Will I Need to Have a Tooth or Teeth Pulled to Get Invisalign? (Photo)

Doctor Answers 12

Tooth extraction wiht Invisalign

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In your photo it appears tha the canine is not in the right position.  In order to move it into the right position we would do interproximal reduction not an extraction in your case.  Consult your dentist or orthodontist for specifics on your case.  Good luck

Philadelphia Dentist
5.0 out of 5 stars 3 reviews

Invisalign For Upper Crowded Teeth

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Please don't let anyone take out your upper cuspid tooth!  Removing an upper canine will compromise your bite and will never look cosmetically correct.  Invsalign works amazingly well for crowded teeth if your gum health, surrounding bone, lower teeth crowding and existing bite relationship will allow a positive outcome. Consult with a qualified Invisalign dentist to have your case evaluated.  One of the great advantages of the Invisalign system is you will see your completed case by a virtual computer model before any treatment is started.  Best of luck for a great smile.

Dustin Nelson, DDS
Pasadena Dentist

Extraction with invisalign.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I agree with all the other posts in that there is not enough info to determine if extractions will be necessary.  It does appear that you have a crowding problem.  If you will need extractions then invisalign might not be the best option for you.

Michael Minars, DMD
Miami Orthodontist

Extractions are sometimes necessary...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In your case, there is not enough information to make that determination. I would recommend seeing aa orthodontist for an opinion on your case.

Good luck!

R. Scott Smith, DMD
Springfield Orthodontist

There are many ways to open space for crowding with Invisalign

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Orthodontically, there are generally 3 ways to open space: pulling teeth, expanding the arches, or shaving between teeth. The decision on what to do, either alone or in combination, depends on the degree of crowding, the measurements of the angulation of your teeth within the medullary bone of your jaws from your side head film(lateral cephalogram), and the health of your gum tissues.

Its hard to say with certainty without seeing you clinically, but it seems that you should be fine assuming you dont have too much lower crowding, which I cannot see off of the photo provided.

Mazyar Moshiri, DMD, MS
Saint Louis Orthodontist

Will I Need to Have a Tooth or Teeth Pulled to Get Invisalign?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I treated a case similar to your, where we saved this tooth and everything looks straight and patient is very happy.

More information is needed to provide a proper diagnosis though. I would advise to consult with an Invisalign specialist, who can take ALL necessarry data and make sure you are reaching your goals.

Do you have to take teeth out everytime you see crowding?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

We rarely need to take teeth out for any orthodontic treatment whether that’s invisalign or braces, etc.
In most cases, crowding is a result of narrow or irregular arch forms especially on the upper arch.  This is something that can be corrected with invisalign or braces. Clinically speaking if the distance between the lingual of upper first molars is less than 35 mm in adults, we have a narrow arch and must expand and/or upright the teeth that are tilted in to create room for crowded teeth.  We consider age and periodontal health of the patient as to how much expansion may be possible.  

Small percentage of patients have large teeth and smaller jaw bone.  If the size of upper front tooth is more than about 10 mm from right to left of that tooth near the edge,  a patient may have larger than average sized teeth making it difficult for all teeth to fit into upper arch unless they also have prominent large jaw bone.  The only situation extraction may be recommended is when a patient has large teeth but small jaw bone but even then, we strive for reducing size of the teeth cosmetically as opposed to extractions.

Although traditionally extractions were done routinely in crowded teeth, it’s no longer an acceptable nor a conservative way of doing orthodontics nowadays.  There could be rare exceptions such as when a tooth is very compromised and or when a patient genetically has extra tooth.   Also wisdom teeth that are coming in sideways and/or have been decayed are candidates for extraction.  Although we do not have enough info in your case, you are very likely NOT going to need an extraction.  NOTE: Canines should never be extracted unless they are dentally or periodontally hopeless or they are fully impacted and fused to the bone.

***Online Answers should NEVER be substituted for a complete clinical exam and following advice of your treating doctors based on proper and full diagnosis and treatment planning.   There is no way anyone can properly diagnose and treatment plan a patient online without an in office exam.

Daniel Noor, DMD, PC
New York Dentist

Absolutely No Extractions Necessary

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your upper right canine is very high in your gum line and the movement of pulling the tooth down into alignment is called extrusion. This movement is very difficult with Invisalign, but not impossible. With the assistance of attachments and elastics you can move the tooth into position. Before we can pull the tooth down you need to make space for it. One way to make space, without extracting, is to slightly epand the palate with your Invisalign and reduce the size of the teeth by recontouring them. Your case is a little more complicated and I would suggest going to an orthodontist that has the experience to deliver the results without extracting teeth. If you go to the invisalign website and enter your area code you can find the most qualified orthodontist in your area.


Good Luck!

Dr. Jacquie :)

Jacqueline Fulop-Goodling, DMD
New York Orthodontist

Tooth pulled prior to invisalign?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Only the dentist that examined you can make that determination. We rarely not to remove teeth prior to Invisalign. This is done only as a last resort to make room for all of the teeth.

Zola A Makrauer, DMD
Philadelphia Dentist

Extracting teeth for invisalign

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The answer is it is hard to tell.  Based on the picture in having the canine that is ectopically erupting, it appears that we should be able to fit this tooth into the arch no problem without having teeth taken out.  However, I would encourage a complementary orthodontic examination to evaluate the malocclusion to have a definitive answer.  In the past, we used to extract teeth on 30% to 40% of our patients, as this was a standard care for orthodontics at the time.  Now, we have better technology and more research that allows us to treat most cases non-extraction if possible.  I would say that extractions in my particular practice, we are down to about 5% compared to 30% or 40% in the past.  However, there are multiple factors that contribute whether to take the teeth out or not so I would consult with an orthodontist to know for sure.

Ron D. Wilson, DMD
Gainesville Orthodontist

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.