Why might teeth need to be removed?
The BOS explains that extractions may be necessary in adults or younger patients to create enough space to align crowded teeth or correct the bite. The need depends on the individual problem, not on a blanket treatment philosophy.
Which teeth are usually considered?
The choice depends on crowding, tooth condition, bite and symmetry. Premolars are sometimes selected because of their position in the arch, but damaged or heavily restored teeth may influence planning. Wisdom teeth are a separate question and are not automatically removed simply because someone has braces.
What are the alternatives?
Depending on the case, space may sometimes be created through IPR, arch development/expansion, distal movement or different tooth-position goals. Not every alternative is appropriate for every adult.
Will extraction gaps remain?
In an extraction-based orthodontic plan, the spaces are typically used during treatment and closed as teeth are moved. The intended final result should be discussed before treatment begins.
Be cautious with absolute “no extraction” promises
BOS patient guidance explicitly warns against claims that treatment can always be completed without extractions before a proper assessment. If you are uncertain, seek a second opinion from an appropriately trained orthodontic clinician.
Questions to ask
- What problem does extraction solve in my plan?
- Which teeth and why those teeth?
- What non-extraction alternatives exist?
- How would those alternatives affect the bite, profile or stability?
- Who performs the extraction and when?
Sources & further reading
- British Orthodontic Society — Will I Need Teeth Extracted? — Explains case-specific extraction decisions in adult orthodontics.
- NHS — Orthodontics — General orthodontic treatment and bite/crowding information.
These references support general information. Your own dentist or orthodontist should make recommendations for your specific teeth, gums, appliance and treatment plan.