There's usually more to straightening a smile than simply applying braces. That's why an orthodontist takes the time first to learn all they can about a patient's bite and, depending on what they find, take other actions before treating with braces or clear aligners. One such action might be removing one or more teeth.
That might at first seem out of place with our intended goal of straightening teeth. But there are situations where subtracting teeth can benefit bite correction. Here are a few scenarios where a dental extraction might be necessary before orthodontics.
Crowding. When a jaw is failing to grow to a normal width, teeth erupting later may not have sufficient room and thus come in misaligned. It's possible to help widen the jaw during early growth development through a device called a palatal expander, but it's best attempted before puberty. Later, it may be easier to open up more room for tooth movement on a crowded jaw by removing select teeth.
Impacted teeth. Impaction occurs when a tooth doesn't properly erupt and remains totally or partially submerged below the gum line. Although in some situations we may be able to coax an impacted tooth down onto the jaw, it may be easier to extract it, along with the matching tooth on the other side of the jaw for balance. We can then move the teeth or use other restorations to close the gap.
Jaw abnormalities. A bite problem may in reality be a jaw problem: For example, a lower jaw set too far back may not be aligning properly with the upper jaw causing the bite to skew. Jaw surgery could correct this alignment, but those procedures can be highly invasive. An alternative is to remove a couple of select upper teeth, then use braces to move the remaining teeth back. This can result in a less noticeable overbite.
Orthodontics not only enhances your appearance, it can also a improve your oral health. Extracting one or more teeth may be a necessary prerequisite to straightening your smile.
If you would like more information about straightening a smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removing Teeth for Orthodontic Treatment.”