Several factors can lead a kid to need orthodontics in Cool Springs, TN: a misaligned tooth, an over- or underbite, or even an overcrowded smile. Although it may seem surprising, having too many teeth is a common issue for many children.

However, if tooth removal seems daunting, imagine your kid going through it—it's even worse. For this reason, we wrote this post outlining the reasons behind the extraction of some teeth before orthodontics, the teeth that are typically extracted, and how taking these steps helps create a healthier and more aligned smile.

What Are Overcrowded Teeth and Why Is Extraction the Only Solution?

When parents hear their child needs to lose one tooth or two for their orthodontic treatment, most raise their brows in suspicion. Baby teeth fall out on their own, and it’s no source of concern—adult teeth, however, are another story.  

After loss, there’s no replacement for natural teeth, and the available procedures (like dental implants, for example) aren’t available for young children. Still, tooth extraction can be a necessary step for patients with an overcrowded smile who need to gain a healthy bite.

In essence, orthodontics is the art of aligning and straightening teeth and jaws. When teeth, as they are, can’t be manipulated, and lack of space is an issue, pulling them may be necessary—especially for older patients.

Teenagers' and adults' palates are already fixed into position at this point, and the only way to make space may be to pull out teeth or jaw surgery.

However, this last option is considered too invasive in comparison to simple extractions.

When it comes to children, they’re young and still developing, so their palates are very malleable. Doctors can install expanders across the palate. Adjusting them systematically widens the palate so that there’s room for more or larger teeth.  

Extractions may still be necessary, but the expansion helps the child with a larger jaw to accommodate those adult teeth.

Which Teeth are Removed for Braces?

Bicuspid (premolar) teeth are extracted the most frequently when getting braces. They are situated in the center of the mouth, between the molars, or back teeth, and the canine teeth, or front teeth.  

Extraction may also be advised for teeth with large fillings, impacted teeth, or damaged teeth.

Why Does Crowding Occur?

Extractions are necessary mainly due to crowding. Even when a child has undergone palatal expansion with expanders, once their adult teeth emerge, they may be too large for the child’s jaw.

Often, the child’s jaw development is slower than the speed of tooth maturation, causing crowding and crooked teeth. Teeth twist into unusual positions to accommodate. Strategic extractions help mitigate the issue of crowding.

The degree of tooth crowding will determine how many teeth need to be extracted. Some patients need only one tooth extracted, while others need two or three.

Other causes of tooth extractions are:

Impacted-Tooths

Sometimes, teeth become impacted. They stay inside the gums and don’t drop down into their normal positions. This makes them harder—if not impossible—to clean, so extraction is recommended.

In other situations, impacted teeth may erupt at any angle, including perpendicular to the jaw. If the tooth is at a reasonably normal angle, an orthodontics specialist can use a bracket and chain to reposition it. If not, we’ll remove it.

Wisdom-Teeth Arrival

The final set of molars to erupt during adolescence are the wisdom teeth. Patients often see them when they are fifteen or sixteen years old. Orthodontists will advise the extraction of wisdom teeth because their eruption may cause crowding or twisted teeth along your jaw.

Braces, wires, and bands will not strain from the extra space in the jaw during orthodontic treatment.

Fighting Back Protrusions

When someone smiles, the front teeth are obviously visible; however, when teeth behind the front teeth press forward, the front teeth may protrude or stand out. Then, extractions are necessary.  

To make it easier for your front teeth to reposition themselves, most orthodontists will extract a few teeth that are close to the back of the mouth.

Midline Shifts

Symmetry plays a critical role in orthodontics. Both the upper and lower jaws should be aligned with the space between your two front teeth. When this happens, you have a midline shift.

To correct this misalignment, orthodontists remove the offending teeth. Another option to realign the jaw is to put on headgear.

Bite Alignment

The worst issues regarding orthodontia involve a misaligned bite. Besides being unattractive, this can lead to speech problems, trouble chewing, and even damage your child’s quality of life by giving them headaches or sleep issues.

When this occurs, a number of tools are available to address the bite issue, ranging from headgear to rubber bands and braces. When there are some teeth in the bite that make adjustments difficult, extraction becomes a possibility to relieve the strain on the jaw.

Extra Teeth

In addition to all the cases we’ve numbered, another possibility is simply having extra teeth. This is a developmental anomaly in which children have more teeth than what’s considered normal.

These teeth cannot possibly be supported by the jaw, especially since children and preteens will soon be getting their wisdom teeth. The orthodontist will extract the extra teeth and any other problems that might arise.

Some Last Considerations

Extractions are typically a quick procedure that lasts between 20 to 40 minutes per tooth. However, if there are several extractions, the duration may increase. The first healing phase usually lasts between one and two weeks.  

Adhere to your dentist's care recommendations during this period to encourage healing. A few weeks to several months may pass before the extraction site closes and the patient fully recovers.

Learn More About Orthodontics in Cool Springs, TN

No parents wants to see their kids undergo surgery, even if it’s a tooth extraction. Although anesthesia makes the procedure painless, they may experience discomfort during recovery, and maintaining a soft diet is key to preventing further pain.

Still, teeth extractions are often a necessary step for kids to finally obtain a healthy and long-lasting smile. Each case must be addressed specifically, tackling every possibility before making a decision.

If you have any remaining doubts or want a second opinion regarding your kid’s orthodontic treatments, reach out to Happy Harpeth!