Do I need tooth extractions for my orthodontic braces?
Apr 2, 2017
Orthodontic treatment or braces is the treatment of choice for misalignment and malocclusion. Ideally, treatments will involve the mere pushing, pulling, tipping, tilting and rotation of the teeth. Different forces are placed on them to bring them to the proper position. And sometimes, there is a need for tooth extractions.
Common Myths about Extractions
Orthodontic treatment often involves the use of braces or aligners to straighten teeth and correct misalignments. However, when it comes to the role of extractions in orthodontics, there are several myths that need to be addressed.
One common misconception is that extractions are only necessary for severe cases of overcrowding. While it is true that extractions can help create space in overcrowded mouths, they are not limited to such situations.
Another myth is that extractions can lead to a sunken or hollow appearance of the face. This misconception stems from the belief that removing teeth will cause the lips to cave in. However, this is not the case. Orthodontists carefully consider the overall facial harmony and balance when recommending extractions, ensuring that the result is aesthetically pleasing.
Another misconception is that extractions are a painful and traumatic experience. With advancements in dental technology, the extraction process has become safer and more efficient. Local anesthesia is used to ensure a pain-free procedure, and orthodontists take measures to minimise discomfort during and after the extraction.
Understanding the benefits of Extractions
Now that we have addressed some common myths surrounding extractions in orthodontics, let’s explore the numerous benefits they can provide.
One of the primary reasons why extractions may be recommended is to address overcrowding. When there is not enough space in the mouth for all the teeth to properly align, extractions can create the necessary room, allowing for more effective orthodontic treatment.
Another is to remove “extra tooth”. Sometimes the teeth are removed because they erupted outside of the occlusion, or it did not erupt at all. Although in some cases, impacted canines and premolars are taken out and bought into place within the jaw, some teeth may just be removed. When they are extra teeth because the smile can do without them, they are just taken out.
To prevent relapse. In the case of impacted molars or wisdom teeth, their removal may be prescribed as a preventive measure. Wisdom teeth that are impacted will not come out into occlusion anymore, but their position within the bone can be destructive, because they can push the adjacent teeth. This is why relapse is common after braces. When the wisdom teeth are left after braces, they may render the treatment useless, because of the relapse. A valuable measure would be to take them out, whether they are present with any symptoms.
Extractions can also play a crucial role in bite correction. When the upper and lower jaws do not fit together properly, it can lead to various issues, including difficulty chewing, speech problems, and jaw pain. By strategically extracting teeth, orthodontists can manipulate the position of the remaining teeth, improving the alignment of the bite and restoring proper functionality.
Another benefit of extractions is the enhancement of overall facial harmony. The position and size of the teeth impact the appearance of the face. In cases where the teeth are protruding or too large for the jaw, extractions can help achieve a more balanced and aesthetically pleasing facial profile.
Finally, to reduce the total treatment time. If the teeth are to be moved to the desired new position without extraction of teeth, the whole treatment may consume a lot more time than usual and the treatment may extend from one year to two or two and a half in some cases.
Factors to consider for Extractions
The decision to recommend extractions in orthodontic treatment is not made lightly. Orthodontists must carefully evaluate each patient’s unique situation to determine whether extractions are necessary. Several factors are taken into consideration during this process.
One of the key factors is the severity of the overcrowding or misalignment. In cases where the crowding is mild, alternative treatment options may be explored. However, when the crowding is more severe, extraction may be the most effective way to create the necessary space for proper alignment.
Overall facial profile is another crucial aspect to consider. Orthodontists assess the relationship between the teeth, jaws, and soft tissues of the face to determine whether extractions will improve facial harmony. This evaluation considers factors such as lip support, the position of the chin, and the balance of the features.
The patient’s age and oral health play a role in the decision-making process. Younger patients may have more growth potential, which can influence the treatment approach. The presence of any underlying dental or periodontal issues will also be taken into consideration to ensure that extractions are safe and appropriate.
Process of extracting Teeth
Orthodontic extractions are typically performed by an oral surgeon or a general dentist with specialised training in oral surgery. The procedure is usually carried out under local anesthesia to ensure the patient’s comfort.
Prior to the extraction, the dentists or oral surgeons will take detailed X-rays and impressions of the teeth to aid in planning the procedure. These images help determine the exact location of the teeth to be extracted and ensure that the orthodontic treatment can progress smoothly.
During the extraction, the oral surgeon or dentist will carefully remove the selected teeth. The area will be numbed with local anesthesia to minimise any pain or discomfort. The extraction process may involve gently rocking the tooth back and forth to loosen it from its socket. In some cases, a small incision may be made to facilitate the removal of the tooth.
Once the tooth is extracted, the orthodontist will provide instructions for post-extraction care. This may include recommendations for pain management, oral hygiene practices, and dietary restrictions. Following these instructions is crucial for a smooth recovery and successful orthodontic treatment.
Potential Risks and Complications of Extractions
As with any dental procedure, there are potential risks and complications associated with extractions in orthodontics. However, it is important to note that advancements in dental technology and the expertise of orthodontic professionals have minimised these risks significantly.
A potential risk is the possibility of infection at the extraction site. To mitigate this risk, dentists or oral surgeons prescribe antibiotics or antimicrobial mouth rinses following the extraction. It is important for patients to follow the prescribed post-extraction care instructions to minimize the likelihood of infection.
There is potential complication is damage to adjacent teeth or surrounding structures during the extraction process. However, dentists or oral surgeons take great care to protect surrounding tissues and minimize the risk of such damage. By utilising advanced imaging techniques and careful surgical techniques, the chances of complications are reduced.
In rare cases, patients may experience prolonged bleeding or delayed healing after an extraction. This can be caused by various factors, including underlying health conditions or medication use. It is important for patients to inform their dentists or oral surgeons of any pre-existing medical conditions or medications they are taking to ensure appropriate measures can be taken to minimize the risk of complications.
Alternative treatment options to Extractions
While extractions can be highly beneficial in many cases, there are alternative treatment options available for certain orthodontic conditions. It is important to understand that extractions are not the only solution, and that each patient’s situation is unique.
In cases where the crowding is mild to moderate, alternative treatment options such as expansion or interproximal reduction (IPR) may be considered. Expansion involves widening the dental arches to create additional space for alignment. IPR, on the other hand, involves selectively removing tiny amounts of enamel between the teeth to create space.
For patients who are averse to extractions or have specific medical conditions that make extractions risky, alternative treatment options may be explored. It is important to consult with an experienced orthodontist who can assess your specific needs and recommend the most suitable approach for your case.
Making an informed decision
Extraction plays a valuable role in orthodontic treatment, addressing issues such as overcrowding, bite correction, and overall facial harmony. By debunking common myths and shedding light on the benefits and considerations associated with extractions, this article has provided you with a comprehensive understanding of their role in orthodontics.
It is important to remember that extractions are not the only solution and that alternative treatment options may be available depending on your specific needs. Consulting with an experienced orthodontist and considering factors such as experience, patient testimonials, and communication can help you make informed decisions about your orthodontic journey.
With advancements in dental technology and the expertise of orthodontic professionals, extractions have become safer and more efficient than ever before. By understanding the truth behind the extractions, you can embark on your orthodontic treatment with confidence, knowing that extractions, when recommended, can contribute to achieving the beautiful smile and facial harmony you desire.