dental examinationOne orthodontic treatment approach recommends pulling out some of the permanent teeth to make room for crowded teeth to fit into the dental arches.  The most common teeth that are removed for orthodontic reasons are the four bicuspids.  The dental arches are the bones that contain the teeth.  The upper arch is the maxilla and the lower arch is the mandible.  The balance between the tongue, cheeks and lips muscular forces determines the correct development and the shape of the dental arches.  A complete adult dentition consists of 32 teeth.  Four incisors, two canines, four bicuspids and six molars on each dental arch.  Each one with a particular form and function, just like the rest of the parts of our body.

Research has shown that following bicuspid extractions on average the maxillary incisors are retracted 7 mm and the mandibular incisors are retracted 3.5 mm.  This usually has as a consequence unfavorable facial changes and detrimental TMJ effects, especially on females.  Pulling teeth out will reduce the size of the dental arches resulting in a reduced space for the tongue.  Reduction of the tongue space could cause soft tissue dysfunction, like tongue thrust and incorrect resting tongue position, and eventually, orthodontic relapse.  In addition, retraction of the dental arches could result in upper airway space reduction creating breathing problems, especially during sleep time.  Reduction of oxygen levels due to reduced airway space represents a threat for overall health.

A better approach than doing dental extractions is arch development with dental arch expanders.  Dental arch expanders are used to create better arch form and enough room to align crowded teeth.  In addition to the expanders, myofunctional appliances are designed to help stimulate the patient’s maximum facial growth potential by correcting the bad habits that are responsible for the muscular imbalances of the face.  When soft tissue dysfunction is corrected, orthodontic stability can be really achieved.

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