I Was Told That I Would Need To Remove 4 Teeth In Order To Get Invisalign? (photo)

hello, i have included 4 snap shots of the my teeth, i was informed once that i would have to remove 4 of my teeth and can not be corrected with invisalign. Any thoughts or comments would be appreciated. Thank you. one last note, my profile is a bit protruding so the removal of 4 teeth is to allow my profile to look more esthetic. definitely a desired goal. thank you

Doctor Answers 6

Extractions not be needed if another approach is used.

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Not all orthodontists would agree, as we all were trained that extractions are the best option in many cases, but I personally would not have any teeth removed to do your treatment.  However, we would use an approach which normalizes your facial bone structures and increases supporting bone structure prior to braces or invisalign.  With this approach you could also reduce the protrusion you seek, but give you a very balanced full "movie star" like smile.

Extract teeth with Invisalign?

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The amount of dental crowding you have can certainly be eliminated with Invisalign, without extraction. However, in doing so it is probable your teeth and lip profile will become more protrusive. Thus if your goal is to reduce protrusion, this is probably not the best treatment choice. The question is not, "can it be done withourt extraction", but rather "is it appropriate to do it without extraction if the goal is to reduce protrusion".

Extraction does not simplify treatment. In fact treatment of an "extraction case" with Invisalign is one of the more challenging corrections that we face. I suggest that you clearly define your objectives and use them as a guide to the appropriate treatment choice. 

R. William McNeill, DDS, MS
Mercer Island Orthodontist

I agree second opinions are good

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I always think, what is the final result you are trying to get???  Do you want to get the job done quickly?? Do you want to get the job done without extractions??? Or do you care if teeth are taken out or not??? I would put some thought into that. Are you opposed to regular braces?? My personal take on this is I would try to avoid taking any teeth out. However, that may mean  you need to get regular braces, and it may take a little longer. I would seek someone who has experience doing invisalign and regular braces. I would weigh all of my options, and what is inportant to me (the patient), and go from there. I have seen some cases where teeth are taken out and it completely changes a persons profile. I am not saying that this would happen to you.  However, many times when teeth are taken on some people their profile looks flat on the lower 1/3 of the face, and some people look fine.

James Merrett, DDS
San Antonio Dentist

Removing Teeth Before Braces/Invisalign -- Good Idea or Bad?

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For your case I would NOT remove teeth to create space -- now, I might recommend you get rid of your wisdom teeth (3rd molars) either before or after Invisalign treatment...

For most cases, it is no longer necessary to remove teeth in order to do orthodontic movement.  Doing so can create new problems/issues you didn't have before.

Do I need teeth removed for Invisalign?

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Just read Dr. Timmerman's answer...I disagree completely!...not over whether teeth do or do not need to be removed but over the "simple" comment.  Anyone who has done any Invisalign at all knows that it is much harder to treat a multiple extraction case than to do it without extractions.

  That said...sometimes the best long term result for the patient requires extractions.  We do extractions for the patient's benefit not because it makes the orthodontist's life "simpler!"

So sure, get another opinion...just from someone who is not trying to treat ever one without extractions..

Robert Waxler, DMD, MS
Saint Louis Orthodontist

Second opinions are good

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I can't tell for sure from the photos, but you may be able to avoid extractions.  It certainly would be simpler to remove teeth and place brackets and wires, but we don't do that as much as we used to.  Some clinicians still like to simplify things and suggest extractions for all cases.  It appears that you have a 5 mm problem and extractions would be a 20 mm solution.
I would suggest another doctor's opinion.

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.