Why are extractions needed during orthodontic treatment?

Braces can correct a variety of orthodontic problems. One of the most common one is crowding of the teeth. This condition has multiple causes including a small mouth, narrow jaw bones, teeth that are too big, extra teeth in the mouth, teeth that didn’t grow straight down, and teeth that are blocked by others. Correction of overcrowding can be done by either extracting teeth or by creating the space needed to avoid extractions.

When the crowding is minimal the braces alone can correct the problem and no extractions or orthodontic appliances are needed. In some cases however, when more space is needed, an expander may be used. This appliance will widen the jaw and is therefore used for patients with small narrow jaws or those with cross-bites. The expander is a very effective tool to create extra space in the mouth and avoid extractions.

Another option to create more space is called “slenderization” or “inter-proximal reduction”. In this procedure the orthodontist will use a small hand file, or an electrical one, to gently remove a thin layer of enamel from the sides of one or few larger teeth and use the extra space created by this procedure to align teeth that are blocked out. This is a very simple procedure and does not cause any damage to the teeth if done correctly. It also does not create sensitivity or caries.

If the non-extraction option fails, or if the crowding is just too severe, the orthodontist may have no other choice but to remove permanent teeth. The exact number and location of the teeth to be pulled is unique for each patient. In most cases bicuspids are the teeth “sacrificed” to create space and align other more important ones. As an orthodontist I try to minimize extractions as much as possible and always look for alternatives to create a full elegant smile. However, some cases necessitate extractions to allow all the teeth to properly fit inside the mouth and achieve the best bite. If treated properly, extraction cases can have the same great result as non-extraction cases and still produce a beautiful smile with lasting impressions.

Dr. Reza Salmassian is a Board Certified Orthodontist and specializes in orthodontics for Children and Adults. For any questions regarding this article or to schedule your complimentary orthodontic evaluation, please contact Dr. Salmassian’s office located at the Bridgeport Marketplace, 24001 Newhall Ranch Road, Suite 220 Tel: 661-222-7444 or visit www.salmassianortho.com.