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When Should You Extract Teeth to do Orthodontics?

Interesting question!  As it turns out, there is almost no reason to extract permanent teeth to do orthodontics.  Only in the extremely rare case when there are too many permanent teeth or when there is a genetic mutation should teeth be pulled.

So why are so many kids getting permanent teeth extracted to have their braces done?  As it turns out, there are a number of misconceptions contributing to the mistreatment.  It has taken decades to unravel this mystery and it is now safe to reveal how all of this came to be.

Years ago there was a flawed study that claimed that the jaw didn’t grow after 8 years of age and that the full set of crooked teeth the small child presented with would “inevitably” cause severe crowding that would never resolve.  This turned out to be a wrong assumption on two counts.

For all you mathematics buffs out there, here’s an interesting discovery.  As it turns out, all of the room needed to straighten teeth was overlooked mathematically.  A misunderstanding of a simple middle school math concept proves that the room was there all along.  This formula says that if you increase the width of your smile by only a 1/8th of an inch you would get more than 3/8ths inch of space around the arch (the formula is 2Πr, if you want to look it up).  This is more than enough room to stick a whole tooth into the set.  This alone is an incredible revelation that makes it fascinatingly easy to see how you could get a tooth or several teeth completely blocked out of the arch to fit in easily.  Just widen the smile a little!

The other misconception was that the teeth were stuck in a jaw that wasn’t going to grow.  Well, the fallacy of this is easy to spot.  Just look at the jaws of any 30-year-old and you will have your answer.  The 30-year-old’s jaw is obviously bigger… unless that person has had his or her permanent teeth pulled and has braces.

For thirty years now we here at this San Antonio dental office have been straightening thousands of adults’ teeth without pulling any, and invariably they fit.  Why is this?  It’s because when the teeth are moved in a way that encourages the jaw to expand, the jaws expand.  It’s as though they “want” to be correct.

Now, why would this be?  Well it’s almost unfair how simple this explanation is.  Let us say there’s some sort of divine intervention.  Let’s pretend for a moment that God had something to do with this.  Do you suppose somehow He messed up and put too many teeth in millions of children?  I doubt it.  Even if you don’t believe this and you are an “evolution” buff – how in the world did millions of years of evolution screw up and in just the last 100 years start putting too many teeth in humans?  It’s just not logical.  It makes no earthly or heavenly sense that “things” are just screwed up in our kids’ mouths and we had to start pulling their permanent teeth out.  Think about it.  Millions of mutant children!  What’s going on?

Once again, it’s something very simple with a very simple remedy!  All you have to do is wait a little bit, for crying out loud.  Wait until the child has a head a little closer to a grown-up sized one before you go straightening their teeth. By waiting until high school or so, your children will now have the necessary amount of space without having to pull any permanent teeth.

So what gives?  Why does modern man have this problem all of a sudden?  Well, we’ve seen how the math is misunderstood, so what is causing this problem developmentally – you know, making the smile narrow?  Unfortunately, it turns out that this common cause of malocclusion is also the most overlooked and least appreciated problem with the smile!

Most likely this problem is from two sources, thumb sucking and sleeping on a pillow on the side of your face.  Apparently applying pressure to the side of a developing face 8 hours a day or more (while they are sleeping) for years and years is enough to cause the dental arch to collapse inward a 1/16th of an inch or so!  This is more than enough to cause all the crowding and unfortunate extractions of permanent teeth in our children.

Just so we know, this “least understood” and “least treated” aspect of the human smile is how narrow the smile is.  By simply widening the smile, we can get the room to straighten the teeth (a little wider equals a lot of room around the arch).  When adequate room is created there is no need to extract.  The teeth all fit in like they were meant to.  Only rarely does anyone measure or calculate how wide the smile should be, especially a 30-year-old’s!  It is because of this lack of appreciation that so many parents are being told their children need their permanent teeth pulled.

So how do we know this?  All too often we see adults (30 years and up) arrive in our San Antonio cosmetic dentist office asking what we can do to make their smile larger and more attractive.  They often come in complaining that their profile is unappealing.  They feel their nose and chin are too prominent and the smile “too small,” kind of like the profile of a witch.  Orthodontists refer to this as the “dished in face.”  Yes, believe it or not, this bad name is intended to convince pull-happy orthodontists to lay off. It is caused by extracting your or your children’s permanent teeth.

Worse than this, we have consulted with individuals so disfigured over this that they’ve considered having part of their nose and chin removed by plastic surgery to correct their look.  Instead, more times than we can count, we have moved the teeth back out to where they belong and put in 4 bridges or implants right where they had their teeth pulled when they were younger and got braces.   How expensive, time-consuming and painful can you get?

It’s so much easier to go about it the way mother nature intended in the first place.  So, if you’re curious about this issue, come see how we can fit all the teeth your child was born with into their smile.  We’re betting you’ll be glad you did.

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