19 doctors weighed in:

Should orthodontist pull child's teeth for braces if crowded?

19 doctors weighed in
Dr. David Schleimer
Dentistry - Orthodontics
4 doctors agree

In brief: Sometimes

Every patient is different with skeletal and dental presentations that may warrant removal of teeth.
I am of the philosophical school of orthodontics that believes that expansion of the lower teeth, if more than just mild, will end in relapse or periodontal breakdown. By careful case selection and understanding growth and harmony of the face, extractions can be very successful.

In brief: Sometimes

Every patient is different with skeletal and dental presentations that may warrant removal of teeth.
I am of the philosophical school of orthodontics that believes that expansion of the lower teeth, if more than just mild, will end in relapse or periodontal breakdown. By careful case selection and understanding growth and harmony of the face, extractions can be very successful.
Dr. David Schleimer
Dr. David Schleimer
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Dr. James Ferguson
Pediatrics
3 doctors agree

In brief: Some do

Jaw growth and teeth allignment is what they know.
My understanding is that selective removal of some teeth can reduce alignment issues if done early enough. I am grateful for that procedure in my early teens, needed minimal work and still have my wisdom teeth decades later.

In brief: Some do

Jaw growth and teeth allignment is what they know.
My understanding is that selective removal of some teeth can reduce alignment issues if done early enough. I am grateful for that procedure in my early teens, needed minimal work and still have my wisdom teeth decades later.
Dr. James Ferguson
Dr. James Ferguson
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Dr. Hilary Baskin
Dentistry - Orthodontics
2 doctors agree

In brief: See your orthodontis

I agree that the "damon system" is the answer to everything response you got is highly misinformed and unprofessional.
Short answer, yes, sometimes teeth do need to be pulled to get optimal results. See a couple of orthdontists and get a couple of opinions, and do not beleive anyone who says damon is the only, or even the best solution (studies definately debate this!).

In brief: See your orthodontis

I agree that the "damon system" is the answer to everything response you got is highly misinformed and unprofessional.
Short answer, yes, sometimes teeth do need to be pulled to get optimal results. See a couple of orthdontists and get a couple of opinions, and do not beleive anyone who says damon is the only, or even the best solution (studies definately debate this!).
Dr. Hilary Baskin
Dr. Hilary Baskin
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1 comment
Dr. Zackary Faber
Sometimes teeth need to be extracted. There should be an ndividual plan for each patient. There is no magic appliance.
Dr. S. Jay Bowman
Dentistry - Orthodontics
2 doctors agree

In brief: Perhaps it's needed

Actually, extraction treatment is supported by vast scientific literature as superior when the removal of teeth is warranted (typically patients that have significant crowding and/or protrusion.
Expansive treatment, on the other hand, often demonstrate the least stability. Seek an opinion with a licensed orthodontic specialist.

In brief: Perhaps it's needed

Actually, extraction treatment is supported by vast scientific literature as superior when the removal of teeth is warranted (typically patients that have significant crowding and/or protrusion.
Expansive treatment, on the other hand, often demonstrate the least stability. Seek an opinion with a licensed orthodontic specialist.
Dr. S. Jay Bowman
Dr. S. Jay Bowman
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Dr. David Muench
Dentistry - Orthodontics
1 doctor agrees

In brief: NO

In the 21st century, it is no longer necessary to extract teeth no matter how severe your child's crowding.
If you wish to avoid extractions, be sure to work with a damon system orthodontist, where the decision to remove teeth is based on facial esthetic demands. So, for example, if the lips protrude, and you would like to reduce their fullness, then extraction is appropriate (www.Damonbraces.Com).

In brief: NO

In the 21st century, it is no longer necessary to extract teeth no matter how severe your child's crowding.
If you wish to avoid extractions, be sure to work with a damon system orthodontist, where the decision to remove teeth is based on facial esthetic demands. So, for example, if the lips protrude, and you would like to reduce their fullness, then extraction is appropriate (www.Damonbraces.Com).
Dr. David Muench
Dr. David Muench
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6 comments
Dr. Arnold Malerman
I couldn't disagree more with Dr. Muench's answer. Sometimes there are good and just reasons for extracting test, for example if aligning teeth would expand them off of basal bone support, or tip them so severely that they are unstable. If non-extracton treatment means violation of Andrew's 6 Keys of Occlusion, extractions may be necessary to improve function and enhance post-treatment stability, in addition to esthetic considerations. And it doesn't matter what appliance is used, the Damon appliance, the MBT appliance, the Roth appliance, a removable appliance. or anything else. What matters is the skill of the practitioner, their knowledge of growth, development, anatomic principles, and bio-mechanics. Beware of "always" and "never."
Dr. Robert Waxler
totally agree with Dr. Malerman and totally disagree with DrMuench! Just a question for Dr Muench...exactly what has changed in human biology in the 21st century? It has been well established scientifically that extractions are sometimes necessary....some people just have big teeth and small jaws....just because he uses Damon brackets doesn't change the biology
1 doctor agrees

In brief: No

It's controversial but if you think about it, removing teeth while the jaw is still growing is bad treatment.
Adult teeth come out when the jaw isn't big enough. Let the tongue do its work of making the jaw bigger and let time take its course. You will soon have enough room for all your teeth. Including the wisdom teeth.

In brief: No

It's controversial but if you think about it, removing teeth while the jaw is still growing is bad treatment.
Adult teeth come out when the jaw isn't big enough. Let the tongue do its work of making the jaw bigger and let time take its course. You will soon have enough room for all your teeth. Including the wisdom teeth.
Dr. Marvin Pantangco
Dr. Marvin Pantangco
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10 comments
Dr. David Schleimer
Spoken by someone who truly does not understand the growth and development of the face and jaws. It is not controversial at all, and a reading of the literature from the 1940's onward overwhelmingly advise against NEVER removing teeth for orthodontic therapy. Knowing where centers for growth are in the jaws is necessary to understanding the specialty. The tongue does not create room for teeth in people who do not have the genetic potential for the requisite growth of the dental alveolar supporting bone. I have thought about it, as you put it; and have treated malocclusions for 30 years. Not only is it wrong to say you should never remove teeth for orthodontics, but if this philosophy is used clinically, it is malpractice.
Dr. S. Jay Bowman
Dr. Schleimer's comment is well-founded.
Dr. Arnold Malerman
Dentistry - Orthodontics
1 doctor agrees

In brief: 30% of the time

Crowding does not self-resolve.
If test are too large, jaws too small, or both, 30% of time extractions are necessary. An orthodontist is trained to do a lab test called an arch length analysis to scientifically make this determination.

In brief: 30% of the time

Crowding does not self-resolve.
If test are too large, jaws too small, or both, 30% of time extractions are necessary. An orthodontist is trained to do a lab test called an arch length analysis to scientifically make this determination.
Dr. Arnold Malerman
Dr. Arnold Malerman
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Dr. Louis Sterling
Dentistry - Prosthodontics
1 doctor agrees

In brief: Depends

Sometimes the teeth are too crowded and too large to fit properly in the dental arches and allow the patient to close their lips easily over their teeth.
These cases need extractions in addition to braces.

In brief: Depends

Sometimes the teeth are too crowded and too large to fit properly in the dental arches and allow the patient to close their lips easily over their teeth.
These cases need extractions in addition to braces.
Dr. Louis Sterling
Dr. Louis Sterling
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Dr. Srijan Mehta
General Practice
1 doctor agrees

In brief: If required

After determining the need an orthodontist may suggest extraction of some teeth to straighten them.

In brief: If required

After determining the need an orthodontist may suggest extraction of some teeth to straighten them.
Dr. Srijan Mehta
Dr. Srijan Mehta
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Dr. Gary Sandler
Dentistry

In brief: When appropriate

The answer to that question is best determined by a trained and skilled orthodontist who after taking records and carefully evaluating the specific circumstances of each case determines that the removal of some teeth will be necessary in order to attain the best orthodontic result.
Some cases require it and others do not. “crowding” alone is not the only determining criteria.

In brief: When appropriate

The answer to that question is best determined by a trained and skilled orthodontist who after taking records and carefully evaluating the specific circumstances of each case determines that the removal of some teeth will be necessary in order to attain the best orthodontic result.
Some cases require it and others do not. “crowding” alone is not the only determining criteria.
Dr. Gary Sandler
Dr. Gary Sandler
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2 comments
Dr. Gary Sandler
Sorry, but I just came upon this post, the answer and the exchange of comments. I graduated from dental school as the #1 senior in a class of 175, a member of OKU (an honor society bestowed on the elite in dentistry), and awarded many other honors, a practicing dentist with over 40 years of experience, and as I am NOT an Orthodontist, have seen many completed cases by many different Orthodontists both with and without extracting teeth. From what I have seen on this website, my hat goes off to both Dr. Schleimer and Dr. Malerman for their knowledge, dedication and commitment to both their profession and their patients. I also visited Dr. Pantangco's website. Everyone is entitled to their own opinion, including Dr. Pantangco, who seems to be against extractions for Orthodontics, Endodontic therapy, and titanium implants. This is a unique perspective and contrary to mainstream dentistry which has stood the test of time and proven to be effective, safe and benefit patients immensely with excellent long term success. My children had some teeth removed for Orthodontic purposes, and I have had both RCT and a Titanium implant and would do it over again in a heartbeat! Each individual can make their own decision as to what to believe. Personally, I would be cautious about extremist contrary recommendations not supported by scientific research. I am willing to keep an open mind and learn from my colleagues so would welcome any valid proof for what appears to me thus far as an outlandish perspective from Dr. Pantangco.
Dr. Robert Stoner
Bravo Gary! We need more dentists like you!
Dr. Kenneth Grossman
Dentistry - Endodontics

In brief: Early diagnosis

Sometimes by seeing the child young , the orthodontist can alter jaw growth and mitigate crowding , an example being palatal expansion.
It is also important that the child's airway be evaluated and treatment takes this into consideration. There are many alternative for a crowded dentition.

In brief: Early diagnosis

Sometimes by seeing the child young , the orthodontist can alter jaw growth and mitigate crowding , an example being palatal expansion.
It is also important that the child's airway be evaluated and treatment takes this into consideration. There are many alternative for a crowded dentition.
Dr. Kenneth Grossman
Dr. Kenneth Grossman
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1 comment
Dr. David Schleimer
Dr. Grossman, palatal expansion is indeed a wonderful clinical aid, and of course it creates arch length. what if there exists no cross-bite? Would you accept a buccal cross-bite or Brody bite? Or would you expand the lower dentition to occlude with your expanded maxilla? The mandibular dentition is the key to so very many orthodontic treatment plans. Expanding because we can, does not make it right, youth notwithstanding. With respect, David.
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