One visitor suggested that she was recommend the removal of teeth.  A few visitors have inferred that those who recommend removing teeth are uneducated or old fashioned. The truth is that no matter how young or innovative a clinician may be it is still the size of the lower jaw that determines how many teeth will fit. While there are alternatives to extraction in the upper arch (expanders, interproximal reduction, TADS, headgear, functional appliances, and numerous gizmos that push the top teeth backwards and create space), there are not as many options in the lower jaw.

Unlike the upper arch which has a growth plate and extra room behind the molars, the lower arch has more defined limits.  The amount of space available down there is set after the patient has stopped growing. All expansion in the lower arch occurs by tipping the teeth outward away from the center of the supporting bone.  Many times NOT extracting teeth produces results which just snap back to their original positions as soon as treatment is complete and retainer wear is relaxed. If removing teeth will give you a smile that is more attractive, healthier, and more stable, that’s the treatment plan that we will recommend.

The other most critical decision to determine if extractions are required is the facial esthetics.  If the face is in protrusion with a full lip and difficulty in closing the lips at rest, we may recommend to extract teeth.  In contrast, if the face is retruded or the lips are very set back, then a non extraction  method is proposed.