The decision to carry out extractions for the correct performance of a treatment may generate doubts, concerns or even fears in future orthodontic patients. However, it is a necessary measure to achieve the aesthetic and functional objectives necessary to correctly complete the treatment.
But why is this necessary?
Lack of space
The most common reason for extractions in orthodontic treatment is lack of space. When the mouth does not have enough room to properly align all the teeth, extractions can create the space needed to move them into their ideal position. This is especially common in cases of severe crowding, where teeth are crowded or overlapping, and there is no choice but to 'sacrifice' a healthy tooth to get them all into the dental arch.
In other words, when there are too many teeth for the size of the dental arches, there may not be enough space to align them. A common solution is to create the necessary space by removing teeth to allow the others to align properly.
The bite
In some cases, the bite may be unbalanced due to the position of the jaws or the size of the teeth and extractions can help to correct these imbalances and improve dental occlusion.
To prevent future problems
In some cases, extractions can help prevent future problems, such as tooth impaction or alveolar bone loss.
And which teeth are usually extracted?
The teeth extracted will vary according to the specific and individual needs of each case, although the most frequently extracted teeth for orthodontic purposes are the premolars (those that are located just between the fangs and the molars). It doesn't always have to be the premolars, of course, if we can gain space for wisdom teeth, this option is prioritised, and sometimes it may be necessary to extract a combination of teeth.
In the same way, whenever there is a tooth in poor condition or with a poor prognosis (which has already been endodontically treated, for example), the extraction of these teeth is prioritised over the extraction of a completely healthy tooth.
And how is this decision made?
It is important to note that the decision to perform extractions should be made by a qualified orthodontist after a thorough orthodontic study of the patient's case.
The orthodontist will consider all the factors involved, such as the patient's age, oral health, severity of the problem and treatment goals.
What is true, and obvious, is that orthodontics does not have the capacity to create bone, so it always has certain limits that must be accepted, even if the technology and experience are adequate. Therefore, if the patient's dental health is at risk due to malocclusion or severe crowding, it is preferable to have an extraction and start orthodontic treatment than not to do so.
However, fear not:
It is not the most common practice to perform extractions to begin orthodontic treatment, in fact it is usually not necessary. If it is possible to align all existing teeth into a healthy bite and correct position, it will be done without extractions, but for some patients a tooth extraction is an effective part of achieving a healthy, aligned smile with long lasting results.
If you have been given a diagnosis with extractions in orthodontics, but you still have doubts, you can come to our clinic for a second opinion, and we will give you a completely personalised treatment plan for your case.