Is permanent teeth extraction necessary for my son's overcrowding issues?

Hello,

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I have gone through your query and OPG (orthopantomogram) attachment (attachment removed to protect the patient's identity). There is crowding, but I cannot predict the severity of crowding from OPG. Clinical examination and photographs are necessary. One has to create a space for ideal alignment and positioning of teeth when there is severe crowding. There are few ways to make space, such as proximal stripping, expansion, and extraction. In case of severe crowding, one has to go for extraction of teeth. In most instances, premolars are extracted. Moving adjacent teeth will fill that space, so one cannot see or notice any black space like extracted tooth after completion of orthodontic treatment. So, it will not hamper the looks of the patient. There are no such side effects when considering orthodontic extraction. I would like to know what is troubling you in the aspect of side effects of orthodontic extraction? Please upload images of facial photographs, photos of the upper and lower teeth of your son. For further discussion, kindly get back with the above details. Regards.