Child pulling teeth

Is Pulling Teeth Necessary?

One question we hear often is, “Will my child need to have teeth pulled?” Here’s what to know about pulling teeth, and why your child may or may not need an extraction.


Then and Now

Not long ago – that is, around twenty or thirty years ago – extractions were commonplace in orthodontic treatment. Probably 75% of patients had teeth pulled. Orthodontists pulled teeth in order to make room for other teeth coming in.

These days, extractions are much less common. Instead of pulling teeth to make room in the mouth for emerging teeth, we can often move teeth earlier and/or use palate expanders to create the space needed without extractions. In our practice, we see extractions in less than 20% of patients.


When Pulling Teeth is Necessary

In some cases, it’s simply not possible to make enough room for erupting teeth through braces or expanders. Teeth have to go somewhere and there’s only so much bone and gum. In a very crowded mouth, it’s possible to push the teeth too far.

This is when the expertise and experience of the orthodontist really matters. I can see if there’s enough bone to accommodate all the teeth or if an extraction is necessary to make space. The goal is always to avoid pulling teeth, but I also know that there are some situations where it’s the best course of treatment.


Is There Any Way to Avoid Pulling Teeth?

The best way to reduce the chances of needing teeth pulled is early intervention. Some parents balk at the idea of taking their 6-10-year-old child to the orthodontist but this age is the perfect opportunity to make some significant changes.

That’s because some but not all of the permanent teeth are in and the jaws are still developing. This means we can intervene to shape that development which leads to better outcomes. The other bonus of early intervention is that treatment at this age is often faster and less invasive than it would be if the patient were to wait until adolescence or adulthood for treatment.


Choose an Orthodontist with Care and See Them Early

The moral of the story is to choose an orthodontist with experience and expertise. You can even ask orthodontists you’re “interviewing” what percentage of their patients have permanent teeth pulled, and ask them why. And if you’re a parent, be sure to take your child for a first visit to the orthodontist by age seven, as recommended by the American Association of Orthodontists. While it’s likely your child won’t need any early intervention, if they do you can reduce the likelihood that they’ll need teeth pulled later.