My Orthodontist says: I need some of my permanent teeth extracted, is he crazy??

Recently I have been getting this question from quite a few of my patients and/or patient’s parents.  This is probably one of the more controversial topics in orthodontics.  Here at Newpark Orthodontics we believe that a multitude of factors can determine if a case is an extraction case or a non-extraction case. I am going to briefly go over some of those factors:

1-Facial structure:

The most important factor in determining extraction vs. non- extraction is the patient’s face.  If the patient has crowding along with protrusion ( when teeth stick out too much ) and is unable to close his/her lips without straining his/her facial muscles then most likely the best option for this patient is to remove permanent teeth. This is done to relieve the crowding and to bring the protruded front teeth back in order for the lips to close properly and to improve the facial profile.

2- Gum tissue and the bone that surrounds the teeth:

One of the most important goals of orthodontics is to improve the health of gums and the bone that surrounds the teeth.  Certain types of gum tissue that are generally categorized as thin tissue are very prone to recession if the teeth are moved too much from their original position in order to resolve the crowding. In these cases it is imperative to make sure teeth stay within their biological limit, otherwise gum recession and other serious periodontal problems can occur which can have a negative long term consequences.

3- The age of the patient:

In young patients if there is a skeletal problem with the jaws such as narrow upper jaw and a constricted lower jaw, we are able to orthopedically change the size and shape of them so that jaws have more room to accommodate the eruption of all permanent teeth.  In some severe crowding cases even orthodontics combined with facial orthopedics are not enough and we still need to remove some permanent teeth.

4-The amount of crowding:

The ability of fitting the teeth in the jaws is directly proportional to the amount of crowding in each jaw.  Some severe crowding cases are impossible to treat without extraction of permanent teeth in order to establish a proper bite and a healthy gum tissue along with a nice facial profile.

There are many more factors that your orthodontist will consider before deciding on extracting permanent teeth.  If you are not happy with your smile give us a call to set up your complimentary consultation.