One of the biggest concerns people have about getting braces is whether they will need teeth removed in order to straighten their teeth. Any good orthodontist should explore whether there are any other options, before removing healthy teeth, and make decisions on a case-to-case basis to ensure it’s the right course of action.
Let’s look further into why tooth extraction may or may not be the best option when having braces fitted.
What Are Braces, and How Do They Work?
Traditional braces are a common method of straightening teeth, using bands, brackets and wires to reposition the teeth in your mouth. A bracket is bonded to each tooth, along with a flexible archwire to connect the brackets. Small elastic bands are also often used, as they apply resistance to further pull the teeth into position.
Over a period of time (typically anywhere between 12 and 24 months), the teeth move into the desired position.
Why Might Teeth Need to Be Removed for Braces?
Where possible, other techniques should be used to allow braces to be fitted without the need for tooth extraction. However, in a small amount of cases, taking teeth out for braces may be necessary. Some of the most common reasons for this include:
Addressing overcrowding and spacing issues
One of the most common reasons for tooth extraction before braces is severe overcrowding. When there isn’t enough space in the jaw for all the teeth to align properly, removing one or more teeth can create the necessary room for the remaining teeth to be straightened effectively.
Correcting bite problems and misalignment
Severe bite problems, such as overbite, underbite, or crossbite, might require extractions to improve teeth alignment. Removing teeth should be the last option in these circumstances, but in some cases may be required to ensure a better fit between the upper and lower rows of teeth.
Types of Teeth Extractions for Braces
Premolars
Premolars are the most common tooth to be extracted for orthodontic treatments such as fitting braces. In some cases, premolars may need to be removed to alleviate overcrowding and create space for the teeth to align properly.
Wisdom Teeth
Wisdom teeth are also occasionally removed as part of orthodontic treatments. This is because they can sometimes cause overcrowding when there isn’t enough room for the wisdom teeth to grow in. This can cause complications when combined with braces, which is why it is sometimes recommended to deal with the wisdom teeth before the beginning of your orthodontic treatment.
Other Teeth
Canines and incisors are less commonly removed before braces, as they play a more crucial role in the function of your mouth. Incisors on the bottom row of teeth may sometimes be removed if required to create more space, but other options will likely be explored first.
Reasons Why Removing Teeth May Not Be The Best Option
Each tooth in the mouth serves its own purpose, and so taking teeth out for braces should never be the go-to option. Any good dentist or orthodontist will be reluctant to remove teeth unless absolutely necessary for relieving pain, or to get the results you want.
Here are some of the main reasons why tooth extraction should be avoided where possible…
Removing Teeth Can Impact Other Remaining Teeth
As mentioned above, the most commonly removed teeth are premolars. You may think for this reason, that they don’t serve much purpose in the mouth. But in fact, they are there to support the molars with their function of chewing up food, and are really important for making sure food is chewed properly.
When premolars are removed, more of the work lies with other surrounding teeth such as the canines, which can cause them to show more signs of wear and potential damage.
Tooth Extraction Can Change Your Face Shape
Teeth play a vital role in our face shape, particularly as we age. Taking teeth out for braces (to create space for others to align) can sometimes cause a flatter face profile and sunken cheeks, which can make the face appear older.
It Can Change Where The Tongue is Positioned
Tooth removal can change the structure of the area where your tongue sits in the mouth, which can cause potential problems. This can impact your breathing, speaking, and swallowing. It may not affect every patient, but it is worth talking to your orthodontist about if you are concerned, and is something they should explain to you if they do recommend tooth extraction.
Conclusion: Should Teeth Be Removed For Braces?
The decision of whether or not teeth need to be removed to allow for alignment using braces, should be made by a dental professional. Having said this, they can only recommend what they feel is best, or what is needed to allow braces to do their job, and the decision of whether to go ahead with the tooth extraction is down to you.
A good orthodontist should explain the pros and cons, much like we have in this article, but tailored to your specific mouth structure and requirements.
If you would like a braces consultation with one of our qualified dental professionals, get in touch with our team today.
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