For some patients, taking out teeth is part of preparing for treatment with braces. It can be a little scary to think about having teeth taken out, but sometimes it is necessary.
One of the first things we do when a patient comes in is take an “inventory” of their teeth. This includes baby teeth, which are the first set to come in, and permanent or adult teeth, which come in after the baby teeth are gone. When baby teeth fall out too early, they can create spacing problems. If the baby teeth come out late, permanent teeth may not be able to grow out in the correct position.
We use x-rays to see the complete picture of all teeth and the jaws, upper and lower. At that point we are able to determine if any teeth need to be taken out.
For some patients, removing permanent teeth is needed when they have an extremely crowded jaw. When teeth are sideways, they take up less space on the jaw. When they are lined up straight, they need more space along the arch of the jaw. So if there is not enough room for the teeth when they are straight, removing teeth will create more space.
If there is an overbite or an underbite that is the result of having a top jaw or bottom jaw that is dramatically different in size, it may be necessary to reposition the jaws. But when the jaws are close in size, removing teeth can create enough room to eliminate the bite problem.
The most important thing to keep in mind is this: removing teeth, especially permanent teeth, is taken very seriously by the orthodontist. They would not recommend it unless it was very important for the end result – a spectacular smile!