Crowded teeth: Is it necessary to extract before Invisalign? (photo)

hi, my teeth are crowded and the dentist advised me that they need to pulled out two upper teeth and two lower teeth before invisalign. Is it really necessary? Thank you very much. Attached photo

Doctor Answers 3

Reluctant to Remove Teeth

Hey NE2244, Removing teeth, especially four teeth should only be done if it's absolutely necessary.  In my orthodontic practice, we generally remove 4 teeth for severe crowding (which you do not have) or changes in profile (which I cannot see).  Just based on the photos, it does not look like extracting teeth is absolutely necessary.   I find that you can easily add 1 year of treatment time by extracting 4 teeth especially in Invisalign.  It is very difficult to do removal of 4 teeth with Invisalign and I hope you have an experienced Invisalign doctor for that situation.  Good luck!

Irvine Orthodontist

Removing 4 teeth for invisalign

Looking at photos you have mild to moderate crowding 
the arches can be expanded to correct the crowding so I do not recommend removing 4 teeth

Raj Kumar, BDS, LDSRCS
London Dentist
5.0 out of 5 stars 8 reviews

Are extractions necessary?

Thanks for taking photos.  You basically have two options when it comes to reducing the crowding of your teeth.  Here they are:

Option #1:  Extract a couple of teeth per arch.  Then use Invisalign to align your teeth in a non-crowded manner.

Option #2:  IPR (inter-proximal reduction).  This is when the dentist makes each tooth skinnier by creating small spaces between them.  These spaces are later closed as your crowded teeth spread out into better alignment.  

Ultimately, your dentist would make the decision that he/she feels is best, so if you are wavering, it is nothing wrong with getting a second opinion by a cosmetic dentist.  I actually encourage my patients to get 2nd opinions whenever they seem undecided on care. Good luck to you and I hope this helps. "Follow" me on Real Self to ask more questions.
Sarah Thompson, DMD
St. Louis, MO

Sarah Thompson, DMD
Saint Louis Dentist
5.0 out of 5 stars 15 reviews

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.