Tooth Extraction for Braces Or Invisalign - Do Orthodontists Pull Teeth

Tooth Extraction for Braces Or Invisalign – Do Orthodontists Pull Teeth?

Invisalign or braces may recommend tooth extraction as part of orthodontic treatment. The procedure involves removing one or more teeth from the jaw. Orthodontists usually decide whether to extract teeth after carefully evaluating a patient’s dental and facial structure, as well as their treatment goals. An Oral Surgeon performs the extraction, who is specially trained to do so. Invisalign or braces can be used after the extraction to align the remaining teeth and improve the overall bite and appearance of the smile.

Extraction for Braces

“I have wanted braces for a long time now, but the thought of getting my upper premolars extracted for my braces freaks me out. My teeth aren’t actually too bad, I have a moderate overjet and a slight overbite, my bottom jaw is perfect apart from one crooked tooth. Although, I do have a rather small mouth and jaw due to being half asian.

Every orthodontist I have been to has insisted on removing teeth to make space. Although I’ve wanted braces, I’m unsure if I would extract my perfectly healthy premolars for it. So my questions are:

Is there any way I could get braces without getting my teeth extracted? And if I do decide to get my teeth extracted, how much would it hurt? And finally, is keeping my healthy premolars or not a big decision for me in the future?

Thank you for answering everyone!”

So let’s start from the beginning.

How Common is Tooth Extraction for Braces?

In orthodontic treatment, tooth extraction is not very common. Having stopped growing, the teeth and bones of adults may become difficult to move, causing severe crowding. You will have as few teeth removed as possible to achieve optimal results.

Does Tooth Extraction Change Face Shape? 

If the patient undergoes a teeth straightening procedure in a severely overcrowded mouth without extractions, the patient may end up with excessively protruding teeth and lips, which negatively affect the appearance of the face. It is also possible for protruding teeth to pose a long-term health risk, as the excessive splay of some teeth can lead to the gums receding if they are partially exposed to the bone.

Which Teeth Get Extracted for Braces?

It is the bicuspid (premolar) teeth that are removed most frequently for braces. Located right in the middle of your mouth, between your eyeteeth (canines) and molars (the largest back teeth), these are the teeth that line the inner side of your mouth. It may be necessary to extract teeth that have large fillings, are impacted, or have previously been damaged.

Does an Orthodontist Remove Teeth?

There are no teeth pulled by orthodontics. In order for you to achieve a healthy bite and straightened teeth, they determine if you need to have the teeth extracted, and then refer you to an oral surgeon or general dentist for the extraction.

How Long Does it Take for Invisalign to Close Gaps After Extraction?

In this case, the answer is “it depends” due to the fact that patients have orthodontic issues varying in complexity.

0.2 millimeters of movement is possible with Invisalign aligners. For example, if you have a 2.0 mm gap between your teeth, it will take approximately three and a half months for the gap to close.

Aligners will need to be worn for every tooth in order to prevent gaps in the back teeth, all the teeth need to be moved by a small amount.

An orthodontist typically recommends wearing aligners for three to six months to heal teeth gaps and prevent new ones from occurring. They should normally work between 20 and 22 hours per day if they wish to do so.

Are There Alternatives to Tooth Extraction?

Extractions can be replaced by…

Repositioning the molars
In order to allow the front teeth to be inserted more comfortably, this procedure is performed most commonly on younger patients. With braces or headgear, this is relatively easy to accomplish with patients who are still growing. It is harder in adults who have stopped growing.

Expansion of the Arch
is a common procedure in young patients with high success rates. Extreme expansions can, however, pose risks. It is very easy for the teeth and bones to move back into their old positions if retainers are not worn long enough. Furthermore, since the root of the teeth is moved outward with this procedure, thinner layers of bone are created over the roots, which may result in receding gums in the future.

Operation on the jaw
If a patient has a severe overjet or underbite, he or she may be able to do without removing teeth by having surgery to move the lower jaw forward or backward. It is more common for patients to have a few teeth pulled instead of undergoing such a lengthy procedure.

Reshaping of the teeth
Adults are more likely to have this procedure done, especially if their teeth have become misshapen over time or they have less crowding. The edges of the teeth are trimmed lightly to remove enamel. By decreasing the spacing between multiple teeth by fractions of a millimeter, you can prevent crowding while retaining enough enamel to keep the teeth resistant to cavities and sensitivity.

How Much Does it Cost to Extract Teeth?

Every dentist who is a professional will do the following:

  1. Listen to your concerns
  2. Advocate saving your teeth
  3. Prescribe preventive measures
  4. Explain your options, and
  5. Allow you to make an informed decision

Costs are influenced by how far away your normal tooth is from your dental office, if there is unseen decay, if there are unseen fracture lines, and where the dental office is located.

Pacoima and Lompoc are cheaper than San Francisco and New York City because of high rents. This also applies to an office that offers staff medical insurance (not all do).

One doctor is quoted online as saying: In the case of a patient coming to me, I would charge them for three films (2 pre-op and one post-op), a dental laser cauterization, an extraction, and laser sterilization. The lower ‘routine’ fee would apply if your normal tooth came out routinely and without fracture.

The sum of all these amounts would be easy to calculate. In addition, there would be no need to use the gentle laser if only one film is taken.

teeth pulled out

Is it Safe to Extract 4 Teeth at Once? 

Having one or more teeth removed at the same time is not a problem. While it is rare to remove multiple teeth during the same procedure, patients with severe tooth decay may only have this option. We recommend extraction of multiple teeth in a single visit if you have severe tooth decay as opposed to coming in for multiple procedures. In this way, the bacteria will not spread between appointments and affect more teeth.

Does Getting Teeth Pulled for Braces Hurt?

It is likely that a local anaesthetic will be administered for a simple extraction. As a result, you will only feel a little pressure and no pain during the extraction because this procedure numbs the area around the tooth.


To summarize, tooth extraction is a common orthodontic procedure that may be recommended along with braces or Invisalign treatment. Orthodontists determine if extraction is necessary based on the dental and facial structure of the patient and the patient’s treatment goals. Following the extraction, the patient can continue orthodontic treatment to align the remaining teeth and improve their overall bite and appearance. The extraction is performed by an oral surgeon. In the long run, this procedure will improve your overall oral health, resulting in a better bite and a beautiful smile.

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