hey there doctors it's Dr Amanda with Street smile Solutions Street smile solutions.com and
today we're going to talk about errs or extraction retraction regret syndrome I did not trademark
that that is the trademark of Dr William hang with fake face focused Orthodontics he is an amazing
orthodontist out of somewhere in Orange County staying a point maybe somewhere down there in the
beautiful world of SoCal with the beautiful people but anyways he's amazing I've talked to him before
and a lot of you are getting trained by him and I'm all for it his orthotropics he's CRS classes
that's fine nothing wrong with that um I would not say at all that he competes with me I completely
100 agree with everything he teaches a lot of what I teach is a spin-off of that um this mine is like
a little more practical version of that but seeing Concepts because what is ERS well it happens all
the time we're going to get patients um who want re-treatment and they're saying Hey I want to fix
my smile again I had braces as a kid maybe maybe they pulled out some teeth one two three or four
premolars and what they're asking you to do is impossible because there was teeth pulled out
and we're looking at the case and we're like this we're taking a Seth and we're seeing the incisors
are crazy upright and we're looking at the e-line and we're looking at the profile and it's looking
terrible and if you don't know anything what I'm talking about all these keywords that I said I
have videos already made so this is just a high level video specifically about ersrs if you want
to know about more about premolar extractions when to do and when to avoid them cephs anything like
that you can go into my channel and look up those keywords or playlists you can go to the top tab
navigation bar at the top of my YouTube channel which is straight smile Solutions you'll see a
little magnifying glass put in those keywords and everything I've taught you on that subject
will come up so yeah I mean sometimes just there's nothing we can do I mean sure we can straighten
the teeth but the profile's still going to look awful the bite's still not going to be good
um lips are still going to be flat airway's still going to be small sometimes the only solution and
I look at a case I'm like uh we got to put the premolars back in where they're supposed to be
you know that were pulled out when they were a teenager you know I'm sorry which can be a
little bit tricky I I find it way way easier to do an Invisalign like ways or to do an Invisalign to
open up some some spaces sometimes you're going to do one sometimes you're going to do two three
four and then they get to restore it after um so this is an interdisciplinary case so it's really
important that we're taking x-rays along the way and it's really important that we're working both
with the surgeon and the restorative dentists to make sure that the placement of the roots of
the adjacent teeth is proper sometimes you know the doctor that's doing it is going to be doing
all they're going to be doing the Invisalign they're going to be placing and they're going
to be restoring in that case that makes it a lot easier but you need to make sure you're working
with your lab that you're getting what you want not all patients I mean sometimes after you've had
extractions the bone starts collapsing The Ridges start collapsing and you just don't have the
you're not able to open the spaces again so this is why this is why it's amazing to get saf to get
a CBC slice you can even have something like beam readers read it and let you know if it's possible
to labialize um our Buckle eyes are both the teeth so that you can make space you can use sequential
distillation you can use proclination you can use Arch expansion but you need to find out what
methods you can use to make that space because sometimes it's not possible if the bone isn't
good enough because it's already collapsed but it is out there patients get ersrs all the time
obviously it's going to be very expensive they're going to spend five to seven thousand dollars on
the ortho they're gonna have to spend goodness a couple thousand a pop on each implant so I mean
this is basically the cost of a car or College tuition it is not a cheap it's a multi-multi-year
plan to put their teeth the way it should have been to begin with and you know it gets a little
more messy if it was a recent extraction so you just have to tread really lightly
um you know with the whole suggestion or you might be dragged into a little bit of a lawsuit so
um you know tread lightly I tend to feel a little more comfortable with cases than
where it's done 20 30 40 years ago I don't need someone orthodontist on the street trying to sue
me because I'm saying they didn't need teeth out because sometimes they did so
um you know but that's what ERS is it happens and often it can be fixed all right thanks so much