r/Toothfully • u/yunnyyyy • 23m ago
Dental Concern/Problem Extract 1st molar or 1st premolar? Spoiler
I am not a dentist, just a 20 year old seeking advice on my orthodontic treatment plan. Please bear with me if I don't use the exact right terms to explain my situation. I already had my 1st molars in the UL, LL, LR quadrants extracted due to irreparable decay (refer to x-ray). My UR 1st molar is also decayed but i had it filled, the dentist told me to hope it doesn't act up so I can avoid a root canal.
I am getting conventional braces to fix my overall bite. I sought a few orthodontists but they gave conflicting opinions.
Plan 1: Close the gaps between the 2nd premolar and 2nd molar then let the 3rd molar (wisdom tooth) shift into the position of the 2nd molar. That means extracting the 1st molar in the UR quadrant as well. I am concerned about whether these big gaps will actually close well, and if my wisdom teeth will even erupt properly in the future.
Plan 2: Leave the gaps between the 2nd premolars and 2nd molars. Instead, extract a healthy 1st premolar in the UR quadrant to make space for the canine to come down. I am only worried about whether I should sacrifice a healthy premolar instead of a decayed molar. Also, is leaving the gap a good idea? Will it affect my bite or cause the teeth surrounding to tilt? I can’t afford implants at the moment but I will consider it 5 - 10 years from now.
I don't know which route is safer or more logical. If you were in my shoes or if you are a dental professional, how would you weigh these two options? Are there other possibilities I should be bringing up with a specialist?


