To Extract or Not to Extract Teeth for Orthodontic Treatment

February 21, 2017, Irresistible Smiles

San Diego Orthodontists
San Diego Orthodontists
Orthodontist at the initial consultation examines how many teeth your child has. While every individual is different, primary teeth usually erupt by a certain age in a particular order.

Since the early 20th century, orthodontists have been arguing about extraction therapies vs. non-extraction treatment plans. This debate has continued for past 100 years and most likely will continue far into the future. Presently, most orthodontists go with non-extraction treatment plans for patients first, and consider extraction only after confronting with few clinical problems.

At times, extraction becomes necessary in order to achieve the best orthodontic results. The goal of orthodontics is to achieve straight teeth and a balanced facial profile. Whether or not to extract the teeth before orthodontic treatment varies from case-to-case and comes down to analyzing facial features, the amount of crowding present, the profile, and incisor tooth position.

Removal of Primary Teeth

Every individual has two sets of teeth during their lifespan - primary teeth and permanent teeth. The orthodontist at the initial consultation examines how many teeth your child has. While every individual is different, primary teeth usually erupt by a certain age in a particular order. These teeth can be tricky if they fall out too late or too early. If they do not fall out early, they can create an orthodontic issue and if they come out too early, a plan can be executed that will keep the space until the permanent, replacement teeth grow in. Therefore, it is sometimes necessary to extract primary teeth to ensure there is normal eruption and development of the teeth.

Removal of Permanent Teeth

Most parents are not much concerned about their kids having primary teeth extracted, but they are hesitant to have their permanent teeth removed. Teeth removal is recommended before placing braces due to many real reasons and these are:

Protrusion: When a person has protruding front teeth, tooth extraction on either side will let the orthodontist move the teeth into the proper position so that the person attains a good facial profile.

Crowding: When the amount of space available to align the teeth is less than the space required, permanent teeth may need to be taken out. If the patient has moderate to severe crowding and insufficient gums or bone, it may be important to extract permanent teeth prior to orthodontics.

Overbite or Underbite: When the upper and lower jaw sizes are mismatching, it may be important to extract the teeth to compensate for the problem. It can eliminate the need for jaw surgery in most patients with overbite and in some underbite patients too.

If you are looking for Orthodontic Treatment in San Diego, then go for the comprehensive evaluation first, as it will determine whether or not some teeth should be extracted prior to placing braces on your teeth. At Irresistible Smiles, Dr. Safarian doesn’t always jump to extraction if it is avoidable. He is able to make treatment plan in a way that negates the need for extractions.

Whether to extract or not has been an ardent contested debate in the orthodontic specialty for decades. The only answer is - it depends on the problems at hand.


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