Is it worth treating crowded lower incisors orthodontically? Should wisdom teeth be removed in this case?

Teeth that overlap create difficult conditions for maintaining good oral hygiene. Crowded, rotated incisors are difficult to clean properly. Inadequate brushing of teeth causes a plaque to remain on their surface or between the teeth, which mineralizes over time and forms what is commonly known as tartar. It is the cause of persistent inflammation of the gums and then the periodontium, i.e. the structures surrounding the tooth root. This leads to the destruction of, among other things, the bone in which the tooth is embedded, then loosening of the tooth, and in extreme cases, to its loss. However, this situation will not occur if oral hygiene is properly maintained. Incorrectly positioned teeth are not only a problem of poor cleaning. A tooth that stands in the arch differently than it should takes on a different distribution of chewing forces than those for which it was created, which can also lead to its loosening due to overload. Before making a decision regarding orthodontic treatment, you should always talk to your doctor about the possible complications of the treatment. As with any medical intervention, we may encounter certain problems during brace treatment. The most important question that should be asked before starting treatment is whether the patient will be able to attend regular check-ups and whether they will be able to brush their teeth after every meal. Lack of regular visits increases the likelihood of complications, and lack of proper hygiene causes tooth decay and gum inflammation. Very often, before orthodontic treatment, the doctor refers the patient to have wisdom teeth removed. This happens in cases where there is not enough space for the third molars or these teeth are positioned incorrectly, which in both cases does not promise their eruption. An incorrectly positioned wisdom tooth can also damage the adjacent tooth. In such cases, the teeth are removed before starting treatment to avoid problems while wearing the brace. It is much more convenient for the patient and sometimes the doctor to remove the tooth when the brace is not yet in place. Leaving a poorly prognosed wisdom tooth can cause inflammation during treatment, which will make further treatment difficult for some time and will be very uncomfortable for the patient. At the current level of development of dentistry, tooth extraction is no longer a painful procedure, and painkillers also eliminate post-procedure discomfort. Of course, as with any extraction, complications can occur, but this can never be predicted.

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