Are Extractions Good or Bad?

Although most orthodontists claim to avoid extractions whenever possible national statistics suggest that extractions are routine and that probably over 90% of patients have sound teeth extracted at some point. Other clinicians say the jaws should be encouraged to grow from an early age to avoid the need for extractions altogether. Professional discord is always confusing but we recommend that you ask for a professional consultation if the permanent teeth look crooked when they first appear at about six years of age as it may be too late to avoid extractions or surgery after the age of eight.

Whoever is providing treatment, you should ask how many permanent teeth will be taken out initially and if more teeth may need extracting later. We also suggest that before treatment starts you ask if your clinician feels confident in avoiding an increase in Vertical Growth. It is your right to be told about all types of treatment and be warned of likely problems.

Unfortunately the various groups of orthodontists are in competition with each other so that it is sometimes difficult for a patient to get impartial advice and especially ‘fully informed consent’. A recent survey suggested that over 95% of orthodontists only tell patients about the methods they themselves prefer. This is likely to leave the patient with little information about non-extraction methods. The courts are reluctant to become involved in professional disagreements about which treatment is best but if all the risks and alternatives were not clearly explained, you may be able to claim to have the work re-done or be compensated for any long term damage (see Legal Advice).

Patients who feel that they have suffered often have difficulty in obtaining redress because of the reluctance of colleagues to criticize each other. Unfortunately, if a complaint is lodged, the records are at risk of getting ‘lost’ and it is wise for every parent to ask for a set of the facial photographs before treatment starts. If you failed to do this, we suggest that you ask nicely to have copies of your original photographs, before issuing a complaint. All patients have the right to see their records.

Orthodontic Outrage offers lay and professional advice and is able to put patients in touch with specialist lawyers who may be able to help.