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Considering Orthodontic Treatment Part 4: Pulling Permanent Teeth

August 23, 2017

After your initial exam with an orthodontic provider to check for misaligned teeth and a “bad bite,” one or more treatment plans will be presented. If your doctor recommends pulling any permanent teeth, it’s wise to stop and think twice.

The question you should be asking is, “Is there a better option than pulling out my permanent teeth?”

The Consequences of Pulling Teeth

Removal of permanent teeth is more of a last resort than a treatment of choice. Unless this is a “last resort” case, a doctor may be recommending extractions when modern orthodontic techniques could treat equally or better, without removing teeth.

Pulling permanent teeth can compromise the health of gum and bones, and result in long-term negative effects on facial structures. The negative effects seen in the aging process are a huge deterrent to extraction. As people age, their lips naturally flatten out. The test of time shows that, in patients who had permanent teeth extracted, this flattening is significantly magnified because support for the lips was reduced.

Nobody wants the pain of permanent tooth removal if a fuller, more beautiful smile can be achieved through a less painful, more effective, treatment.

Advances That Prevent Pulling Teeth

In the past, up to 75 percent of orthodontic cases included the removal of permanent teeth. Fortunately, the number of cases best treated by extractions has drastically reduced with early orthodontic intervention and advanced treatment options. Improved wires, better braces and research proving the cause of crowding are three advances that allow orthodontists to avoid pulling permanent teeth.

  1. The Real Reason for Crowded Teeth

In the past, orthodontists believed that crowding was due to teeth that were just too big to fit in one’s mouth. Research has shown that this is not the case at all. Crowding is a result of smaller dental arches. Instead of pulling permanent teeth, orthodontic treatment should focus on creating additional room for crowded teeth.

  1. Gentler Wires

Today’s wires provide a much lighter and gentler force on the teeth than traditional, stainless steel wires. This gentleness allows the bone to adapt and change with the movement of teeth, increasing the ability to treat more cases without pulling teeth.

  1. Better Braces

Traditionally, braces were tightened with small wire tires or colored elastics. They kept the wires in place but caused friction and prevented the teeth from sliding freely. Now, braces have a door or clip that opens and closes to hold the wire in place. This new type of brace does not require ties or elastics, so teeth are free to slide and don’t need to be pushed as hard to move.  In our office, the Damon System braces have completely changed the way we treat certain cases and have mostly eliminated the need for permanent tooth extraction in our patients.

Make Room

These discoveries and advanced technologies allow orthodontists to make room for teeth, rather than to remove them. If a doctor recommends the extraction of permanent teeth, be sure to advocate for yourself and consider getting a second opinion. Once teeth are removed, they’re gone for good!

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