Extraction versus Non-extraction

The debate about pulling teeth for braces has been going on for over 100 years. This website will not attempt to resolve this issue, but merely attempt to explain the debate and offer an opinion based on the available literature.

Why are teeth pulled for braces?
The necessity of extractions in a particular patient is most commonly a result of inadequate space availability in the dental arch. The crowding can be so severe in some people that entire teeth are blocked out of the arch. In those cases, the need for extraction is more obvious than in other patients. There are also times where it may be possible to fit all of the teeth into the arch with the braces and align the teeth, however, doing so may be at a detriment to the stability of the teeth, the gum tissue, or the esthetic appearance of the teeth or soft tissue. For example, in a patient that already has excessively flared front teeth (incisors), forcing these teeth further forward to fit in additional crowded teeth would flare them even further. It is well known that teeth forced too far forward may be more susceptible to relapse, and would ultimately give an unaesthetic result.
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