Why does the orthodontist recommend removing teeth?

orthodontistWhy does the orthodontist recommend removing teeth?

Most people associate the orthodontist with a professional who aligns and straightens teeth. The idea of removing teeth during orthodontia treatment doesn’t seem to match with the specialty. However, there are numerous instances when your Reston, VA, orthodontist might suggest a removal. Take a close look at the reasons that prompt a tooth-removal procedure. It’s entirely normal and common among most orthodontia patients.

Baby Teeth Hanging On

Parents are so thrilled to see their children’s baby teeth come in. They might also dread the day that they fall out. This sign of maturity usually occurs around age five or six. Baby teeth, however, don’t always fall out on a regular schedule. There are often times when a few teeth just hold on for many months.

If you know that orthodontia treatment will be necessary for the child, pulling the remaining baby teeth is an option. This choice is beneficial in a number ways, such as:

  • Soft baby-teeth roots
  • Only a handful of teeth to remove
  • Opens up space for permanent teeth to erupt

When baby teeth remain in place, they hinder normal growth and possibly derail future, orthodontia-treatment success.

Crowding Along the Jaw

As permanent teeth work their way into place, they might be incredibly large in comparison to a child’s jaw. The child simply needs to grow into his or her teeth. As an adult, the teeth will look normal with the mature face.

Orthodontists may opt to remove teeth when the child is about to receive braces, however. Although the brackets and wires are designed to align the teeth, too many teeth on a small jawbone will look crowded. The alignment may not ever be achieved.

Doctors will pick the best teeth to remove as they ease the crowding scenario. In the end, the procedure improves the smile.

Considering Expanders

Many orthodontia professionals turn to expanders as a way to reduce the number of teeth being pulled for crowding. Children are perfect candidates for expanders. Their jaws and mouth palates are still developing.

Professionals place expander or metal appliances in the mouth. Over time, the appliance enlarges the palate and jaw so that they can accompany more teeth. Parents who opt for this treatment will be active participants with these required tasks at home, such as:

  • Turning the expander screw to a certain position each day or week
  • Helping the child with oral hygiene so that the expander can do its work

Expanders may help with spacing, but some tooth-removal processes might still be required. Every case will be unique to the person’s physiology.

The Protrusion Factor

There are many other factors that orthodontists must consider before they apply traditional appliances or opt for Invisalign. The angle that the teeth protrude from the jawline is a consideration. With teeth that stick out, the lips follow suit. The entire face has an unusual shape.

Doctors suggest teeth removal in this instance because the extra space gives the protruding teeth a place to retreat. Through orthodontia treatment, the teeth can now hang in a vertical position that’s more attractive. The lips respond in kind, which improves the patient’s overall appearance.

Tooth Impactions

Your child’s baby teeth may be falling out at a regular pace, but one or more permanent teeth aren’t dropping down. In fact, the child might have an impacted tooth. Unless the tooth can be surgically pulled down by the proper experts, most professionals will suggest removal.

The impacted tooth might be at an usual angle, causing pain and impeding other teeth from moving downward. Parents should approach this removal option as a good idea for the long term. The child will have fewer teeth along the jawline to straighten. Crowding won’t be an issue. If there’s any pain, the child will feel much more comfortable with the tooth removed.

Bite Corrections

The majority of patients have some sort of misaligned bite. These issues include:

  • Underbites
  • Crossbites
  • Overbites

Brackets, wires and rubber bands might fit a few bite issues, but others persist. In the past, orthodontists had no choice but to recommend outright surgery. There’s a better choice today, however.

By removing strategic teeth, the professionals can create the appearance of a normal bite. There’s no need to put the patient through a surgery when extractions make a big difference. After the procedure, everyday treatments can proceed. Patients might choose Invisalign over other options in order to further improve the smile.

Wisdom Teeth Frustrations

As your child grows into a teenager, the orthodontia treatment may be nearing an end. However, the wisdom teeth tend to grow in at this age. These molars aren’t always welcome because they further crowd the teeth that may be relatively straight at this point.

Allowing the wisdom teeth to erupt in the mouth can lead to these issues, such as:

  • Straightened teeth twisting in place
  • Headaches
  • Painful chewing

Most orthodontists will suggest wisdom-teeth removal as soon as they erupt into the gums. The procedure is commonplace and requires a short recovery. Because teenagers are still young by physiological standards, they should heal with no residual side effects.


Schedule an Appointment with Tisseront Orthodontics

At Tisseront Orthodontics in Reston, Va., you can receive a free consultation with Dr. Stephan Tisseront to learn more about your orthodontic options. Our orthodontist takes care of children, teenagers and adults at our top-of-the-line office, and he offers these treatments:

• Lingual braces – worn on the backs of teeth
• Invisalign – aligners for teenagers or adults
• Ceramic orthodontia – made with clear wires and color-matching brackets

It is also possible to reduce your orthodontic treatment time by using a small device from AcceleDent Aura that helps to accelerate the movement of your teeth into the correct positions.

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

Phone: (703)773-1200


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