Space can easily be achieved by expansion, mechanically thinning the teeth or extraction of permanent teeth. However, there are limits to expansion and IPR to avoid gum recession and bone loss around those teeth. To avoid this, if your crowding is severe, the only way to create space is removal permanent teeth, however, if not you can either expand the arch or reduce the size of individual teeth by thinning the enamel between each tooth or a combination of both. If you are within limits of expansion, by just placing a wire that is larger than your arch you are going to expand that arch and pick up additional space. We routinely do this in orthodontics today without extracting teeth. A long time ago, because the braces were bands that fit around each tooth we needed about 7mm of space just to place the braces. That is really the main reason so many us, including myself, had four bicuspids extracted to create enough room to align the teeth. However, today we bond the brackets on each tooth and no space is require between the teeth to place braces. So we can easily expand each arch 6-8mm. Secondly, if more space is required we can thin the enamel between each tooth to create space between the teeth. This is no way will adversely affect the health of those teeth. This happens naturally many years ago as we chewed because of our abrasive diets and work conditions. Hope that helps,Dr. Jim Awbrey
