Does Straightening Teeth Mean Pulling Teeth?

Mar 11, 2021 | Patient Education

Should teeth be pulled as part of orthodontic treatment with braces? The answer to that question is the subject of significant debate amongst dentists, orthodontists and even periodontists near you. Like so many other questions that people undergoing orthodontic treatment and parents of children about to receive braces, the question is too important to answer with a simple and dogmatic “yes” or “no.” The truer and more nuanced answer to the question is that “It depends.” What does it depend on?

Whether or not you or your child should have teeth pulled as part of orthodontic treatment is something you should discuss carefully with your dentist, orthodontist or periodontist in Kelowna after they’ve carefully reviewed the condition and position of your teeth, images of your developing teeth and jaw, and your prior medical and dental history. Depending on that careful review and assessment, a dentist, orthodontist or periodontist may recommend undergoing tooth extraction in Kelowna in the following circumstances.

Severe crowding

Mildly crowded teeth do not generally require any extraction in the context of orthodontic treatment with braces or aligners. Braces and aligners can in fact treat and resolve mild crowding. Severe overcrowding, on the other hand, may mean you or your child have insufficient space for the number of your current or emerging teeth. Your dentist may recommend that you undergo a tooth extraction in Kelowna to address severe overcrowding as part of your orthodontic treatment plan

Bite asymmetry

One of the causes of misaligned teeth is because your jaws don’t align properly. Misaligned upper and lower jaws cause orthodontic issues referred to as overbites and underbites. One common cause of misaligned upper jaws that contribute to misaligned teeth is a size difference between your upper and lower jaws — a situation called bite asymmetry. In most cases, someone’s jaw asymmetry is minor enough that it doesn’t interfere with orthodontic treatment. If the asymmetry is extreme enough, however, the extraction of one or more teeth — or even corrective jaw surgery —may be required. In some cases, extracting teeth may be enough to correct the asymmetry without the need for corrective surgery.

Tooth protrusions

One of the teeth alignment issues that has the largest effect on your appearance or your child’s appearance is tooth protrusion — when your front teeth extend and point outwards from your jaw rather than up-and-down. Tooth protrusions affect the appearance of your lips and face generally. Extracting the teeth on either side of those front teeth may be necessary to allow your dentist to reposition your protruding front teeth properly.

Diseased teeth or gums

Seriously infected or diseased teeth or gums around teeth being manipulated through braces, aligners or other orthodontic treatment can interfere with that treatment. Similarly, teeth damaged by injury or accident can interfere with — or not respond predictably or appropriately to — treatment with braces or aligners. Your dentist may recommend a disease or damaged tooth be extracted to ensure your orthodontic treatment plan proceeds predictably and successfully.

Ankylosed teeth

Ankylosed teeth are teeth that are fused to your jaw bone. Ankylosed teeth can interfere with the smooth and effective progress of an orthodontic treatment plan. To eliminate that interference and any resulting distortion of your teeth and progress, your dentist may recommend that ankylosed teeth be extracted prior to or during treatment

Is it appropriate for you or your child to have teeth pulled as part of your or your child’s orthodontic treatment? We encourage you to avoid jumping to any immediate conclusion one way or the other, and to question closely any dental or medical professional who answers that question without carefully considering the position of your teeth and the development of your jaw. The question is an important one and one that deserves careful consideration.


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