Tooth Extraction Concerns And Implications For Orthodontic Treatment

tooth extractions during orthodontics are not unheard of.

Teeth removal is a major concern for dentists, orthodontists, and patients. For the most part, removing teeth is considered a last resort option, given the potential adverse effects losing denture pieces bring to a patient’s quality of life.

As a result, removing a denture piece or more requires a comprehensive evaluation to determine that an extraction favorably outweighs keeping teeth in place. Failing to do so might compromise a patient’s future oral health.

Some of the problems associated with teeth extractions include 

Post-Surgical Risks

After tooth extraction, patients might experience pain, an inflammatory process, facial bruising, bleeding, and infections. Infections require a dentist to administer antibiotics and follow up.

Bite Collapse

A bite collapse might occur when a patient loses several back teeth, affecting the occlusion, which is the corresponding upper and lower teeth touching each other at the bite. This causes the lower jaw to approximate further to the upper jaw and affects the muscles that permit movement of the jaw.

Dry Socket

It is usual that, after an extraction, a socket forms in the same place as the removed tooth. However, if the blood clot dislodges early, a dry socket might form that exposes the bone.

Nerve Injury

Removing a tooth might affect the nerve that goes with the tooth, causing a patient to lose sensitivity in the area.

Maxillary Sinus Exposure

Extraction of an upper molar is a process that must follow a rigorous evaluation to avoid opening a hole into the maxillary sinus.

Conditions Associated With Preexisting Illnesses

Some preexisting illnesses like cancer or osteoporosis treated with bisphosphonates might cause delayed healing. 

Previous treatment with radiation next to the neck and head might lead to Osteoradionecrosis, characterized by the death of the bone in the affected area. 

Also, elderly patients with cardiovascular diseases might present health-related problems after tooth extraction. 

Improper Teeth Alignment

Also, and most prominent, an extraction might lead to Improper teeth alignment that requires orthodontic treatment in adults.

These are some of the problems associated with teeth extractions. However, depending on the case, dentists and orthodontists seeking to maximize results concerning proper bite and teeth alignment might recommend patients undergo teeth extraction. 

Why Would Dentists Remove Teeth?

As mentioned, removing a dental piece is the last resort in most cases as it can negatively impact the bite function and produce complications that go further than oral health. However, there are also cases in which the extraction of dental pieces is necessary.

Crowded Teeth

An extraction might be necessary before undergoing orthodontic treatment. This is because patients sometimes have crowded teeth, and the jaws might not have enough room for teeth to sprout normally. 

For crowded teeth, an orthodontist might refer a patient to a dentist or oral surgeon to perform an extraction of several denture pieces. They often recommend removing the first bicuspid (premolar) or molar teeth.

Badly Damaged Tooth

Patients can suffer traumas or tooth decay, making saving a dental piece fruitless to repair. 

Infections

The pulp is the living part of a tooth and locates in the inner part of the teeth. Tooth decay might extend to the pulp, causing an infection that might compromise the tooth and extend further to the gums and blood vessels, carrying the infection to other body parts.

Compromised Immune System

Some patients present a higher risk of infection due to a compromise in their immune system by treatments like chemotherapy or other conditions like diabetes. In such circumstances, a dentist might recommend the extraction of a dental piece to avoid potential infection spread.

Periodontal Disease

In some cases, an infection caused by tooth decay might compromise the gums, causing an advanced stage of periodontitis that produces the tooth to get loose; in such circumstances, an extraction is imminent.

Can An Orthodontist Remove Teeth?

No, although orthodontists might have the training and expertise to remove dental pieces, teeth extractions are referred to dentists or oral surgeons depending on the difficulty of the procedure or if it requires surgery.

Can Orthodontic Treatment Be Done Without Tooth Extraction?

Yes, orthodontists might carry out orthodontic treatment without sacrificing dental pieces. Consequently, in some cases, orthodontic treatment might not require the extraction of dental pieces. 

However, diagnoses might show the need for teeth extractions to make room for teeth to sprout; some patients might have extra teeth or overcrowding. These cases opened an ongoing debate among orthodontists about the need for the extraction of dental pieces.

Those favoring maintaining teeth contemplate using orthodontic devices such as palatal expanders to stimulate the mouth to grow larger, making room for teeth; this is especially useful in younger patients and helps reduce the need for extractions and prevent impacted teeth.

Notwithstanding, palatal expansion in adults might require a lengthy and uncomfortable roundabout process, but it is achievable. Furthermore, a study included patients with no extractions and four premolar extractions, revealing that those that kept their teeth had better occlusion contact and root angulations than those with extracted teeth.

On the other hand, an orthodontist may recommend teeth extractions in adults to enhance orthodontic results by making room for teeth and using braces or clear alignment appliances for alignment. Patients can also have lingering baby teeth that need to go to allow permanent teeth to sprout or accommodate.

In summary, teeth extraction help patients avoid a traumatic orthodontic process that requires using complex braces and extra time to see results. This means an orthodontist must first expand the dental arches, which require high levels of patient commitment and compliance.

Ask Your Fort Worth Orthodontist

The great news is you can set an appointment at Perkins Orthodontics, and our caring staff will evaluate your case and provide the most suitable solution for your orthodontic needs with a lesser impact possible regarding extractions. Your oral health is our highest priority, and we want to help you achieve a smile with which you can feel confident and happy.

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