By Dr Saud Al-Anezi, Consultant Orthodontist

KUWAIT: Orthodontics (braces treatment) is a branch of dentistry which deals with problems of teeth alignment or jaws. It aims to improve the facial appearance and the smile of the individual. Removing teeth, or teeth extraction, to make space before the orthodontist starts the treatment is one of the most extensively debated topics among doctors all over the globe. The current standard suggests that each individual case should be considered on its merits. That is to say, there is no such thing as saying that removing teeth is always required, or vice versa.

Certainly, a decision not to remove teeth before treatment has its advantages, such as the fact that the patient would not have to go through this process (which is not a pleasant experience to most people), and treatment time would theoretically be shorter. Nonetheless, it must be stated that removing teeth is sometimes required; not only to make space to align all the teeth, but also in individuals with certain facial features, such as people with prominent cheekbones, where it could also improve their facial appearance and smile. The risk of attempting braces' treatment without taking teeth out in individuals with prominent cheekbones could make the facial appearance worse.

The decision to remove teeth or not is based on several factors that the doctor has to bear in mind. Examples include crooked teeth, if there is a discrepancy of the facial jaws, i.e. the maxilla (top jaw) and the mandible (bottom jaw), and how wide the jaws are. If the jaws are narrow, then there are special and contemporary devices that widen the jaws, which provide space, allowing the doctor to align the teeth without removals. In conclusion, I personally examine my patients thoroughly before making the decision. Although removing teeth prior to braces still exists, it is minimally required now with the advancements in technology.