The question of whether to extract teeth or not extract teeth is as old as orthodontics itself. The original orthodontists in America first espoused a non-extraction philosophy which did not always work in all cases. Typically, the teeth would lean too far forward and lips would start to look too full for a pleasing profile.
In about the 1950’s, orthodontists started to experiment more with an extraction philosophy. While this produced great improvements in the angulation of the front teeth and the ability to align complicated cases more easily, they also could produced profiles that were too collapsed.
Nowadays, a kind of middle ground is used where orthodontists consider what is best for obtaining a pleasing soft tissue profile. Where such a profile would be produced with extractions, then extractions would be undertaken. It is far better to extract and obtain the ideal result than to let the fear of extractions prevent you from achieving the ideal result. it is true that the degree of crowding is often less in Caucasians and therefore extractions are indicated less. However in Asians, especially braces patients in Singapore, the crowding is often worse and the teeth tend to lean forward much more, extractions are therefore much more common.
With the advent of newer temporary anchorage devices (TAD), it is possible to achieve significant retraction without the need for extractions. They do create additional costs and the quality of the bone must be good enough to hold these devices in place. For those who are considering braces treatment in Singapore, it is best to speak to an orthodontist about this option if they are bothered by extractions.
