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Why take teeth out?

Orthodontics and why it is sometimes necessary to have teeth removed…

Many patients who attend an orthodontic practice have poorly aligned teeth as a result of crowding. When there is not enough room for all the teeth to erupt into their correct position, the teeth often arrive in the wrong place or at the wrong angle.

To correct crowding problems and improve appearance, the removal of specific teeth will facilitate alignment (straightening of the remaining teeth). The severity and location of the crowding will determine which teeth will need to be removed.

Extractions can also help camouflage certain conditions such as incorrect jaw positions or undesirable profiles. A typical example is if the upper jaw is much further forward than the• •lower, or vice versa. Taking teeth out in a protruding upper jaw will allow the upper front teeth to be pulled back into a much better position so that they can match the lower jaw. It is important to note that extractions are not the answer for all protrusion problems. Every case is different and will need to be individually assessed.

If some teeth are in an unusual position (ectopic or impacted), selected extractions might yield the space to move the teeth to where they should be.

Very rarely, if the teeth are in a poor condition due to extensive decay or gum disease, extractions could be prescribed to preserve the other healthy teeth in the mouth.

Are there any problems associated with having teeth extracted?

All cases are carefully and individually planned to provide the best possible results for a patient. Removing teeth and creating a space can prolong overall treatment time as teeth have to move a greater distance to align correctly. Inappropriate extraction of teeth can lead to collapse of the facial profile, causing a flat face or collapsed lips.

Some people believe that extractions could lead to a more stable dentition and make it less likely your teeth will move again, or relapse when treatment is completed, this is not true! Relapse can occur whether extractions are part of your treatment or not.

Current thinking

Professional opinions with regard to extracting teeth in orthodontics have changed considerably in recent times. 20 years ago, extractions were more commonplace. The modern specialist orthodontist is keen to avoid extractions and will employ the latest technology to deliver the best possible results. A philosophy called therapeutic non-extraction has been adopted by the profession – orthodontic treatment may be started without taking teeth out and extractions will only be suggested if alignment or a proper bite cannot be established without doing so.

Some people believe that extractions could lead to a more stable dentition and make it less likely your teeth will move again, or relapse when treatment is completed, this is not true! Relapse can occur whether extractions are part of your treatment or not.

Are extractions the only answer?

Space can be gained by methods other than tooth removal. Jaws can be expanded to enable the teeth to fit in better and teeth can also be rearranged to allow a more suitable or ergonomic fit. Headgear, tooth reshaping techniques, bone screws, implants and other orthodontic stabilisation devices can be used as alternatives to extractions.

Please discuss any concerns you might have about extractions with your orthodontist at your consultation appointment.

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