Abstract
This article discusses the trends in orthodontic extractions since the birth of the speciality in the early 1900s to the present day. It explores reasons for these changing trends and seeks to place apparent reasoning for current practice.
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Orthodontic extractions: history and current trends
From Volume 15, Issue 1, January 2022 | Pages 41-46
Article
The decision whether extractions are required to facilitate orthodontic treatment has been a long-standing issue within orthodontics. Trends have waxed and waned for over a century and continue to be debated. The debate is often based around the principles of the health of the hard and soft tissues, occlusal stability and dental and facial aesthetics. The removal of teeth has been suggested to be ‘damaging’ to facial aesthetics, reducing stability, causing pain and dental anxiety as well as resulting in lengthier orthodontic treatment. Conversely, it is argued that extractions aid stability, facilitate dental health and potentially give better facial and dental aesthetics (Table 1).
In an increasingly litigious society, there is a burgeoning need to justify the removal of permanent teeth. Orthodontic extractions create space that can be used for relief of crowding, anchorage management, overjet and molar relationship correction. Alternatives to creating space are molar distalization, arch expansion, incisor advancement or interdental enamel reduction. A Royal London Space analysis is just one formal approach that can be used to quantify space requirements in order to justify, or not, orthodontic extractions, as well as determine how any space gained will be used.1,2
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