Braces are the simplest and the most effective way of aligning teeth and gifting patients a beautiful smile that they truly deserve. One of the main reasons people opt for orthodontic treatment is crowded or crooked teeth, which are protruding. A common practice to orthodontically treat these cases is the extraction of premolars. This is don’t to achieve the best results and find space to align the crowded teeth appropriately. However, the orthodontist takes into consideration other non-extraction options to align teeth and suggests extraction only as the last resort.

It is normal for people to wonder if extractions are the best option. Tooth extractions also make people nervous. Let us understand more about tooth extractions as a pre-orthodontic treatment.

When Do You Need a Tooth Extraction Before Braces?

Not all patients who need braces need tooth extractions. In fact, in a large number of cases, orthodontic treatment can begin immediately, without the need for any tooth extractions.  The number of teeth that require extraction ranges from 1 to 4, depending upon each case. When there is an asymmetry in bite or smile, an odd number of teeth may be extracted. In some cases where the crowding is only in one arch, teeth are extracted only from that arch.


Here are some cases when tooth extraction is useful:

  • Severe crowding, either due to small jaw size or big tooth size or a combination of both.
  • Heavy protrusion of teeth in the upper and lower arch gives the face a convex profile
  • When there is a disharmony in the skeletal structure of the face where one jaw is ahead or behind the other
  • For better alignment results
  • To eliminate unusual teeth- Some people have extra teeth that can apply unnecessary force on the other teeth and disrupt their alignment. It is best to extract these teeth and their space is used to shift and align the others.
  • Allow normal jaw growth and development: If your orthodontist diagnoses that your teeth are impeding the growth of your jaws, tooth extraction may be recommended before proceeding with braces.
  • To get rid of impacted wisdom teeth: Your wisdom teeth grow in the later teenage years and their eruption can disrupt the alignment of your teeth or interfere in your braces treatment.

Which Teeth Are Extracted?

Tooth extraction can make you nervous and more so wondering about which teeth may be extracted. After a thorough clinical evaluation, your orthodontist will determine which tooth or teeth need to be extracted before your braces treatment. Most often, it is the 4th or the 5th teeth from the front, on both sides of the jaw, in both jaws. However, each case is different and so is their treatment plan.

Is Extraction the Best Way Orthodontic Treatment

Are There Alternatives to Tooth Extraction Before Orthodontic Treatment?

Tooth extractions before orthodontic treatment are routinely done and extremely safe. They offer long-lasting effects and give you a healthy smile. But if you are wondering about alternatives to tooth extraction– do they exist? Well, indeed there do!

Tooth extraction alternatives have always existed but whether to recommend tooth attraction or not depends largely upon the patient’s case.

Some alternatives for tooth extraction before braces are:

  • Widening of the palate: This is very commonly recommended in children as they are still growing. This growth in children is used to widen their palate to create space for aligning teeth rather than extracting teeth. The orthodontist uses removal or fixed devices to allow palate expansion. Once the palate has expanded as per the need, the orthodontist uses the space created to align teeth.


  • Surgical widening of the palate: If palatal widening is not possible using removable or fixed devices, surgical widening is done by adding bone to the palate.


  • Distalization: This is a procedure by which the teeth in the mouth are pushed slightly backwards to make space for the crowded teeth. This can prevent tooth extraction for an orthodontic patient.

Is Teeth Extraction Safe?

If your orthodontist feels you need extractions before your braces treatment begins, you will be referred to a general dentist or an. Oral surgeon for the process. The procedure of teeth extraction is a safe procedure and is routinely performed by dentists.

Extraction the Best Way for Pre-Orthodontic Treatment

When you arrive for your tooth extraction, the dentist will use local anaesthesia to numb the area around the tooth or teeth that need extraction. The tooth is, therefore, removed painlessly. After post-extraction instructions and some pain medication, you can go home the same day. 2-3 weeks after your extraction areas in your mouth have healed, your orthodontist will begin your braces treatment.

Takeaway Message!

Tooth extractions are routinely done prior to braces treatment. There are other alternatives to extractions but the treatment varies for each patient based on their teeth alignment.


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