When considering braces or clear aligners, one of the most common concerns is: “Will I need to have teeth removed?” The thought of extractions can feel worrying, but the truth is this: teeth are only removed if clinically necessary.
Why Would Tooth Extraction Be Clinically Necessary?
Orthodontists only recommend removing teeth when it’s the best option for a healthy, stable, and long-lasting smile. Some situations include:
Severe Crowding
If your jaw doesn’t have enough space to fit all your teeth, removing one or more may be the safest way to make room.
Bite Problems
In certain cases of deep overbite, underbite, or crossbite, extractions help align the jaws and teeth properly.
Protruding Teeth
When teeth push too far forward, extractions may improve both function and facial balance.
Problematic Teeth
Teeth that are impacted (stuck under the gum) or damaged may sometimes need removal before or during orthodontic treatment.
What Are the Alternatives?
Modern orthodontics offers many ways to avoid extractions whenever possible:
Palatal expanders (mostly for children/teens)
Interproximal reduction (IPR): very small reshaping between teeth
Arch development using braces or aligners to gently expand the dental arch
Your orthodontist will always consider these options first before recommending extraction.
The Bottom Line
Tooth removal is not routine in orthodontics. It’s only done when clinically necessary to ensure the best outcome for your bite, smile, and long-term dental health. Many patients complete treatment without extractions, while for others, removal is the key to achieving a healthy, lasting result.
If you’re considering orthodontic treatment, your orthodontist will guide you through all your options, explain why extraction may or may not be needed, and recommend the plan that’s best for you as an individual.
