Hearing that a healthy tooth needs to be removed before starting braces or Invisalign can be surprising. In certain cases of significant crowding, extraction creates the space needed to properly align the remaining teeth and achieve a stable, healthy bite.
Extraction is typically considered when there is not enough room in the jaw to align all teeth without it, often due to significant crowding, a severe overbite, or teeth that are protruding noticeably. It is a deliberate strategy to achieve better long-term results, not a routine step for every patient.
Premolars are the most commonly extracted teeth for orthodontic purposes because their removal creates useful space without significantly affecting the visible smile or chewing function, and the gap closes gradually as other teeth are guided into position.
The decision is based on a full evaluation including X-rays, models or digital scans of your teeth, and measurements of available space versus the space needed for proper alignment. Many cases can be resolved without extraction using expansion or other space-creating techniques, so it is never assumed by default.
Once the tooth is removed and the socket has begun healing, orthodontic treatment proceeds as planned, gradually moving the surrounding teeth to close the gap and achieve proper alignment. The timeline for starting braces or aligners after extraction is usually just a short healing period of one to two weeks.
No. The space created by extraction is used deliberately during treatment and closes as teeth are moved into better positions, so there should be no lasting visible gap once treatment is complete.
Not always. Some crowding cases can be resolved with expansion appliances or careful spacing without removing any teeth, which is why a full orthodontic evaluation is important before assuming extraction is required.
Most orthodontists wait for initial healing, typically one to two weeks, before starting active treatment, though this can vary depending on your individual healing and treatment plan.
Speak to our team about tooth extraction today.
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