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Is teeth extraction necessary when going for orthodontic treatment?

When people realize that they have teeth problems, one of the main concerns they always have is whether the orthodontic treatment they will go for includes teeth extraction. In orthodontic treatment, whether or not a patient’s teeth need to be extracted is a topic that must be discussed by a dentist or an orthodontist and the child’s parent or the patient. However, current trends and the reason why a Selbstligierende Keramikbrackets (Self-Ligating Appliance) is used in orthodontist are because the treatment is moving towards the non-extraction of permanent teeth where applicable. Even if there is minor crowding of teeth, this can still be treated without using dental extractions.

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Minor crowding of teeth can be corrected by using either removable or fixed orthodontic appliances such as ceramic brackets which can expand the jaws and relieve crowding. Patients are most likely to seek for orthodontic evaluations mainly because they have noticed dental crowding. Moderate to severe dental crowding may require teeth extraction in order to relieve the crowding. Teeth extraction, however, has a problem whereby the exact teeth to be extracted is controversial. In traditional orthodontic treatment, bicuspids were mostly extracted (two from the lower arch and two from the upper arch). Removal of the first four bicuspids is relatively easy to perform and very beneficial for patients with protruding faces.

The difference today is that dentists are now recommending that second molars should be removed instead of the first four bicuspids. The option to remove second molars is mostly favored in few cases because this allows for fuller smiles in patients. It also creates room for wisdom teeth or third molars to develop into their original position. In case there are no second molars in the mouth, wisdom teeth erupt into their position. Thus, surgical extractions of the wisdom teeth are often avoided, and orthodontists do this by allowing the wisdom teeth to grow into the space where second molars were extracted. But where extraction is not necessary, molar bands can be used to correct the teeth.