How does a dentist determine whether tooth extraction is necessary for crowded, overbite and overjet teeth?

Doctor's Answers 1

There are 3 main reasons to consider extractions in the treatment of crowded teeth.

  1. The crowding is too severe to be corrected with IPR (interproximal reduction: sandpapering the teeth to make them slimmer) or arch expansion.
  2. The patient has bimaxillary protrusion of the soft tissues (lips) and incompetent lips (lips that cannot meet without actively straining).
  3. The patient has an underlying skeletal discrepancy.
  • If the upper jaw is too large/the lower jaw is too small (class 2), then upper extractions may be considered as camouflage.
  • If the upper jaw is too small/the lower jaw is too large (class 3), then lower extractions may be considered as camouflage.

Overjet (how far the upper incisors are from the front surface of the lower incisors) and overbite (how much the upper and lower incisors overlap in the maximum biting position) are NORMAL features of occlusion that should be present in ALL humans. Orthodontic treatment merely optimises this (reducing a large overjet or reducing a deep overbite, for example) but cannot eliminate overbite or overjet!

Similar Questions

How do I know if my wound is healing after wisdom tooth extraction?

When wisdom teeth are taken out, minimal wound closure ie gums merging together to close the socket hole usually takes about 2 weeks. Signs and symptoms that the socket is not healing includes 1. Pain - dull ache that does not decrease or increases over the next few days 2. Bad taste / smell - usually a sign of a dry socket if this starts only 3 -5 days after the wisdom tooth has been taken out 3. Swelling / bruising - usually dissipates in 1 - 2 weeks but if it stagnates then it is best to consult with your dentist Tips to help with wisdom teeth healing include 1.

Photo of Dr Beth Seow

Answered By

Dr Beth Seow

Dentist

How do dentists determine the amount of space needed to fix an overbite? (photos)

The decision to extract, or not to extract, for any case depends on several factors, such as the facial and lip profile (e. g. are the lips protruding?) the amount of overlap or crowding of the teeth, how much the teeth are flared forward with respect to the bone, etc. Patients with a substantial overjet would more often have lips that unable to close due to the teeth which are sticking out. In situations like this, extractions will result in a more aesthetic or pleasing outcome.

Photo of Dr Geraldine Lee

Answered By

Dr Geraldine Lee

Orthodontist

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