Case Study 7

Crowded front teeth


his female teenager presented concerned about the crowding of her upper and lower front teeth.

Examination showed severe crowding of her upper and lower adult front teeth. All 4 adult LITTLE front teeth [lateral incisors] were positioned inside the other teeth due to severe space shortages in her upper and lower jaws.  The only baby tooth remaining was her lower left “E” [LLE or lower left second baby molar] and this was close to falling out as the underlying adult tooth erupted.

Treatment Performed:

case-study-7-1Orthodontic treatment with removal of adult teeth was recommended due to her fine facial features, small size of her jaws and the severely crowded nature of her adult front teeth. The patient was referred back to her dentist for removal of her four first premolars to enable space to be created to fit her LITTLE front teeth in. An estimated treatment time of 27-30 months in full braces was provided, with treatment taking 26 months.


Within dental circles and the wider community a debate as to whether adult teeth should be removed for orthodontic treatment continues even to this day. Some claim faces/smiles are ruined when adult teeth are removed for orthodontic treatment.

A ‘cookbook’ approach or philosophy to treatment can be detrimental no matter what the approach. Every person is an individual and must be assessed as such. What is appropriate for one person might not be appropriate for another person.

In this case, removal of two upper and two lower adult ‘side’ teeth allowed for alignment of the adult upper and lower ‘front’ teeth and a well functioning occlusion. A full smile was maintained and a lovely outcome achieved.

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