22 doctors weighed in:

I have 28 teeth and the dentist wants to pull 4 teeth for braces. Is this normal?

22 doctors weighed in
Dr. Hilary Baskin
Dentistry - Orthodontics
9 doctors agree

In brief: Can be

Extracting teeth as part of orthodontic treatment is not unusual.
If you have excessive crowding, and there is no other way to address this (expansion, slenderizing, proclining are all methods used), then yes, extraction may be required.

In brief: Can be

Extracting teeth as part of orthodontic treatment is not unusual.
If you have excessive crowding, and there is no other way to address this (expansion, slenderizing, proclining are all methods used), then yes, extraction may be required.
Dr. Hilary Baskin
Dr. Hilary Baskin
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Dr. Louis Gallia
Surgery - Oral & Maxillofacial
2 doctors agree

In brief: Sometimes

Sometimes if you have lots of crowding.
Extraction of 4 bicuspids can compromise your facial balance despite improving the bite. A second opinion is mandatory. Make sure the doc and the second opinion doc are board certified orthodontists. Most aren't.

In brief: Sometimes

Sometimes if you have lots of crowding.
Extraction of 4 bicuspids can compromise your facial balance despite improving the bite. A second opinion is mandatory. Make sure the doc and the second opinion doc are board certified orthodontists. Most aren't.
Dr. Louis Gallia
Dr. Louis Gallia
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2 doctors agree

In brief: Second opinion

I would get more than one opinion.
..Depends on what teeth need extraction...(first bicuspids/premolars- most common, ) a lot of orthodontists now try not to have teeth extracted because of tmj/tmd potential.

In brief: Second opinion

I would get more than one opinion.
..Depends on what teeth need extraction...(first bicuspids/premolars- most common, ) a lot of orthodontists now try not to have teeth extracted because of tmj/tmd potential.
Dr. Jeffrey Bassman
Dr. Jeffrey Bassman
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1 comment
Dr. Arnold Malerman
Not quite accurate. Orthodontists try to treat non-extraction if there is sufficient bone to support the teeth. If teeth and bone don't match either bone has to be made bigger (and this is a finite process with limitations) or tooth mass has to be made smaller. About 30% of patients require extractors. Incidence of TMD in ext/non-ext the same
Dr. Brent Mcfarland
Dentistry - Orthodontics
1 doctor agrees

In brief: Many times

Very often sever crowding or large overbite requires tooth removal.

In brief: Many times

Very often sever crowding or large overbite requires tooth removal.
Dr. Brent Mcfarland
Dr. Brent Mcfarland
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Dr. David Schleimer
Dentistry - Orthodontics
1 doctor agrees

In brief: Normal

If there is too much crowding, that when unraveled leaves the teeth poorly supported by alveolar bone or puts them at an extreme angle, then it is absolutely correct to remove bicupids.
One of the early rules an orthodontist learns (and is supported by clinical experience) is that the inter-canine width of the mandible should never be enlarged, doing so invites relapse and periodontal breakdown.

In brief: Normal

If there is too much crowding, that when unraveled leaves the teeth poorly supported by alveolar bone or puts them at an extreme angle, then it is absolutely correct to remove bicupids.
One of the early rules an orthodontist learns (and is supported by clinical experience) is that the inter-canine width of the mandible should never be enlarged, doing so invites relapse and periodontal breakdown.
Dr. David Schleimer
Dr. David Schleimer
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1 comment
Dr. David Schleimer
There are a great number of dentists who advocate NEVER removing teeth for orthodontia; almost all of whom are general dentists. It takes skill and experience to correctly treat an extraction case, paralleling roots and adjusting to a correct occlusion is hard to do for a generalist, so expanding and aligning are easier to do, and for some a "philosophy" of nonextraction becomes their only plan. In my practice 20-30% of patients require removal of teeth.
Dr. S. Jay Bowman
Dentistry - Orthodontics
1 doctor agrees

In brief: YES

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: YES

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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1 comment
Dr. David Schleimer
100% agreement
Dr. Ronald Konig
Dentistry - Cosmetic
1 doctor agrees

In brief: No

Extracting bicuspids is really an outdated way of doing orthodontics.
There are, however, a few exceptions. It is much better to expand the arches than to extract which can cause more complications later. This being said, it is not possible to give you a clear answer without seeing your situation. Perhaps seek another opinion from someone who understands functional orthodontics.

In brief: No

Extracting bicuspids is really an outdated way of doing orthodontics.
There are, however, a few exceptions. It is much better to expand the arches than to extract which can cause more complications later. This being said, it is not possible to give you a clear answer without seeing your situation. Perhaps seek another opinion from someone who understands functional orthodontics.
Dr. Ronald Konig
Dr. Ronald Konig
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3 comments
Dr. S. Jay Bowman
Absolute misinformation
Dr. David Schleimer
Dr. Konig: With respect, you truly show your complete lack of understanding NO, IGNORANCE when you make a statement like that. You have no specialist degree in orthodontics, and as such, to say that expanding the alveolar bone is superior to extractions is not only silly, it is injurious to the poor patients who subject themselves to such frowned upon notions of orthodontic understanding. Functional orthodontics is a construct used by ill-trained GP's doing ortho. Please just do your cosmetic dentistry.
1 doctor agrees

In brief: Within normal limits

It all depends on your bite, how much room you have in your mouth, and the treatment objectives.
No one can second guess your orthodontist without examining you.. There is no yes or no answer for your question. Seek a second opinion if you are unsure as to how to proceed.

In brief: Within normal limits

It all depends on your bite, how much room you have in your mouth, and the treatment objectives.
No one can second guess your orthodontist without examining you.. There is no yes or no answer for your question. Seek a second opinion if you are unsure as to how to proceed.
Dr. Theodore Davantzis
Dr. Theodore Davantzis
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Dr. Arnold Malerman
Dentistry - Orthodontics

In brief: Stop

Before you make a final decision please see a qualified Orthodontic Specialist instead of a General Dentist for an Orthodontic opinion.
Less than a third of all Orthodontic patients require extractions, but that number is lower in kids, higher in adults, because of anatomic limitations. You want a brain surgeon who does nothing but brain surgery all day long, not a GP who doesn't do a lot.

In brief: Stop

Before you make a final decision please see a qualified Orthodontic Specialist instead of a General Dentist for an Orthodontic opinion.
Less than a third of all Orthodontic patients require extractions, but that number is lower in kids, higher in adults, because of anatomic limitations. You want a brain surgeon who does nothing but brain surgery all day long, not a GP who doesn't do a lot.
Dr. Arnold Malerman
Dr. Arnold Malerman
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Dr. Alan Zweig
Dentistry

In brief: Yes

Extracting teeth to gain room for crowding is an accepted method in orthodontics.

In brief: Yes

Extracting teeth to gain room for crowding is an accepted method in orthodontics.
Dr. Alan Zweig
Dr. Alan Zweig
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