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Crowded Teeth- To Extract or Not?

Posted June 30, 2014

Times change, and so do approaches to orthodontic treatment. It once was common practice to wait until all of a child’s baby teeth had erupted to begin treatment.

That often meant extracting some adult teeth if a child’s teeth were too crowded, or the jaws were deemed too small to provide adequate room. But that isn’t always the case today.

The American Association of Orthodontists recommends parents have their children evaluated by an orthodontist when they reach age 7, and NYC orthodontist Dr. Mark Bronsky agrees. Your child has a good mix of baby and adult teeth by this age, and the bite is established. Dr. Bronsky can determine at this stage whether your child would benefit from interceptive treatment, or if we should put your child on a monitoring regimen to be evaluated periodically and determine an appropriate time for treatment.

In some cases, early treatment can prevent the need for tooth extraction later in life because your child is still growing. Dr. Bronsky frequently can put that growth to work during the treatment process by widening the palate and promoting or inhibiting jaw growth as necessary to alleviate mild to moderate crowding. He also can help guide teeth that haven’t yet erupted to ensure they wind up in their proper position to create a winning smile and a healthy bite.

Some studies show there are aesthetic benefits to preserving all of the teeth when possible. Your teeth support your cheeks, lips and other soft tissue. Removing teeth sometimes can cause slight changes in the profile, and lead to appearances of early aging in adulthood.

When Tooth Extraction is Needed

There are instances where tooth extraction is necessary and beneficial to treatment. Let’s say your child has baby teeth that haven’t fallen out and they’re preventing adult teeth from erupting properly. That situation might require some intervention.

Other indicators that may call for extraction are severe tooth crowding and insufficient bone. Dr. Bronsky is limited in the amount of space he can create without removing adult teeth. If your child has overjet or underbite because the upper and lower jawbone sizes are disproportionate, sometimes removing teeth can correct the discrepancy.

The point we wish to leave you with is this: much can be done to avoid tooth extraction when orthodontic problems are identified and addressed early enough, but sometimes tooth extraction can actually be a good thing. The key to making the right treatment decision is for Dr. Bronsky to see your child at age 7 for a baseline evaluation. Then we can map out a monitoring or treatment path as necessary. Our goal is to give your children smiles they will always be proud to show off.