Understanding the Reasons for Teeth Removal in Orthodontics

Why tooth extractions? Orthodontists recommend tooth extractions for various reasons, primarily related to achieving proper alignment and function of the teeth and jaws. Here are some of the main reasons why tooth removal may be necessary in orthodontics:

Inadequate Space in the Arch

Tooth extraction for braces is often necessary when there isn’t enough space in the arch. This lack of space can cause teeth to crowd or overlap, as the arch is too small to accommodate all the teeth properly. To align your teeth, an orthodontist may need to create space by removing certain teeth, allowing the remaining teeth to be positioned correctly.

When there is less space required to position the teeth than what is available, it may be necessary to either enlarge the arches or reduce the number or size of the teeth. Mild to moderate crowding can sometimes be managed by expanding the arches, but this expansion may be limited by the bone structure, facial aesthetics, or the supporting gum tissues. In cases of moderate to severe crowding, extracting permanent teeth might be necessary to create sufficient space.

Overcrowding
Protrusion

Protrusion

Another reason for tooth removal is protrusion. Extracting some side teeth can provide the space needed for the orthodontist to move the protruding teeth backward, thereby improving the facial profile and dental function. This approach is particularly beneficial for patients with a dental arch that is too large for their facial structure (Graber et al., 2011).

Achieving Symmetry

Tooth extraction may be necessary to achieve a harmonious and symmetrical dental arch. For instance, if a tooth is congenitally missing or has been lost due to trauma or decay, extracting a corresponding tooth on the opposite side can help maintain symmetry. This ensures that the bite remains balanced and the smile appears even and natural. Strategic extractions are often employed to enhance the overall outcome of orthodontic treatment (Bishara, 2001).

Managing Impacted Teeth

Impacted teeth, especially wisdom teeth, are those that fail to erupt properly due to being blocked by other teeth or a lack of space. Impacted teeth can cause pain, infection, and damage to adjacent teeth. Removing these teeth can prevent these issues and facilitate effective orthodontic treatment. A comprehensive review in the American Journal of Orthodontics and Dentofacial Orthopedics highlights the importance of timely removal of impacted teeth to ensure successful orthodontic outcomes (Daskalogiannakis, 2000).

Impacted tooth
Missing tooth

Correcting Bite Issues

Malocclusions, or improper bites, include conditions such as overbites, underbites, crossbites, and open bites. These issues can cause problems with chewing, speaking, and maintaining oral hygiene. In some cases, removing specific teeth can help in repositioning the jaws and teeth to correct the bite. For example, in patients with a severe overbite, extracting teeth from the upper arch can allow the orthodontist to retract the front teeth, resulting in a more balanced and functional bite (Nanda, 2016).

Conclusion

Tooth extraction in orthodontics is a well-established and often necessary procedure to create a healthy, functional, and aesthetically pleasing dental arrangement. Whether addressing crowding, correcting bite issues, or managing impacted teeth, the reasons for teeth removal are varied and patient-specific. Understanding these reasons helps patients appreciate the benefits and necessity of this procedure in order for our dentist at Smile Craft Dental Clinic Puchong to be able to help you in achieving the best possible orthodontic outcomes.

References

  1. Nanda, R. (2016). Esthetics and Biomechanics in Orthodontics. Elsevier Health Sciences.
  2. Daskalogiannakis, J. (2000). “Impacted Teeth and Their Influence on Orthodontics.” American Journal of Orthodontics and Dentofacial Orthopedics, 118(4), 483-487.
  3. Graber, L. W., Vanarsdall, R. L., & Vig, K. W. L. (2011). Orthodontics: Current Principles and Techniques. Elsevier Health Sciences.
  4. Bishara, S. E. (2001). Textbook of Orthodontics. W.B. Saunders Company.

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