Dental Education Lecture: Extraction or not

Dear Dr. Wei:

I have consulted an orthodontist.  He suggests that four of my premolars should be extracted before braces are placed, since my dental arches are crowded.  He also recommends extraction of four wisdom teeth because of  bad position.  In all, eight of my teeth need to be taken out.  Is this too much?  I are scared.  Thank you very much for your opinion.

Best regards


Dear Eve:

This is a complicated issue.  As a general dentist, we do not do complicated cases involving extraction of four premolars.  Generally, there are two schools of thought among orthodontists on extraction.  Some of them prefer extraction, while the others do not.  According to two X-ray images you sent, it appears that extraction of 8 teeth is necessary and appropriate, particularly for wisdom teeth.  But decision on extraction or not also depends on clinical examination, which we have not done for you.  Therefore my advice may not be right.

After extraction of these 8 teeth, you have 24 teeth remaining.  If you brush and floss regularly, you can keep these remaining teeth all your life.  You still have plenty of teeth to chew with.   Good luck!

Editor: The X-ray films on our right side are the most common used for braces.  The first one is called panoramus. We can see all of our teeth.  The second one is named cepholometric.  It is used to determine whether our jawbones are positioned abnormally or not.  If it is, we may need to do surgery to reposition the jaws.  If not, we just place regular braces.

Xin Wei, DDS, PhD, MS 1st edition 01/16/2011, last revision 01/16/2011