Extract good teeth to match bite or save space for implants

My 13yo daughter has two baby teeth on the bottom that do not have any permanent teeth beneath. She has crowding and class II deepbite. Her lower jaw appears somewhat smaller and sits back a tiny bit but not even close to needing oral surgery to expand (rubberbands recommended).

We have two options:
1) Take out the lower baby teeth AND extract two good teeth on the top to match the spacing and proceed with braces.
2) Keep the upper teeth, keep the baby teeth as long as she can (or pull and keep spacers) and proceed with braces knowing that around 20yo she would get implants for the two lower teeth.

My concerns are that she is a slow grower and might need grafting for the implants later (inconvenience and major expense when she's not going to have the money) AND pulling the top and bottom teeth seems easy and less expensive but a concern would be would make her tiny jaw and appearance even smaller and lower teeth might pivot inward?

I've spoke with two orthodontist and received two different opinions. Looking for a third or a tie breaker. I am hoping for an honest answer even though this site is for implant specialists.

I'd prefer she not have to go through the implant procedure if the other option is viable.

Thanks for any advice!

Comments for Extract good teeth to match bite or save space for implants

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Ortho Options
by: Sharon B., RDH

Hi Mom,

It's difficult to answer the question in that I don't know what teeth are missing, and this could be a real decision maker. Baby teeth, if well cared for (flossing daily, diligent brushing twice a day) can last up to about age 30. By that time many things can change and perhaps your daughter would be able to have implants placed to replace the missing teeth.

If this were my child, what I would ask the orthodontist is this "If these were adult teeth, would you still recommend extracting them for treatment, as well as the opposing adult teeth that you want to extract?" and then go with the answer that they give you.

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