Teeth Extraction for Braces: Do I Need to Remove Teeth for Orthodontic Treatment?

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If you have crooked or crowded teeth and are considering getting braces or Invisalign clear aligners to get them straightened out, it might be possible that you’d need additional treatment.

Teeth Extraction for Braces

Your dentist or orthodontist might recommend you get your tooth removed if your tooth alignment poses a hazard to the other teeth. Getting your tooth extracted may be necessary to achieve the best outcomes for straight teeth.

Learn the ins and outs of removing teeth for braces and why you may be one of 10 to 20 percent of orthodontic patients who require it.

What is tooth extraction for braces?

In certain cases, tooth extraction – where the dentist may pull teeth – may be necessary to achieve the best results, with straight and healthy teeth. Tooth removal is done for those with extra teeth or too much crowding to make room for the teeth surrounding it.

This procedure may include removing one or many teeth before braces so that the teeth can be properly aligned and the bite can be fixed. However, not all braces treatment requires the orthodontist to extract any number of permanent teeth.

The importance of a proper dental alignment in orthodontics

According to the American Association of Orthodontists, orthodontists may choose to straighten teeth for reasons greater than cosmetic purposes.


Proper dental alignment in orthodontics enhances proper oral function and corrects any bite issues that hinder function.

Braces may also play a significant role in fixing minor to moderate jaw abnormalities or discrepancies by guiding the upper and lower jaws into a perfect balance. Good tooth position can also improve speech patterns and reduce the likelihood of dental complications.

The best course of action to treat straight teeth is by tailoring a treatment plan for braces that suit the patient. To achieve superior results out of the orthodontic treatment, some teeth may need to be extracted for the teeth to align.

When is it necessary to get your teeth extracted for braces?

Not all cases require extractions. Your orthodontist will examine your teeth and decide whether to extract one tooth, two teeth, or even more teeth. Wisdom teeth are considered separate from orthodontic extraction cases as there are various other reasons for removing them.

Your tooth/teeth may need to be extracted before orthodontic treatment:

  • If there is significant crowding of teeth in the jaw.
  • If your front teeth are protruding significantly.
  • If you have bite issues such as underbites or overbites.
  • If you have a smaller jaw with larger teeth.
  • If you have misaligned teeth that are affecting your bite.
  • If you have teeth that are too large to fit in their positions.
  • If you have multiple extra teeth (supernumerary teeth).
  • If your tooth has been damaged by decay and some space has formed.
  • If you have impacted teeth.
  • If you have midline or other uneven gaps between teeth.
  • If you lack facial symmetry.

In any of these cases, you may need tooth extraction before you proceed onto get your teeth straightened out with braces.

Which teeth are extracted most often for orthodontic treatment?

The tooth to be extracted for braces depends on the desired goals of the orthodontic treatment. However, the most common teeth removed for orthodontic purposes are the premolars (4th and 5th teeth in order from the front of the jaw).

Dental Extraction for braces

You may have your wisdom teeth removed for various reasons such as impacted growth, dental decay, or insufficient eruption space, therefore, it may not be considered as the most extracted tooth during braces treatment.

In cases where braces for kids become necessary, the dentist may wait for all of their adult teeth to erupt before extracting any.

The process of Dental Extraction for braces

During the initial consultation with the orthodontist, they may thoroughly examine your teeth, including X-rays, photos, or scans of your teeth to gauge your unique condition.

If your orthodontist forwards you to receive an extraction in line with orthodontic care, you may get either of these extractions:

  • Simple extraction: For this, you’ll receive a local anesthetic that numbs the area around the tooth. It may take anywhere from 5 to 30 minutes depending on the tooth.
  • Surgical extraction: This is done in cases where the tooth is partially embedded within the gums and has not erupted entirely. You’ll receive a local anesthetic, after which the gums are peeled back to expose and then remove the buried tooth. 

What are some alternatives to removing teeth before getting braces?

Having your teeth extracted before getting braces can be worrying and, therefore, you may be wondering if there is anything you can do to avoid removing teeth.

Fortunately, other treatment options do not require removing teeth for braces.

For patients with a narrow upper jaw, it is possible to widen the dental palate to make room for the teeth, instead of removing one or more.

widen the dental palate

These devices are known as palate expanders and work best in children whose bones are still growing and can adapt to the expansion.

If the palate cannot be expanded, some surgical procedures can add bone to the palate to allow effective expansion of the adult palate.

Alternatively, it is possible to shift the teeth back into the mouth using orthodontic distalization so that there is more room for the crowded teeth.

What are some potential risks of removing teeth for braces?

The removal of teeth for braces does not have many negative side effects. You will not feel pain during the extraction, however, some individuals may take longer to recover, prolonging or delaying the braces treatment. 

Some others can lose jaw density after extraction as the bone shrinks after removal.

Do you need a tooth extraction?

If you suspect that you may require a tooth extraction, you should consult an orthodontist. They will tell you whether teeth need to be removed or not to help you achieve the best results for braces.

Some cases require tooth extraction of certain teeth (either your upper teeth or lower teeth). To prevent any complications before getting your braces, you can confidently embark on your orthodontic journey.

Don’t let a simple tooth extraction stop you from achieving your perfect smile. Think of it as you move a step closer to an attractive, straighter, and healthier smile. 

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