How to extract teeth during orthodontic treatment?

Many people have heard that orthodontic treatment may require tooth extraction, but they do not fully understand the principles of tooth extraction. Therefore, when dentists suggest tooth extraction, patients often hesitate. Especially when multiple teeth need to be extracted, they feel even more torn.

In fact, the dentist's decision on which teeth to extract and how many teeth to extract is made after weighing the pros and cons based on the treatment needs.

Four principles of tooth extraction during orthodontic treatment

1. Conservative principle

Tooth extraction will have adverse effects on periodontal tissues, adjacent tooth relationships, and occlusal relationships. Therefore, during orthodontic treatment, it is advisable to take a cautious attitude towards tooth extraction and respect the opinions of parents and patients. Try not to extract teeth in critical cases.

2. Principle of priority for diseased teeth

Oral examination and full-mouth dental X-ray examination before tooth extraction not only help to fully understand the patient's condition, scientifically diagnose the type of deformity and reasonably formulate a correction plan, but also help to understand the health of the entire oral cavity and periodontal health. In the case of tooth extraction, if impacted teeth, supernumerary teeth, short-rooted teeth, curved-rooted teeth, and severely carious teeth are found, these teeth should be extracted as much as possible.

3 Right symmetry principle

Unilateral tooth extraction may cause the midline to deviate to one side, affecting facial symmetry, so symmetrical tooth extraction is generally advocated. Unless the original dental arch is obviously asymmetrical, unilateral tooth extraction should be chosen with extreme caution. This is one of the reasons for the large number of teeth to be extracted (double the number).

4. Principle of coordination between upper and lower levels

In most cases, after teeth are extracted from one arch, teeth from the opposing arch also need to be extracted so that the upper and lower arches can not only maintain a harmonious tooth count but also achieve a good occlusal relationship. This is another reason for the high number of teeth to be extracted (double the number).

In summary, tooth extraction is not an arbitrary choice during orthodontic treatment, but a rational decision based on professional analysis of the objective condition.