Do you need a tooth extraction for orthodontics? A dentist explains the criteria for tooth extraction and non-extraction orthodontics!

shutterstock 249204610 2 tooth extraction

Last updated January 6, 2022

Oh my god!!!


In this article you will find

When is a tooth extraction necessary in orthodontics?

What happens if a tooth needs to be extracted but is not extracted?

Tooth extraction pain

Where to perform tooth extractions

Criteria for tooth extraction/non-extraction

You need a tooth extraction."

There are many situations in which the above words are spoken by dentists when orthodontic work is done.

In some cases, orthodontic treatment requires tooth extraction.

Tooth extraction treatment in orthodontics is one of the procedures for successful orthodontic treatment, though,

Do we really need to pull teeth?"

Some of you may be wondering.

In this issue.Why do we need tooth extractions for orthodontics?"."Criteria for Extraction and Non-Extraction Orthodontics."The following is an explanation of the following

Do we really need tooth extractions for orthodontic treatment?

Orthodontics Extraction

◎There are cases in which braces require tooth extraction

I don't want to pull out my precious teeth if I can help it."

Many people do not want to pull teeth when undergoing orthodontic treatment.

So is tooth extraction really necessary for orthodontic treatment in the first place?

The answer is, "Not all, but there are cases where tooth extraction is necessary.

The main reasons for tooth extraction in orthodontic treatment are

To provide space for teeth to line up

It is.

When straightening, if the jaw is not large enough for the teeth, there is not enough space for the teeth to line up.

Forcing orthodontic correction when there is insufficient space will result in rattled teeth or protruding front teeth.

For this reason, braces may require extraction of teeth.

What cases require tooth extraction?

The two main cases in which orthodontic treatment requires tooth extraction are as follows

Orthodontics Extraction

(1) When the jaw is small in relation to the size of the teeth

Today, more and more people have small chins due to soft textured foods, retort foods, and westernization of food.

In other words, this type of diet prevents the child from chewing properly and inhibits the growth of the jawbone.

A small jaw provides insufficient space for the teeth to line up properly, causing malocclusion.

When the jaw is small relative to the size of the teeth when orthodontic treatment is performed, extraction of teeth is performed to make room for the teeth to line up nicely.

If a small jaw is corrected without extraction, the following problems are likely to occur

...Bumpy teeth.

...front teeth protrude forward.

... the gums go down.

...and the bite goes wrong.

(2) When there is a large misalignment between the upper and lower jaw

A significant misalignment of the upper and lower jaws can have a significant impact on bite, masticatory function, and tooth alignment.

Surgery is one treatment to adjust the position of the jaw, but many people would prefer not to have surgery if at all possible.

In such cases, teeth are extracted to make space for the teeth to move, and braces are used to move the teeth to the back to straighten the alignment.

What happens if a tooth is not extracted in a case that requires extraction?

I'm going to regret pulling my tooth..."

Can you straighten my teeth without extracting them?"

Even in cases where teeth need to be extracted, there are patients who wish to "not have their teeth pulled" in this way.

So what happens if orthodontics is performed without extracting teeth in cases where extractions are necessary?

Disadvantages of orthodontic treatment without extraction of teeth when extraction is necessary include the following

(1) Front teeth protrude forward (mouth gobble, gorilla face)

If teeth need to be extracted but are straightened without removing them, there will not be enough space for the teeth to line up.

As a result, the front teeth protrude forward, so-called"Mouth gobos," "gorilla faces."may be as follows.

(2) The back teeth are not meshing properly.

When orthodontic treatment is performed without tooth extraction, not only the front teeth but also the back teeth are more likely to be affected.

Forcing orthodontics when there is no space can lead to problems such as improper meshing of the back teeth or back teeth falling at an angle.

(iii) Gums go down.

Orthodontic correction without tooth extraction in cases where extraction is necessary may cause the gums to fall back.

This is because forcing orthodontic treatment when there is not enough space for the teeth to line up properly displaces the teeth from their proper position in the bone, which leads to alveolar bone resorption.

In particular, Japanese people have thinner alveolar bone and gums than Westerners, so they are more prone to gum lowering problems with non-extraction orthodontics.

(iv) Redoing the treatment takes extra time.

When orthodontic treatment is performed without removing teeth even though extraction is necessary for protruding (maxillary protrusion) or receiving (mandibular protrusion) teeth, the treatment may be completed without much orthodontic effect.

In such cases, the tooth must be extracted and the treatment redone.

In some cases, it may take several years or more to redo the work, which can take extra time.

Is tooth extraction painful? Where should I have my tooth pulled?

Orthodontics Extraction

◎Extraction is not as painful as you might imagine

In cases where teeth are extracted for orthodontic reasons, many patients are concerned about pain during extraction.

It is true that many people have the image that "pulling teeth is painful.

When extracting a tooth, more anesthesia is injected than is normally used for carious tooth treatment.

For this reason, it is less painful than you might imagine.

The anesthesia is working.

What was that?" When did you pull that out?"

Some patients are so disappointed with the results that they are not even aware of it.

Don't worry too much.

Pain and swelling may occur after tooth extraction, which can be treated with pain medication and antibiotics.

◎Extraction is performed by general dentistry, which is separate from orthodontic dentistry

Where are teeth extracted during orthodontic treatment? In most cases, the teeth are extracted at a general dentist's office, which is separate from the orthodontic treatment clinic.

In rare cases, some orthodontists also perform extractions, but they are in the minority.

The patient may find the dentist who performs the extraction himself or the orthodontist may refer the patient to a dentist.

Tooth extractions required for orthodontic treatment are basically self-funded and are not covered by health insurance.

Most clinics charge several thousand yen to less than 50,000 yen at the highest.

What are the criteria for extraction and non-extraction?

The following three main criteria are used to determine whether teeth should be extracted or corrected non-extraction.

(1) Size of bumps (rattles) on teeth

If the teeth are bumpy (plexus, uneven teeth), extractions are necessary because of the increased distance the teeth must be moved. If the bumps are small, the teeth can be straightened without extractions.

(2) Size of anterior tooth tilt

If the anterior teeth are tilted too far forward, orthodontics will require extractions because of the increased distance to move the teeth back.

In some cases, the degree of tilting of the anterior teeth is small and can be treated with non-extraction orthodontics.

(iii) Size of mouth protrusion

In cases where the mouth protrudes far forward, the distance to move the teeth back is also longer.

This often requires extraction of the tooth.

In most cases, extraction is necessary, especially for those with mouth gobble and gorilla face.


I explained the criteria for extraction and non-extraction of teeth in orthodontic treatment.

In some cases, orthodontic treatment requires extraction of teeth.

... orthodontics can fail if teeth are not extracted when they need to be extracted.

Basically, extraction of teeth for orthodontic treatment is not so painful.

...Tooth extractions are often performed in a separate dental office from the orthodontist.

In orthodontic treatment, there are always cases where teeth must be extracted.

I don't want to regret pulling a tooth."

Rather, though, many patients who are,

'I've tried to straighten my teeth without pulling them out, failed, and regretted it.'

It is wise to avoid doing so.

I think it is possible that there is a strong desire from the patient to straighten the teeth without extraction because some degree of finish is acceptable,

Dentists who recommend orthodontics with a policy of never extracting teeth are not recommended.

Before undergoing orthodontic treatment, be sure to discuss your questions and treatment options with your dentist to your satisfaction, including whether to have teeth extracted or not.

If you are not sure which dentist to choose, please visit 365dentist for a free online consultation with a current dentist 😊.

imageSupervised by Dentist/issy

After graduating from the National School of Dentistry, he trained at the Tokyo Medical and Dental University Dental Hospital, and is currently working in general and orthodontic dentistry.

Member of the Japanese Society of Oral Implantology


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