Why are extractions sometimes necessary as part of orthodontic treatment?

Every course of orthodontic treatment needs to be tailored to the needs of the individual patient. Sometimes your orthodontist or dentist will need to extract one or more adult teeth in order to achieve the best possible result.

1) To treat dental overcrowding

It is sometimes impossible to provide a successful result where there is dental overcrowding without extracting adult teeth to create space for the desired tooth movement. Expansion of the dental arches and/or backward movement of teeth can create space for some patients but this is not appropriate for everybody and there are limitations as to how much space can be created this way.
This means that for many people with more severe crowding, extractions may be inevitable to get the best and most stable result. 

2) To enhance appearance and profile

In some patients, when attempts are made to provide a treatment without extracting teeth in a crowded mouth, the result can be front teeth or lips that protrude, which may be detrimental to facial profile and appearance.

3) To avoid the risk of damage caused by moving teeth excessively outwards.

When straightening severely crowded teeth without extractions, there is a risk that the teeth will be pushed outside the bone leading to subsequent gum recession.

How will I know if I need teeth extracted?

Much depends on the problem which needs correcting. A decision can only be reached on the basis of a detailed case assessment by your dentist or orthodontist. What is important is to have an assessment by someone who has the right training and experience. 

You must feel confident that the explanation you have been given is appropriate for you or your child. For some patients, in order to get the best appearance and long-term stable result, extractions will be the most appropriate option. 

Any claims that treatment can always be completed without extractions, especially before an assessment has been completed, should be regarded with considerable caution. If you are unsure about the advice you are receiving, you should discuss your concerns with your own dentist or seek a second opinion from a specialist.