Why do I need [teeth removed] for my braces?

Why Do I Need Teeth Removed For My Braces?

An Orthodontist may recommend that some teeth be removed before braces (also known as dental cases or cases) are put in for various reasons. However, this is not always the case and is only done when it is absolutely necessary and other options will not work. Read on for a few reasons your orthodontist might recommend extraction of some teeth.


What Is Crowding?

Orthodontic cases work by straightening and aligning your teeth over time. The wires put pressure on your teeth so that they can move in the right direction. In order for them to move, there has to be space in your jaw. Your orthodontist will access the space required to align your teeth and the space you have available in your jaw. If your teeth are overcrowded and there’s not enough space, then some teeth will have to be extracted to make space for the movement of the teeth as they are realigned. An alternative to teeth extraction, in this case, is increasing the dental arches.

Crowding can be mild or serious. Mild crowding of the teeth can be resolved by other methods aside from extraction such as expanders (Dentofacial Orthopedics). Cases can also help fix crowding of teeth. This is common for children below 15 years of age.

Serious cases of overcrowding are more complex and most of the time extraction will be necessary. However, because people differ in bone structure and facial features, other might have their teeth removed while others might not. If you have more gum space available, then there is space for the teeth to move when braces are installed, and there will be no need for extraction. However, if you don’t have ample gum space, then your teeth have to be removed to create space. The same goes for those who have more bone mass than others.


When your front teeth protrude outwards, then your lips will too, and some people find this unattractive and uncomfortable. Dental cases can help fix this problem, but you will have to get some teeth removed on the side in order for the protruding front teeth to be properly aligned and improve the appearance of not just your teeth, but your lips as well. Alternatively, the lips might be okay, but the teeth beneath are positioned in a crooked manner. They will still have to be moved inward, and this will require an extraction of some teeth.

There are various things that could cause protrusion. The main one is genetics. The upper jaw can be larger than the lower jaw making the front top teeth stick out. Alternatively, the lower jaw can be larger than the upper jaw making it extend outwards. This condition usually gets worse with time and should be dealt with as early as possible. Habits such as thumb sucking and using a pacifier after 18 months can lead to protrusions in young children. Some children have teeth that are too large for their mouths, and this can cause an uncomfortable protrusion of the larger teeth. Whatever the case, aligning the teeth back to a normal and comfortable position might require an extraction.

Jaw Size Discrepancy

Differences in the size of the lower and upper jaw can either lead to overbite or underbite. An overbite occurs when the front jaw protrudes more than the lower jaw, and underbite occurs when the lower jaw is more extended than the upper jaw. Mild cases of overbite and underbite do not require removal of any teeth. However, if the difference in jaw sizes is apparent, then extraction has to be done to make space.

Missing, Extra or Damaged Teeth

If you have any missing or excess teeth in your mouth, your doctor could recommend tooth extraction before the tooth alignment process begins.

If you have a damaged tooth, the doctor might decide it is best to extract it in anticipation of a restorative process in future. Along with this, they might also recommend the removal of other teeth to make space for the alignment of the rest of the teeth.

Which Teeth are Removed?

The most common teeth for extraction purposes are the premolars (first bicuspid). These are located between the eye-teeth (teeth located under the eyes) and the molars. However, there are times when your doctor will recommend that the wisdom tooth be removed. It is always best to go with a renowned doctor who knows what they are doing.

Is the Extraction Process Painful?

This depends on which tooth has been chosen for extraction. Extraction of the premolars is a fairly simple process. It requires an anesthetic, either local or one for the whole body. Getting your wisdom teeth removed is more complicated and painful. You will have to be sedated, and stitches are involved. Bruising after the extraction is also common.

Can I Get Dental Cases at 40?

Yes, you can. Dental cases can be installed at any age although it is recommended that you do it as early as possible. Modern technology makes it easier to get them done. You can even get invisible braces through Invisalign technology.

Tooth extraction is a normal process before teeth are aligned and straightened, and you shouldn’t be afraid of it. You don’t have to get your teeth removed, except in the most serious of conditions.

Call Tisseront Orthodontics Today To Schedule an Appointment

At Tisseront Orthodontics in Reston, Va., you can have an examination from our knowledgeable orthodontist. Dr. Stephen Tisseront provides orthodontic treatments for adults, teenagers, and children with these devices:

• Aligners – designed using Invisalign software
• Braces – metal, ceramic and lingual
• Retainers – to keep teeth in position after orthodontic treatment ends
• Surgical orthodontics – removal of baby or extra teeth

Our patients can have iTero archwires designed at our orthodontic office, and we also offer Acceledent Aura devices to reduce treatment time. Call us today at 703-773-1200 to schedule an examination with Dr. Tisseront in our state-of-the-art orthodontic facility.

Tisseront Orthodontics
11720 Plaza America Drive, Ste. 110 Reston VA 20190-4762