Will Crowded Teeth Need Pulling Before Invisalign?

My bottom teeth are pretty crowded. Would I have to get them pulled for Invisalign?

Doctor Answers 7

This depends on your case and how severe the crowding is

This depends on your case and how severe the crowding is. Extractions may be necessary to make space for alignment. In our practice, about 5% of people need to have teeth removed. Most of the time we can align the teeth using other methods and avoiding extractions.

Unable to be determined from your photo

With no disrespect to previous answers, I am unable to determine whether you require extractions from this photo you have taken.  There are many considerations other than crowding that determine the need for tooth removal including profile and periodontal health.  This photo alone is not diagnostic, which is why you require a complete orthodontic diagnosis including x-rays, photos, and an examination before coming up with a treatment plan.

With Invisalign, some dental expansion is possible, but it is not the type of appliance used that determines whether extractions are required or not.  If you needed extractions, you would require them with braces or aligners.

Jason K. Tam, DDS
Toronto Orthodontist

No, you will not need to have teeth removed

Looking at your photos I feel expansion with orthodontic treatment could eliminate the crowding without the need to remove teeth. In this situation, I will many times start a case non-extraction and evaluate in approximately 4 to 6 months whether to extact teeth or not. I would, however, highly recommend fixed appliances rather than invisalign to treat your case. There are significant angulations issues with your teeth and to properly parallel the roots is very difficult to accomplish without fixed appliances(braces). Without properly paralleling the roots in the bone during treatment will only result in relapse after your braces are removed.

James J. Awbrey IV, DMD
Atlanta Orthodontist

Teeth pulling before Invisalign depends on your age

From the photo it seems like your arch can be widened and thus no need for pulling any teeth. We do so much now days without ever pulling teeth. Plus you can have all your models taken and sent to Invisalign and the doctor can then tell you for sure whether or not its needed before you even start your treatment.

Michael J. Thomas, DDS
Los Angeles Dentist
3.0 out of 5 stars 2 reviews

Crowded teeth pulling before Invisalign?

From your photo, it does not appear that any of your front teeth will need to be pulled.  In most cases it is ideal to keep your teeth (except your wisdom teeth) and use the Invisalign process to properly align them.

Susan Goode Estep, DMD
Atlanta Dentist
5.0 out of 5 stars 3 reviews

Crowded teeth are pulled less frequently today

It used to be very common to have teeth pulled for orthodontic purposes.  Today, we do that much less often.  From what I can see in your attached photo, I would NOT think pulling teeth would be necessary.

Lance Timmerman, DMD, MAGD
Seattle Dentist
4.3 out of 5 stars 6 reviews

Pulling out teeth for a crowded mouth

You may be surprised when your dentist tells you that you won't need extractions
Sometimes severe crowding is due to arch collapse and by just expanding the arch you can create enough space to correct the crowding
you may need 2 opinions as some dentists do prefer removing teeth
in most cases extractions can be avoided with Invisalign 

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