One of my sister's wisdom teeth is sideways and causing her pain. What can she do? Will expanding the upper palate help? I have…

If it’s the upper and she has buggy eyes, I’d extract.  If it’s the lower and there’s decent jaw bone length, I’d extract.  Otherwise, I’d consider keeping.  Also…symmetry is preferable.  But uh…yeah…she can do a little palatal wideneing through SLDA or DNA or even simpler…braces.  Has she had braces?  You can usually get some room with Damon braces or other self lighting like Carriere pretty easily.  But you’ll want to decide the plan up-front.  If you pull, keep teeth where they’re at or you can even move remaining ones distally.  It is not a good idea to take what someone says on the internet.  I would call to orthodontists who are airway focused.  They will give a more honest assessment.  They can see all and have panoramic equipment.  🙂  Anyone who does CBCT or says airway or OSA.

Truthfully any orthodontist.  They want to keep the tooth because they’ll make $ on rotating it and babying the whole thing.  I like regular braces compared to self-lighting where asymmetries are involved.  There is better control.  Damon and those usually end up having teeth converge on right or left or center.  You’ll see this ref elected in the lips and smile.  The lips so lose the fight and can get bigger…which can be pretty, depending.  For girls big eyes and big lips are attractive qualities…so she may prefer self-ligating?  You’d just want someone super detailed to keep it all symmetrical.  Most just let the teeth do whatever.  And if an orthodontist only checks their patients on one side of the seat, they’lol often have their after photos where smiles all slope to one side.  Usually that’s dentists, though.  They lack proper training about checking mid lines and evenness.  Even those with training aren’t always super detailed.  But uh, yeah…a dentist gets paid to pull teeth so they may lean that direction.  

And truthfully.. if it’s still growing and she’s crowded I’d pull sooner than later… the longer it is growing the more the arch length increases so if it gets pulled then the more vacated space.  With her being in pain… it does seem worth pulling with a decent arch length and width.  If she has small perimeter on upper and/or squinty eyes..I’d make a bigger arc.  🙂

One other consideration is her nasolabial angle… if significantly  more than 90-110 degrees I’d want to keep.

So… an airway focused ortho is best… because not all other orthos know what they are doing.

And a lot of people don’t know this…even the vast majority of orthos… the far back of the last teeth you want to be aligned in depth and level so that the eyes appear symmetrical.  Even distance from center… all that whole space is super correlated with eyes.  Aim for symmetry.  Nobody is going to be looking that far back in her mouth.  Everyone will notice the eyes.  But, don’t stress.  If she’s in pain…I’d hate to see that and lean toward relieving the pain quickly.  Just hurry and make a decision.

FYI – the back molars are often a place where orthos can cut corners…but then again..most are just looking at the teeth.  A sloppy (uneven) back tooth placement is often evident as asymmetrical eyes.  The more you know!

Hi there. Thanks for replying!

It’s the upper right wisdom tooth. The others seem to be fine. She’s in her mid-twenties. She had braces as a teenager. I bought this exact palate expander for myself: https://www.bracesshop.net/en/active-plates/4/active-plate

Do you think it would be possible to make room for the wisdom tooth if she expanded? Using a palate expander is just like expanding with the tongue posture so there I don’t think there is no harm. You just have to watch out for things like the teeth tipping.

Replies from anyone else are welcome too. Thank you very much.