Q. For treating crowded teeth, is it necessary to get four teeth extracted?

Answered by
Dr. Prerna Jain
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 04, 2017 and last reviewed on: Sep 11, 2021

Hello doctor,

My son has crowded upper and lower teeth. So, I have been to two orthodontists yesterday, and I got different opinions from both of them. One said we do not need to remove any teeth, however, his upper teeth will come little forward and will not cause much deformation in his face. The other one said, I would not take the case unless you agree to remove four teeth, which I have marked in red, in the attached x-ray. As per him, there is no way to make these teeth straight without removing the teeth. I am really confused on who is correct. Can you please provide your opinion?



Welcome to

I can understand your state of confusion. I have seen the x-ray (attachment removed to protect patient identity). It can be quite difficult to decide. So, I will give you information about both line of orthodontic treatments and the reason behind them.

  • Your son has mild to severe crowding in both his arches. He has no obvious protrusion of lips with respect to his facial proportions. What your son has is a borderline case, wherein it can be treated with or without extractions but there are pros and cons of both lines of treatment.
  • In the treatment without extraction, the arches will be expanded and teeth will be placed in a wider arc to create space and bring all teeth into line. This means that, in the front, they will come at a forward position. That gives a toothy appearance which is youthful, yet might not be acceptable to some patients.
  • However, in this line of treatment, you will have an option to extract teeth later and bring them back. But if that happens, we will be moving teeth back and forth and it will result in longer treatment. But will give you a chance to avoid extraction.
  • In the treatment with extraction, the teeth will be removed to create space for bringing the teeth into line. This line of treatment will be faster. The drawback can be that lips can fall back a little. That is almost irreversible and gives a non-youthful appearance. However, it may not necessarily depend on the confidence of the treating orthodontist and his plan of treatment.
  • Sometimes, different orthodontists have different ways of solving the same problem. Both are usually right. But it all depends on your choices and your confidence in the doctor.

For more information consult an orthodontist online -->

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