Written by Dr. Chaw Su Kyi on October 8, 2014
Braces and Teeth Extraction
One of the most common reasons for having orthodontic treatment is crowded teeth, which can cause the teeth to appear crooked. The teeth often overlap each other and this can cause food or plaque to become trapped between the teeth. Flossing can be quite difficult as the contacts are very tight, sometimes unable to get floss between the teeth. The plaque trap and difficulty with flossing can increase the risk of gum disease due to the crowded teeth
Crowding means the size of the teeth is often larger than the space available in the mouth, hence the teeth erupt in the best position possible and often overlap each other. The degree of crowding is therefore dependant on the total size of the teeth and the size of the mouth. The degree of crowding is often termed mild, moderate or severe crowding.
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Mild crowding |
Moderate crowding |
Severe crowding |
What type of treatment do I need if I have severe crowding?
When we have severe crowding, it is quite difficult to straighten the teeth without creating space which means teeth will need to be removed.
We always assess your profile and lip support first to ensure the end result not only has a great smile but there are no detrimental changes to your profile due to the extractions.
How do you know which teeth to remove?
Dr Kyi is trained using the method of spatial analysis to assess if teeth need to be removed. This scientific method not only assesses the amount of crowding but also if space is required for bite correction. The objective of treatment must achieve a long-term stable result.
We often have cases referred to us following relapse from a previous course of treatment. In some of these cases, the treatment option of not extracting was chosen and teeth were expanded or widened to create space instead of removing teeth. This can end up with an unstable bite and once treatment is complete, the teeth can move back and potentially have ‘bite’ issues.
The commonest teeth to be removed are the premolar teeth. This is mainly due to the premolar teeth being in the ‘middle’ and hence the space created is where it is often needed. However, if there are teeth of poor long-term prognosis, we would always consider removing these teeth rather than removing a healthy tooth.
Who carries out the extractions?
If teeth need to be removed, we will refer to your dentist to remove the appropriate teeth and often the braces can be fitted around two weeks after the extractions.
The key is in planning the treatment and ensuring the appropriate teeth are removed to obtain a good and stable bite.
