Why Orthodontists May Recommend Teeth Extractions During Orthodontic Treatment

The thought of tooth extraction for you or your child during an orthodontic treatment plan may seem intimidating. Tooth extractions are not a “thing of the past” but a modern treatment method that suits some patients. However, there is not a universal right or wrong answer when it comes to tooth extractions and at Noranda Orthodontics we always aim for a conservative approach that avoids tooth extraction where possible.

Will I Need A Tooth Extraction For My Orthodontic Treatment?

It should be made clear that extraction is not always necessary for orthodontic treatment. In fact, less than 1 in 4 people will require an extraction to achieve our healthy smiles.

An orthodontist will always complete a thorough examination of your teeth and jaw before recommending any extractions. This includes comprehensive x-rays to understand the optimum alignment of your teeth for that beautiful smile and healthy bite. 

For the most part, your orthodontist will recommend tooth extraction to make other orthodontic treatments more effective. For example, braces attempt to straighten teeth; a process made easier if there is room for the teeth to move into. 

However, there are some circumstances where extraction may be necessary. A decaying or diseased tooth (typically an impacted one) might require extraction for the health of your mouth. 

Why Do Orthodontists Sometimes Recommend Tooth Extraction?

Removing teeth might be necessary in order to get your perfect, straight smile. It might also be suggested for health reasons, such as achieving a more healthy functional bite. 

As part of your braces or clear aligner treatment, your orthodontist may recommend tooth extraction for one of the following reasons. 

• Overcrowding — sometimes a person’s jaw is not large enough to accommodate all of their teeth. In this instance, strategically removing one or two teeth allows other teeth more room to readjust into the right places. If left untreated, overcrowding can cause tooth or gum disease as the mouth is more difficult to clean thoroughly, so a smile with straight teeth can actually be easier to maintain.
• Protruding teeth — when teeth sit too far forwards, it can affect a person’s facial shape and speech. An orthodontist might recommend extracting teeth at the back of the mouth to make space for the front protrusion to adjust backwards into place.
• Unusual tooth — an unusual tooth might be an extra one, a misshapen one or a damaged one. A small portion of the population have an extra tooth. An orthodontist may remove these teeth as they can affect your bite pattern and healthy smile. They then use braces or aligners to shift the other teeth into the space. 
• Discordant jaw sizes  — a skilled orthodontist will recognise when a child might need teeth extracted to enable their teeth to fit together even though their upper and lower jaw sizes may be too big or too small
• Impacted tooth — an impacted tooth is a tooth that tries to grow through on top of or against its neighbour. Sometimes, it doesn’t break through the gum properly. This can cause multiple issues, from irritating the neighbouring tooth to becoming infected as it is hard to clean thoroughly. An orthodontist may recommend extracting impacted teeth to prevent potential infection or tooth decay.

Sometimes, tooth extraction is done in combination with other orthodontic treatments. For braces to be effective, the orthodontist may need to free up room in your mouth to help the teeth move into a nice straight line. 

An orthodontist will use their skills and training to comprehensively assess the situation before deciding that tooth extraction is the leading recommendation for your perfect smile. 

Is Orthodontic Tooth Extraction Safe?

Long gone are the days of dentists pulling multiple teeth out without local anaesthetic. Today, tooth extraction is a routine and safe medical procedure usually performed under local or general anaesthetic.. 

After the anaesthesia wears off, you might feel slight pain or discomfort. You can take over the counter medication to relieve this. Eat soft foods for the next few days until the site has healed, and keep your mouth clean. 

Your orthodontist will then advise you of the following stages of your treatment plan.

Do Orthodontic Extractions Change The Airway?

There are many myths about teeth extraction. Some people worry that the process limits your ability to breathe. However, current evidence suggests that tooth extraction has little to no significant impact on your airways. A 2021 study showed that 269 participants experienced an average decrease in volume of -0.09 cm3 in the airway behind the nose after extractions. The airway behind the mouth actually showed a mean increase in volume of 0.41cm3. At this time there is no evidence that tooth extraction limits your ability to breathe or changes the size of your airway enough to clinically alter your breathing.

If this is still a concern of yours, speak to your orthodontist. 

Remember that your orthodontist’s goal is to make your smile as healthy and beautiful as possible. 

What Orthodontic Alternatives Are Available?

As discussed earlier, tooth extraction is typically coordinated with other treatments, like braces or Invisalign. During your consultation, the orthodontist will consider your facial dimensions, side profile, jaw position, smile shape and lip shape before recommending which treatment is best for you. If you are concerned about extractions, speak to your orthodontist. They may be able to start your treatment without extractions and review the possibility later on during treatment.

If tooth extraction is recommended to you, trust that your orthodontist has your healthy, perfect smile at the centre of their treatment plan. 

How Can I Find Out If a Tooth Extraction Is Needed?

The best way to determine whether you or your child will require a tooth extraction before starting orthodontic treatment is to book in for a consultation with Dr Trudy Stewart at Noranda Orthodontics. Trudy has years of experience in orthodontic care, and can help guide you or your family member on the best course of action to achieve optimal orthodontic outcomes.