Dental extractions in orthodontics have been a subject of debate for decades. While traditionally seen as a necessary step in specific cases to achieve ideal dental and facial outcomes, some clinicians and orthodontic appliance manufacturers now promote non-extraction treatments as the only option—claiming that extractions can harm breathing, the temporomandibular joint (TMJ), or facial appearance.
However, modern scientific evidence tells a different story.
The goal of orthodontic treatment is to improve function, aesthetics, and long-term oral health. In certain cases—especially where there is severe crowding, misalignment, or jaw discrepancies—dental extractions in orthodontics are essential.
Extractions help create space to align the teeth properly, improve bite relationships, and achieve a harmonious facial profile. When used judiciously, they can lead to more stable and aesthetically pleasing results.
One common concern is that extractions might lead to TMJ disorders. However, a systematic review published in the Journal of Orthodontics found no significant link between orthodontic extractions and long-term TMJ issues.
When performed as part of a carefully planned treatment, extractions do not increase the risk of TMJ dysfunction.
Another myth is that dental extractions in orthodontics reduce airway space and compromise breathing. Research in the American Journal of Orthodontics and Dentofacial Orthopedics found no evidence that extractions negatively impact respiratory function or airway dimensions.
When planned correctly, extraction-based treatments do not harm breathing or oxygen intake.
Patients often worry that extractions might flatten their face or reduce lip support. However, modern studies show that when extractions are done for the right reasons, and with proper biomechanics, the facial profile can remain balanced—or even improve.
A well-executed plan can maintain or enhance facial harmony.
Some brands and practitioners claim that all cases can be treated without extractions and that the removal of teeth is harmful. These claims, however, are not supported by current orthodontic literature.
Orthodontics is not one-size-fits-all. The decision to extract teeth should be based on a comprehensive clinical diagnosis, not on marketing claims or generic treatment protocols.
Every patient is unique. The decision to recommend dental extractions in orthodontics depends on factors like jaw size, tooth position, crowding, facial structure, and bite alignment.
A skilled orthodontist uses advanced diagnostics, facial analysis, and 3D imaging to decide whether extractions are necessary. When chosen appropriately, extractions are a safe and effective part of a personalised treatment plan.
The belief that dental extractions harm facial structure, breathing, or jaw joints is not supported by the latest scientific evidence. When indicated and properly planned, dental extractions in orthodontics are a valuable tool that helps deliver stable, healthy, and beautiful results.
As always, the key to successful orthodontic treatment is individualised care, guided by science and carried out with expert clinical judgement.
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I recommend and prescribe orthodontic treatments to my patients as if they were my own family and I value meaningful relationships based on communication, confidence and trust.
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