Tooth Extractions for Braces

By Dr. Dustin Coles – Premier Orthodontics

As orthodontists, we would prefer to do braces and not have any patients get tooth extractions . . .  but, there are certain types of tooth and bite problems that are better treated, in the short and long term, by having some teeth removed.

There are many reasons why orthodontists may recommend having teeth extracted for braces, but in this video we’re going to discuss 3 of the most common reasons that orthodontists may find extractions necessary.  Those three reasons include:

Tooth Extractions With Braces for Severe Crowding

Many patients have crooked or crowded teeth. Luckily though, not all of them will require extractions. But for patients with severe crowding, having teeth extracted may be the best option.

This patient, for example, had severe crowding on her upper arch.  As you can see the upper canines are completely blocked out.  Based on the amount of crowding she had, we determined that the best way to correct the crowding was to have two of the premolar teeth extracted on her upper arch.

You can see in this animation that after teeth are extracted, an orthodontist can then align the rest of the teeth with braces and close any spaces that may remain.  By the time the treatment is finished, the spaces will be closed, the teeth alignment will look great, and no one will be able to tell that teeth were taken out – not even the patient!  

With the patient we showed earlier, you can see that her final result turned out great, and after having two teeth extracted with her braces treatment, she had a beautiful smile and healthy bite.

Tooth Extractions With Braces for Large Overbites

The next type of tooth or bite problem that may require extractions is a severe overbite.

In severe overbite cases, usually the top teeth are very protrusive and stick out too far forward.  This patient here is a good example.

Patient's teeth with braces and Forsus springs for overbite treatment.

This patient had actually started braces at another orthodontist office, and had been in braces several years before coming to Premier Orthodontics. 

Despite all those years of treatment, her overbite still wasn’t corrected.  

Due to the severity of her bite, we recommended that she needed to have two permanent teeth removed on her upper arch in order to fix her bite.

This short animation will demonstrate how taking out two teeth on the upper arch, and then closing the space, can fix a severe overbite and help reduce the protrusion of the front teeth.

You can see in this animation that we will usually have the first bicuspid (or first premolar teeth) extracted, and then pull the front 6 teeth back into that extraction space.

Once this space is closed, you won’t be able to tell that teeth were removed, the bite will fit together properly, and the overbite should be corrected.

Our patient had two teeth on her upper arch extracted before we closed that space. Finally we pulled back her front teeth. By the time we were done, she had a beautiful smile, no spaces, and her overbite was completely corrected.

Patient's teeth with braces and Forsus springs for overbite treatment.
Teenager's before photo showing overbite and teeth alignment, Premier Orthodontics treatment.

Tooth Extractions With Braces for Large Underbites

The next type of tooth or bite problem that may require extractions is a severe underbite.

In patients with a severe underbite, the lower teeth stick out too far when compared to the upper teeth.  This patient here is a good example.

Patient smiling with corrected overbite after tooth extractions and braces.
Patient's teeth before extraction and braces treatment for underbite correction.

Due to the severity of her underbite, we recommended that she have two permanent teeth on her lower arch extracted in order to fix her bite.

This short animation will demonstrate how taking out teeth, and then closing the space, can fix a severe underbite.

For patients with an underbite, we will usually have the lower first premolars removed, but in some cases two teeth on the upper may also need to be extracted. 

Our patient had  two teeth on her lower arch extracted. Then we closed that space and pulled her front teeth back. As you can see,  by the end of her orthodontic treatment she had a big improvement to both her bite and her smile.Β Β 

Patient smiling with corrected overbite after tooth extractions and braces.
Patient's teeth before extraction and braces treatment for underbite correction.
Patient smiling after orthodontic treatment with braces and tooth extractions.
Patient's teeth before orthodontic treatment demonstrating underbite and need for extractions
Patient's teeth before orthodontic treatment showing underbite and need for extractions

How Can I Tell if Me or My Child Needs Extractions for Braces?

If you think you or your child may need extractions with braces, the best place to start is by getting a free consultation with an orthodontist in your area.Β Β 

Getting with Braces with Extractions in Phoenix, Chandler, Maricopa, and Casa Grande

Premier Orthodontics has 6 locations  providing braces and Invisalign in Phoenix, Chandler, Gilbert,Maricopa, Casa Grande, and Glendale as well as the surrounding areas. 

Schedule your free consultation for braces or Invisalign or read our comprehensive guide to the cost of braces . (We are very transparent about our process and our pricing, as you’ll see in this guide.)