Concerned about teeth extraction in order to fix top teeth overjet and bottom teeth crowding. Is this common procedure? (photo)

I had a very thorough orthodontic consultation where I was told I could get invisalign to make my teeth straight but if I wanted to correct my overjet, I would have to get 2 top premolars extracted. I am very nervous to remove 2 teeth in the hopes of my teeth becoming straight. Is this a common procedure? How long will I have large spaces where my premolars are missing once I start wearing the trays? And I have read elsewhere that extraction can change the look of your face, how is this so?

Doctor Answers 4

Extractions for orthodontics.

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I would be very leary of having the extractions and it could lead to sleep apnea or snoring problems in the future.  It is possible to widen the maxilla in an adult by utilizing Epigenetic Orthodontics (DNA Appliance) to grow the maxillary bone and then finish the case with Invisalign if needed.

In this manner you orthopedically enlarge the bone and  (pneumopedically)   enlarge the airway.

Removing #teeth to decrease crowding and #overbite

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Thanks for providing a photo, it makes your case easier to diagnose.  
Yes, it is very common to remove 1 or 2 teeth prior to Invisalign treatment or metal braces.  This creates spaces that make it easy for your other teeth to move into.  Invisalign is great at closing spaces and reducing crowding. An alternative to extracting teeth is IPR (inter-proximal reduction).  This is when neighboring teeth are shaved to create more space.  I would not recommend IPR for your case, based on your photo.
Spaces left by the removed teeth may remain for up to 6 months.
Good luck to you and I hope this helps.  "Follow" me on Real Self to ask more questions.
Sarah Thompson, DMD
St. Louis, MO


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from the look of your two photos, which are not nearly diagnostic, but anyway, I'd say that's about the stupidest thing you could do.   I wouldn't do it unless there's some good reason that I'm missing here. 

did an orthodontist tell you that?

Frank Celenza, DDS, PC
New York Orthodontist

Extracting premolars

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Removing a set of premolars is very common practice in orthodontic patients that do not have enough room in their arch to move teeth back into the position that is needed. The teeth need somewhere to go when they are being moved, and sometimes the arch can be too small, so the premolars are removed. This affects your facial profile as the way your lips lay against your face, and how the outline will be before and after treatment. The spacing is closed by the time your orthodontic treatment is completed.

Michael Tam, BDS
Australia Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.