Why choose extraction-free braces?

Why choose extraction-free braces?

Why choose extraction free braces?

The practice of removing healthy permanent teeth to relieve tooth crowding prior to the insertion of braces is one that is extremely controversial within the orthodontic community. The practice of removing healthy body tissues is one that is unique to only orthodontics, which is why many people question if there are alternatives that may have the same if not better results.

Why would teeth be extracted?

When teeth begin crowding, it means that there is not enough space and often impacting or other issues begin to occur. Teeth are pulled to alleviate this crowding as well as to align the upper and lower teeth so that they can close and fit together better. It is possible to camouflage jaw discrepancies, achieve straight teeth and a perfect bite through this route as it has been done for many years however there are limitations to this technique.

 What are the limitations of extraction?

The largest limitation in extracting for crowing is the impact on the facial profile, though not all orthodontists will agree with this.

Most of the time, patients who are advised to have teeth extracted only have a moderate degree of crowding ranging between 5 – 8 millimetres. Typical pre-molar measures about 8mm which would mean that removing two creates a 16mm space in the dental arch, an excessive amount for the crowding. To close the space up, retractive orthodontics will need to be performed. This involves pulling the front teeth back into the open spaces which are easier than moving the large molars forward to close the gaps.

Bearing in mind that it is the front teeth that support the lips, extractions and retractive orthodontics have a tendency to flatten the facial profile and reduce the facial balance.

Does retractive orthodontics have any other side effects?

There is now growing support for the idea that retractive orthodontics can contribute to reduced space for the tongue, narrowing the airway space behind the jaw as well as increasing the risk of problems with the jaw joint, while increasing facial and muscle pain in some. It is difficult to gather scientific evidence of these maladies because of how tough it is to get identical “control” subjects which means that this information is not considered to be “evidence-based”.

There are, however, many cases indicating that the airway size can be increased in patients with sleep-disturbed breathing and pain symptoms when dental orthopaedic appliances are used to re-open extraction spaces.


What are alternatives to tooth extraction?

A major study has indicated that a large portion of tooth crowding is caused by underdeveloped jaws rather than by teeth that are too large. For most cases, it makes more sense to increase the dental arch through arch development rather than to extract teeth. This arch development should ideally begin at the ages of 7 – 9 years, though it is still possible in adults to create dental expansion through non-extraction orthodontics. With children, if the intervention is initiated soon enough, they may only need fixed braces for a short period of time. In adults, the appliance therapy will in most cases lead to the placement of fixed braces after the therapy.


What is extraction-free orthodontics?

There are a number of dental appliances available which have the ability to remind the jaw how to develop. At Lake View Dental, we focus on improving the position of the jaws as they will have a beneficial effect on the bite, teeth position, jaw joints, airways and even the smile. Extracting teeth results in an even smaller space for the tongue to fit into and has further negative effects on all these areas that we seek to improve. Instead, we use the following methods to help properly stimulate the genes to begin the remodelling process:

  • Anterior Growth Guidance Appliance
  • Controlled Arch Orthodontics
  • Myofunctional Exercise Therapy


A clinical assessment will allow for a treatment plan and the following is just a guide as to some of the treatment that may need to be applied and is general in nature. If you feel that you could benefit from extraction-free orthodontics, please book a consultation at Lake View Dental where we can discuss the best treatment options for you.

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