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An Asian man showing his crowded teeth.An Asian man showing his crowded teeth.

Is Extraction Necessary for Crowded Teeth?

By: BeSeen Team

Date: August 29, 2023

Will you still consider undergoing orthodontic treatment if the answer is yes? Or will that stop you from scheduling a dental appointment and having your crowded teeth checked? This resistance isn’t surprising as extraction ranks high in the list of most feared dental procedures. Would you voluntarily agree to lose a healthy tooth?

But pause right there – you’re getting ahead of yourself. The answer to your teeth-alignment predicament might not even involve any of that! Read on to know if you can really fix crowding without removing teeth and if you’re among the “lucky ones” who meet the criteria.  

What Are Crowded Teeth?

A boy smiles to show his crowded teeth.
Even kids can suffer from dental crowding.

Imagine your teeth getting cosy with each other – maybe a little too close for comfort that they overlap and protrude in abnormal angles. This is dental crowding, a condition where teeth cannot grow straight and fit within the jaws because of the lack of space.

What happens if your teeth are crowded?

The Journal of Orthodontic Science reports that overcrowding is “the most common malocclusion in patients worldwide.” Thus, it’s easy to spot even for an untrained eye. Dental crowding can manifest as a displaced, twisted, or generally misaligned tooth. And it can affect both kids and adults in varying magnitudes.

Crowded Teeth Causes 

According to the Australian Society of Orthodontists, in many cases of malocclusions, the culprit is genetics. Hereditary causes involve “jaws that are too small to accommodate a full set of teeth and misaligned jaws that did not form properly.” Ultimately, this mismatch between teeth size and jaw size is behind teeth crowding. 

Certain behaviours also contribute to the misalignment, including thumb-sucking, tongue-thrusting, and improper dental care. Additionally, you can increase your chances of overcrowding through the following:  

  • Premature tooth loss
  • Over-retained baby teeth
  • Extra adult teeth

Levels of Dental Crowding 

A severe case of dental crowding.
Your dentist will develop a treatment plan depending on the severity of your crowding.

Oral health care providers classify teeth crowding according to the severity of the condition. They also measure the discrepancy between the widths of the jaws and the rows of teeth to determine the condition’s classification. There are three types, as explained by an article published by the Journal of Orthodontic Science:

  • Mild crowding: The space discrepancy is within 1-3 mm.
  • Moderate crowding: The space discrepancy falls within 4-6 mm.
  • Severe crowding: The space discrepancy is more than 6 mm.  

How can you catch teeth-crowding signs yourself? The easiest way to spot overcrowding is to face the mirror and check the arrangement of your teeth. See if any teeth overlap or are simply out of position. Then, consult your healthcare provider for a more definitive diagnosis.

Does Teeth Crowding Get Worse as You Age?

It’s possible. Crowding can worsen as your grow because of several factors:

  • Wisdom teeth
  • Jaw bone density
  • Changes in mouth shape

Oral Health Risks of Crowded Teeth

A dentist checks the teeth of a young Asian woman.
Crowding can lead to plaque accumulation and tooth decay.

Is managing teeth crowding as simple as taking a painkiller and sleeping it off? Of course not! Instead, ask your dentist about the most appropriate treatment for your case.

Also, don’t dismiss overcrowding as a mere aesthetic concern. Straumann warns: the condition is “a big contributor to the breakdown of dental health over time. Crowded teeth are harder to keep clean, and can create detrimental relationships when biting and chewing.” 

A study published by IOPscience also confirmed that crowding poses a challenge in maintaining proper oral hygiene through brushing. Because of the tight spaces between the teeth, removing food debris becomes difficult, therefore increasing the chances of these dental concerns:   

Can Braces Fix Crowded Teeth?

A timely and fitting treatment plan is necessary to mitigate the repercussions of overcrowding. The most common solution involves traditional braces, which fix alignment by applying pressure on the teeth. These metal brackets are suitable for younger patients and mild to moderate cases. But they’re not the only choice.

How to Fix Crowded Teeth

A teeth model with traditional braces beside removable orthodontic appliances.
Braces, clear aligners, and dental plates can help fix crowding.

Your treating doctor will recommend the most appropriate therapy depending on the magnitude of the crowding. Some possible options:  

  • Clear aligners – invisible trays, like ClearCorrect, which move teeth to their proper positions discreetly and comfortably.
  • Permanent or removable dental plates – plastic devices that use wires and springs to correct teeth alignment.
  • Palatal expanders – a tool that helps widen the upper jaw of children and adolescents.
  • Lingual braces – orthodontic appliances attached inside the surface of the teeth.   

When Is Extraction Necessary?  

Now, when does extraction enter the equation? According to a study by The Angle Orthodontist, “cases of severe crowding may require more extensive therapy with tooth extractions.” The procedure will help create space for proper alignment, establish a stable bite, and eliminate unnecessary teeth.  

Sometimes, extraction is necessary before orthodontic treatment because of decayed and damaged teeth. Your treating doctor might also recommend it for safer, straighter, and long-lasting results. Or, at times, they’ll suggest it after wearing braces or aligners to avoid relapse.  

Ultimately, the decision to remove teeth depends on your condition and your willingness to undergo the procedure. Your dentist will consider all other options first before concluding that extraction is necessary to fix your crowded teeth. Trust that they’ll always have your best interests at heart. Smile those worries away! 

 

References:   

Alqutub, A. W. (2021). Pain Experience after Dental Implant Placement Compared to Tooth Extraction. International Journal of Dentistry, 2021, 1–5.  

Australia, O. (2023, March 8). Dental crowding: causes and treatment options. Orthodontics Australia.

Bahirrah, S. (2018b). Relationship of crowded teeth and Oral Hygiene among urban population in Medan. IOP Conference Series, 126, 012188.

Cardoso, C. a. L., Valerio, C. S., De Carvalho Carmelo, J., Rodrigues, L. G., Silva, A. I. V., & Manzi, F. R. (2022). Impact of orthodontic correction of dental crowding with pre-molar extraction in the anterior mandible evaluated by cone-beam computed tomography. Journal of Orthodontic Science, 11(1), 47.  

Crowded Teeth. (n.d.). Straumann.

Department of Health & Human Services. (n.d.-c). Orthodontic treatment. Better Health Channel.

Filho, H. L., Maia, L. H. E. G., Lau, T. C. L., De Souza, M. M. G., & Maia, L. C. (2014). Early vs late orthodontic treatment of tooth crowding by first premolar extraction: A systematic review. Angle Orthodontist, 85(3), 510–517.  

Jadidi, L. A., Sabrish, S., Shivamurthy, P. G., & Senguttuvan, V. (2018). The prevalence of malocclusion and orthodontic treatment need in Omani adolescent population. Journal of Orthodontic Science, 7(1), 21.  

Peck, S. (2017). Extractions, retention and stability: the search for orthodontic truth. European Journal of Orthodontics, 39(2), 109–115.  

Turner, S., Harrison, J. E., Sharif, F. N. J., Owens, D., & Millett, D. T. (2021). Orthodontic treatment for crowded teeth in children. The Cochrane Library, 2022(1).

Why are my child’s teeth crooked? – Australian Society of Orthodontists. (n.d.).  

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