Extracting Premolar Teeth for Orthodontic Treatment: The Risks

Patients Report Health and Aesthetic Consequences

Reviewed by Dr. Noel Stimson, Dr. Ben Miraglia and Dr. Skip Truitt

Graphics by Alexandre Ruze

50% of patients in braces worldwide on average get their premolar teeth extracted for braces.

Today when a patient goes to get orthodontic treatment, there is a chance that the orthodontist will say that adult teeth have to be extracted: usually 2 upper premolars and/or 2 lower premolars (and perhaps 4 wisdom teeth). The patient might be concerned: is it a good idea to extract healthy adult teeth? Are there any consequences to losing these teeth?

Searching the Internet for answers, they may find claims that extracting premolar teeth can lead to “flattened” profiles and recessed jaws, and assertions that these are just rumors. They may see posts on social media of patients grateful for their beautiful new smile as well as posts from patients complaining Extractions have ruined my face! They might also come across reports that orthodontic extractions can lead to longterm serious health issues such as temporomandibular disorder, jaw joint damage, chronic neck/shoulder pain, a reduced oral cavity, tongue space constraint, narrowed airways and breathing disorders such as obstructive sleep apnea.