you.

Which premolars are extracted for orthodontic reasons?

The first premolar teeth are most frequently removed for orthodontic reasons. Namely, both first and second premolars are located between the canine teeth and the molars, which means these teeth can be removed without sacrificing function or cosmetics. Other than all four premolar teeth, the procedure may entail only the two upper or the two lower premolar teeth, a single lower incisor tooth, or upper and lower second molar teeth.

Does premolar extraction change face shape?

It is a common concern among patients that extraction of premolars may impact the shape of their face. Facial profile and soft tissue considerations truly do play an important part in the diagnosis and treatment planning of orthodontic cases, as one of the goals of the procedure is creating a pleasing appearance.

It is possible that any tooth extraction may affect the patient’s facial form and structure, as these teeth are removed along with the roots, and roots are the integral part of it. However, if a single tooth is extracted, the change to the face shape and structure is not likely to be drastic or immediately noticeable.

Are premolars hard to extract?

While it is generally difficult to extract a tooth with multiple roots, which may be the case with premolars, and all the more so if these roots are curved, crooked or hook-like, as they often are, an experienced oral surgeon is not likely to encounter challenges during the extraction. To complete the extraction, a surgeon would typically use the slightly curved maxillary anatomical forceps.

Despite the obvious complications, an oral surgeon will carefully plan the procedure so as to avoid having to apply excessive force which may lead to breakage instead of extraction or damage to the gum and jawbone.

Is premolar extraction painful?

As is the case with any dental extraction, whether simple or surgical, you will be offered an assortment of anesthetic options to choose from. Depending on which one you choose, you may or may not be awake during the procedure, but you will not experience pain during the procedure. 

More importantly, when done by an experienced surgeon, the premolar extraction procedure should not take longer than 30 minutes at most. You may experience some postoperative discomfort, but your dental surgeon will instruct you on over-the-counter medications you can use to ease it. 

How long does it take for a premolar extraction to heal?

Recovering from a premolar extraction generally takes about 1 to 2 weeks, but it may take 3 to 4 weeks, or even a few months, for the bone and gums to fully heal.

Here’s a general timeline you should expect:

• First 24-48 hours: You’ll likely experience some swelling and discomfort, and it’s important to let the blood clot form in the socket. During this time, avoid activities like smoking or drinking through a straw to prevent dislodging the clot.
• 3-4 days: Swelling and discomfort begin to subside. Soft tissue starts to heal.
• 1 week: Most of the discomfort will be gone, and the area will be mostly healed, though you may still need to be gentle with the extraction site.
• 2 weeks: The gum tissue around the extraction site is mostly healed.
• 3-4 weeks: The bone continues to heal, but full bone recovery can take a few months

Allow us to be your safety net: risk-free orthodontic extractions in Murrieta 

At Temecula Facial Oral Surgery, your wellbeing and satisfaction is what matters most. We’ll guide you through the process of your upcoming orthodontic treatment by presenting you with your custom surgery and recovery plan.

If a premolar extraction is crucial to the outcome of your orthodontic procedure, we will make sure everything goes smoothly and with minimum discomfort. Find out why patients across Murrieta, Temecula and other areas in the vicinity put their trust in us.

For more information, contact us now.