It has been 12 years since I had orthodontic treatment, and I had it done when I was 14 years old.
First, at the time of the consultation, there were two issues. Occlusion was one issue, but they also said my mandible was generally retruded, and that both my maxillary and mandibular dental arches were very narrow.
At first, the plan was to go with extraction orthodontics, removing 2 premolars each from the maxilla and mandible, for a total of 4 teeth.
But they said that even if they removed 2 premolars on the mandibular side, there still would not be enough space for the 4 incisors + 2 canines to settle into place, so the plan changed from extracting 2 premolars to extracting 1 incisor.
I think they made that decision because, for my lower teeth, the issue was more that the incisors were crowded together rather than protrusion. I didn’t hear a precise explanation :(
So now I only have 3 lower incisors.
It doesn’t look awkward aesthetically and there are no functional problems, but personally I wonder whether it may have caused asymmetry in later temporomandibular joint development. (Of course, this is just my guess.)
I’ve been living with an orthodontic retainer attached for 12 years. Other than it breaking once every 2-3 years when I eat tough foods, I haven’t had any major discomfort.
I don’t know if this will be helpful, and since it was quite a long time ago, I don’t remember everything accurately.