Is Removing Teeth For Braces Necessary?

My daughter’s orthodontist wants to have four of her teeth pulled before braces. Why does he want to do that and if we don’t, what will happen?

Dr. Mike Lakota of Lakota Dental in Shorewood, IL explains why removing teeth before getting braces may be necessary.

Pulling teeth for orthodontic purposes has been a common practice for many years.  Usually, this is done when there is crowding of teeth and the orthodontist wants to create some space in order to straighten the teeth easier.  Fortunately, we are learning that we can also create space by expanding the jaws orthodontically.  Though some instances best advocate removing teeth, expanding the jaws eliminates many possible TMJ or “jaw joint” issues in the future.

When the teeth are removed, the lower jaw is usually set too far back after completion of the braces.  This often leads to compression of the joint and causes the joint to “remodel”.  You often know this by a “click” or “pop” of the joint which can cause headaches, difficulty chewing, and clenching or grinding of your teeth.  These symptoms don’t appear until years later.  I often see them starting in their early 20’s.  If you think this might describe you, look at your lower front teeth in a mirror.  If the teeth are chipped or worn down where the teeth are “square” on the top, then you are grinding forward.  Your jaw is telling you it doesn’t like to be positioned so far back.  In fact, one way in correcting sleep apnea is to wear a device that positions the lower jaw down and forward, thus opening the airway.

Expanding the jaws is a lot easier at an early age (between 7-9) and can lessen the need for extractions.  I’m sure your Orthodontist explained the options to you.  It’s up to you to determine what you feel is best.  Treating and correcting a TMJ issue can be done later, however, it’s much easier to prevent.