Why Avoid Extracting

Why do we make every attempt to avoid the extraction of teeth?

In orthodontics, the goal is maximum function with a healthy pleasing smile. Many times (not always) when teeth are extracted the facial features are negatively affected. Please note this patient’s smile. It is broad and the teeth follow the “smile line.” That is the lower lip parallels the edges of the teeth. When teeth are extracted there is a narrowing of the overall width of the arch and one may see dark areas on both sides between the teeth and cheeks. This is the result of the narrowing.

Oftentimes too when teeth are extracted the profile is affected. When the teeth are extracted and the resulting residual spaces are closed it sometimes causes a flattening of the profile. Sometimes this is desirable. Other times, however, it is not. The problem is as we age we become flatter or more concave in the profile. So, if by extracting teeth on a younger individual causes the profile to become flat, with age this will worsen. This is because as we age it appears our nose and chin become larger. So preserving the profile on young individuals is a high priority.

Please observe the following patient. Although he has a flat profile he has very severe dental crowding. However, if teeth were extracted and the residual spaces closed his profile would at best stay the same and most likely become more concave. However, remember with age we flatten in the profile. Therefore, Dr. Dillon elected to treat without the removal of teeth. Not only was the result a beautiful smile, but the profile improved tremendously.