Why do we make every attempt to avoid the extraction of teeth?
In orthodontics, the goal is a maximum function with a healthy pleasing smile. Many times (not always), when teeth are extracted, the facial features are negatively affected. Please note this patient’s smile. It is broad, and the teeth follow the “smile line.” That is, the lower lip parallels the edges of the teeth. When teeth are extracted, the overall width of the arch narrows and one may see dark areas on both sides between the teeth and cheeks. This is the result of the narrowing.
Oftentimes too, when teeth are extracted, the profile is affected. When the teeth are extracted and the resulting residual spaces are closed, it sometimes causes a flattening of the profile. Sometimes this is desirable. Other times, however, it is not. The problem is as we age, we become flatter or more concave in profile. So, if extracting teeth from younger individuals causes the profile to become flat, with age, this will worsen. This is because as we age, our noses and chin appear larger. So preserving the profile of young individuals is a high priority.
Please observe the following patient. Although he has a flat profile, he has very severe dental crowding. However, if teeth were extracted and the residual spaces closed, his profile would, at best, stay the same and most likely become more concave. However, remember, with age, we flatten the profile. Therefore, Dr. Dillon elected to treat without the removal of teeth. The result was a beautiful smile, and the profile improved tremendously.