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Patients commonly wonder about tooth extraction when it is recommended as a part of orthodontia treatment. Sometimes orthodontists recommend removing healthy teeth when they believe it is necessary for successfully treating malocclusions or correcting other problems with bite alignment. Understandably, patients are often hesitant to agree to the removal of healthy teeth. There are some legitimate reasons for taking this drastic step, but you should ask a few key questions before agreeing to this course of treatment. Reasons for Not Extracting Healthy Teeth Let’s start with reasons why you might refuse to agree to the extraction of one or more healthy teeth. This course of action should be used only as a last resort, when no other options would possibly achieve the same goals. If the patient is your child, talk to your family dentist to determine whether his or her jaw has stopped growing. If it is still growing, seek an additional opinion about the proposed tooth extraction. In non-adults, extraction is not recommended unless the malocclusion is severe (known as a class III condition). Some patients do not agree with the elective extraction of teeth or other surgical procedures for religious or other personal reasons. Finally, if any potential risks might outweigh the benefits, it is well within your right as a patient to refuse. Why it’s OK to Extract Some Teeth for Orthodontia In some cases, the extraction of one or more healthy teeth is to the patient’s benefit. If your jaw is truly too small for the number of teeth you have, there is no real way to change that. Overcrowding can result in a variety of problems with gum tissue and long-term bone loss. If extracting one or more teeth will not adversely affect your facial structure (the teeth support the lips and face), or if it will improve the symmetry of the face, this offers less cause for concern. Sometimes orthodontists perform a single-tooth extraction to correct a misaligned bite or to bring the midline back into position, both of which are structurally important for a healthy mouth. Ask These Questions if Your Doctor Recommends an Extraction If your orthodontist recommends extracting healthy teeth, ask for a comprehensive explanation, accompanied by a visual representation of the intended results. Ask about potential alternatives and how they might impact the treatment plan. It is within your right to ask your doctor if he or she generally tries to avoid the extraction of healthy teeth or doesn’t hesitate to recommend it if it’s the best option for the patient. If you believe that refusing extraction may be the right choice, ask your orthodontist to explain to you clearly and honestly the implications of your choice and how it will affect your treatment program with regard to time, cost and ultimate results. The goals for orthodontia extend beyond aesthetics. Correcting the bite and achieving proper alignment are even more important goals for future dental health. If having an extraction is necessary to ensure the future health of teeth and gums, it’s likely to be a worthwhile course of action. When in doubt, you can always seek a second opinion on the proposed tooth extraction from a qualified orthodontist in your area.
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