Do teeth have to be removed?
The majority of the patients seen in our specialist orthodontic practice by Dr Sarah Good or Dr Pourghadiri are treated on a non-extraction basis; i.e. they do not have to have teeth taken out as part of their orthodontic treatment. Our specialist orthodontists employ the latest in orthodontic braces, advanced clinical methods and state-of-the-art wire technology to ensure that the need for extractions is minimised. In our practice, ‘expansion’ and ‘orthopaedic’ techniques are always used in appropriate cases to avoid the need for removal of teeth.
Your orthodontist will use his knowledge, training and experience; as well as your radiographs (X-ray films) and models of your teeth to perform a full evaluation and analysis of your orthodontic condition before devising a treatment plan that’s right for you. This is why we often invite our patients to return for a second consultation appointment so that their orthodontist has the opportunity to study the information gathered at their first visit to make an accurate diagnosis before determining the correct treatment option.
There is no such thing as ‘extraction’ or ‘non-extraction orthodontic treatment’. You may be surprised to hear that arguments over whether teeth should be extracted or not as part of orthodontic treatment have raged for over one hundred years. However a reasonable contemporary view would be that not all patients and faces are the same and it would be illogical and ludicrous to attempt to treat all patients and faces in exactly the same way.
There are several reasons why teeth may have to be taken out is some orthodontic patients. Some of these include:
- Extraction to relieve severe crowding of the teeth particularly when the jaws are very small, or the teeth are very large and/or impacted;
- Extraction because of the presence of more than the normal number of teeth;
- Extraction of teeth that are hopelessly distant from their correct positions and are impossible to move to where they should be;
- Extraction of very decayed, broken-down or infected teeth that cannot be saved by the general dentist in the long-term;
- Extraction of some baby teeth to encourage their corresponding adult teeth grow into their correct positions;
- Extraction of some baby teeth to encourage spontaneous and natural alignment of crowded adult teeth;
- Extraction of side teeth to enable very protruding upper and/or lower teeth be pushed back.
Each individual case should be studied and analysed carefully, taking various factors and circumstances including the patient’s facial profile into consideration. Only then, treatment should be planned based on the specific and unique factors that have created the orthodontic problems in that particular patient. The solution may or may not involve the extraction of teeth. In any event, our priority is always to obtain good facial balance and a full attractive smile.
In all of these cases no space is left behind after teeth are taken out. The spaces either close naturally because other teeth need more room, and/or braces will help the closure of spaces in the right way.
Given that it would be the aim of all specialist orthodontists to provide beautiful smiles in beautiful faces, it would seem, from all of this, that one type of treatment would not be appropriate for all. While there is definitely a bias towards treating without extractions of teeth at the present time, the concept that the extraction of teeth in orthodontic treatment always results in a flattening of the face and lip profile just cannot be supported when all the available scientific and clinical evidence is assessed.
Extractions themselves do not cause negative effects on the teeth, jaws or face. However, it is poor planning decisions and poor treatment control which may cause those effects. The advice therefore for prospective orthodontic patients and their families would be to make sure that they understand the reasons for all decisions – including extractions – made in relation to their treatment. If there is any doubt, we encourage you to seek another professional opinion.
Whatever the case, when treated by Dr Sarah Good or Dr Pourghadiri, our patients should expect to receive treatment of a superior standard, which not only produces straight teeth, healthy jaw function and a beautiful smile, but which also enhances their self-esteem and confidence in the long-term.