Will I Need to Have Teeth Pulled to Get Braces?

  • By Peter
  • 05 Sep, 2016

Many people assume that tooth extractions go hand in hand with orthodontics. In some cases, a parent comes to the office with a child for a consultation and assumes the child will need teeth pulled because that’s how their own orthodontic treatment unfolded twenty or thirty years ago.

Although extractions are sometimes necessary, they are not a given for every patient. In fact, we try to avoid them when possible. At your first appointment and exam, we will be able to give you a good idea of whether you or your child is a candidate for extractions. Just because a parent, sibling, or other relative needed teeth removed prior to braces does not mean your treatment will progress the same way.

Reasons for Tooth Extractions during Orthodontic Treatment

There are several reasons why orthodontists remove teeth as part of orthodontic treatment. In some patients, early orthodontic intervention will achieve a much more satisfactory result. Many younger patients still retain some baby teeth. To get the best results, we sometimes opt to pull these teeth so the adult teeth can move to their permanent position.

In other patients, we must remove permanent teeth due to overcrowding. For example, some patients simply have a small jaw and no amount of maneuvering will create enough room for their teeth. Other patients have protruding teeth or a severe overbite or underbite. We can sometimes correct these problems through surgery and other methods, but removing the teeth – often the premolars – is frequently enough to give us the space we need to create a beautiful, functional smile.

Will a Palate Expander Help?

Beginning your orthodontic treatment sooner rather than later might help you avoid extractions. Palate expanders are a great way to eliminate overcrowding. To be effective, however, a palate expander must be placed before the growth plate in the roof of the mouth has fused. This fusion usually takes place somewhere between age 14 and 16.

The palate expander attaches to the upper arch of the teeth and can be fitted or removable. A fitted palate expander is actually bonded to the teeth. Once the palate expander is in place, the child or the parent uses a key-like device to turn a small screw in the expander once or twice each day. This is a relatively painless process, however, some children report feeling pressure and minor discomfort.

What about Wisdom Teeth?

Some patients wonder whether they should consider having their wisdom teeth extracted prior to getting braces. Wisdom teeth are actually a third set of molars that tend to erupt in the teen years or sometimes during a person’s twenties.

Although wisdom teeth can cause the teeth to shift after orthodontic treatment is complete, the majority of patients will notice when their wisdom teeth start to erupt. Because wisdom teeth don’t always cause problems, many patients choose a wait-and-see approach rather than having their wisdom teeth removed before a problem develops.

Interestingly, about 35 percent of the population does not have wisdom teeth. There are several theories that attempt to explain the reason behind this. Some researchers point to a change in ancient humans’ diet, while others say a random genetic mutation caused our ancestors to pass down a no-wisdom teeth gene to a lucky percentage of the population.

Whether you need an extraction, or alternative treatment options suit your smile, extractions don’t have to be scary or intimidating. If your tooth is infected or severely impacted, you may need to visit an oral surgeon who specializes in removing teeth as quickly and painlessly as possible.  

Call to Schedule Your First Appointment

We serve patients in the greater San Diego region, including La Jolla, Carmel Valley, and Del Mar. Get in touch today to find out what we can do for you.


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