Why Does My Orthodontist Suggest Having Teeth Pulled?

Tooth Extraction cartoon

Have you recently had an orthodontic consultation and the orthodontist recommended having certain teeth pulled before braces or other treatment can begin? There are several reasons why this may have been suggested, says Alpharetta orthodontist Dr. Nima Hajibaik.

“Our baby teeth fall out in a certain order, which then allows for the permanent teeth to come in properly,” says Dr. Nima. “However, for some people, their baby teeth don’t fall out soon enough, which can trigger an orthodontic problem, or highlight an existing one. Sometimes, before we can begin orthodontic treatment, we recommend these teeth be removed so that we can achieve the ideal results.”

Sometimes pulling baby teeth can allow for crowded permanent teeth to come in at their normal time, and hopefully in their normal locations. If a child’s mouth is already severely crowded, the orthodontist may recommend the pulling of baby teeth and some permanent teeth, typically the premolars, to allow the remaining teeth to erupt in more desirable positions. Orthodontic treatment will then follow

In some cases, permanent teeth may need to be removed to allow enough room for the remaining teeth to fit in the mouth properly. There are a few reasons why your orthodontist might recommend having permanent teeth removed.

  1. Your jaw is simply too small to hold all of the teeth without severe crowding issues. In this case, either your orthodontist will need to expand your arches, or he’ll need to remove permanent teeth. For patients who have severe crowding, permanent teeth may need to be removed to make the necessary room to properly align the smile.
  2. In some cases, patients have a protruding smile. This happens when the teeth push the lips out due to crowding. Removing teeth on the sides will allow the protruding teeth to push the teeth back into their proper location and allow the lips to look more natural.
  3. To correct some overbites and underbites, surgery may be recommended to reposition the jaws (see why might jaw surgery be required.) But for minor cases, teeth may be able to be removed to correct the problem, eliminating the need for surgery.

It’s important for patients to remember that the goal of orthodontic treatment isn’t just a straight smile, but one that works efficiently, too,” says Dr. Nima. “Sometimes, removing teeth is the best way to achieve this. Removing permanent teeth is a decision that shouldn’t be made lightly, and should be made with the final proper functioning of the mouth in mind.”

The goal of orthodontic treatment is always to create the ideal smile that functions as beautifully as it looks. Dr. Nima works hard to create the ideal treatment plan for each patient and works hard to retain the teeth whenever necessary. Permanent teeth will only be removed when Dr. Nima has determined it is the best course of action to create the best bite.

The only way to determine if you will need teeth removed is through a comprehensive clinical exam with a trained and licensed orthodontist. There are cases that are best treated by extracting teeth first for both cosmetic and functional reasons. Call Dr. Nima today to schedule a consultation and begin your orthodontic treatment.