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Part 2: When Tooth Removal Is The Healthy Choice

In the 2nd series on tooth removal, let’s take a look at the main reasons when tooth removal is the best and wisest option to achieve an optimal treatment outcome.

Reason #1 Crowding.

Imagine a situation where teeth are crowded and poorly aligned. In this situation, the amount of space required is not sufficient to accommodate the teeth. Either the size of the arches must be increased or the number (or size) of teeth reduced.  Or perhaps space preservation with a space maintainer could be utilized.

Up until the age of about 15, if there is mild to moderate crowding, it can be addressed with expanders and braces alone. After the age of 15, the bone structure is well formed and less plastic and expansion may not be possible or healthy to the surrounding supportive tissues.

When there is moderate to severe crowding and limited gum or bone support, permanent teeth will need to be removed to provide the space required. Failure to maintain the teeth with healthy surrounding bone will lead to periodontal problems down the road.

Continue reading Part 2: When Tooth Removal Is The Healthy Choice

Part 1: When Tooth Removal Is The Healthy Choice

Although I prefer not to remove adult teeth, there are exceptions and situations where tooth removal is beneficial. The pendulum has swung from one extreme to another in regards to removal of teeth. In the very early days of orthodontics the approach was never to extract a tooth, later the pendulum swung in the other direction and tooth removal was the norm not the exception. Over the past 25 years the pendulum has headed back in the other direction. So permit me to take a clear eyed and reasoned scientific approach to the subject.

One of the more common concerns I hear during consultation appointments is the following…you don’t have to remove any permanent teeth do you? We strive for perfection in the smile, a healthy bite and teeth that will last for a lifetime. What if, removal of teeth can help achieve these lofty goals and failure to  remove teeth may cause harm. Continue reading Part 1: When Tooth Removal Is The Healthy Choice