Orthodontic treatment today is more streamlined, comfortable, and all around better than it ever was. As a result, orthodontists prescribe less permanent tooth extraction than perhaps many years ago.
With that being said, a good portion of patients still benefit greatly from extracting permanent teeth. This doesn’t mean that the treatment plan is ‘old fashioned’. Tooth extraction is also not done to make treatment ‘easier’ for the orthodontist. It is quite the opposite I find. Most of my extraction cases are more complicated cases from the get-go and take longer than non-extraction plans. The plans are just different because no two mouths are the same, and different patients require different treatment.
There are numerous reasons why an orthodontist will prescribe teeth to be extracted. Some of these reasons are: Severe crowding, severe protrusion, significant bite discrepancy. Patients who have severe crowding do not have enough room in their jaw bones to contain all their teeth once the teeth are straightened. If extractions are not done in a case with severe crowding, all the teeth have to tip outwards to make enough room. The teeth may even push so far out that they lose bone or gum tissue coverage. This is now a periodontal issue with bone and gum loss. If certain teeth are removed however, then there is enough room in the bone for the rest of the teeth in the mouth to line up nicely and create a healthy periodontal situation.