Why Does My Orthodontist Need to Extract Teeth?

Female dentist working on a patients teeth

Alpharetta, Ga. – Are you seeking Johns Creek braces treatment, but are wondering why your orthodontist might have recommended extracting some teeth before treatment can begin? Dr. Nima Hajibaik is a Roswell orthodontist who treats patients of all ages, and sometimes has to encourage patients to have teeth extracted before he can give them the smile of their dreams.

“Everyone has two sets of teeth, the baby or primary teeth, and the permanent, adult teeth,” says Dr. Hajibaik, who is a surgical orthodontist. “The necessity of removing some teeth before orthodontic treatment begins can depend on both sets of teeth, but especially baby teeth. Baby teeth typically fall out at a certain age, but if they fall out too early or too late, they can negatively impact how the permanent teeth erupt.”

If baby teeth fall out too early, an orthodontist can develop a plan that will maintain those spaces until the permanent teeth have come in. Without it, other permanent teeth could drift into those open spaces, creating a bigger problem in the future.

But what can create a significant orthodontic problem is when the teeth fall out too late. Sometimes to ensure the permanent teeth erupt properly, an orthodontist may have to remove the primary teeth. This normally isn’t an issue since those teeth would fall out anyway, but in some cases, orthodontic patients might need permanent teeth removed, too. So why is that?

“There are several reasons why permanent teeth may need to be removed before braces can be effective,” says Dr. Hajibaik, who is also a certified Invisalign provider. “Crowding, protrusions and correcting overbites and underbites are the most common reasons.”

Crowding is a very common issue many children, and even adults, face. If the amount of space available in your mouth is less than the space needed to properly align them, either the size of the arches must be increased or the number of teeth will need to be reduced. Until around the age of 15, the use of expanders and braces may be effective at correcting mild to moderate crowding. After that, however, you may require the use of surgery or tooth extraction. If a patient has insufficient gums or bone, extraction is the only option to ease crowding issues.

Protrusion is another reason teeth may need to be extracted. If the front teeth protrude, removing teeth from the sides will allow an orthodontist to move the teeth back to improve the position of the lips. If the lips are already positioned well, but the teeth are crooked, extraction may still be necessary to prevent protrusion in the future.

Overbites and underbites occur when the jaws are mismatched in size. The ideal treatment to correct these issues is surgery, but in many cases the size discrepancy is small enough that some teeth can be moved to compensate for the mismatched sizes. This is most common in overbite patients, but can be effective in some underbite patients, as well.

“If it prevents the need for surgery, most orthodontic patients are more than happy to have a couple of teeth extracted,” says Dr. Hajibaik. “In addition to these common issues, an orthodontist may recommend extraction for a few other reasons as well, such as correcting asymmetry or to remove impacted or extra teeth. When we recommend extractions, it is typically necessary, but never be afraid to ask your orthodontist why he is recommending a certain treatment. We love having educated patients.”

If you are wondering if you might need teeth extracted to gain the smile you’ve always wanted, schedule a consultation as soon as possible.

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