Introduction to Aligners

Are you thinking about using aligners to straighten your teeth and wondering if you might need a tooth extraction as part of this process? Clear aligners are nearly invisible plastic trays that fit over your teeth and gently move them into place.1 

They were originally designed for cases where extractions were not needed, making them suitable for mild to moderate crowding and spacing issues. However, aligner technology is rapidly advancing and is now being used for more complex cases where extractions may be necessary to achieve the best results.2 In this blog, we'll explore the conditions where extractions are necessary, if and in what cases they might be needed with aligners and about aligner benefits.

Indications for Tooth Extraction in General

Tooth extraction may be needed for various purposes to improve your dental health and to correct many issues in your teeth: 

  • Severe Tooth Decay: When a tooth is extensively decayed and beyond repair, removing the decayed teeth is the only option many times. Severe decays can affect the teeth structure adversely, making it impossible to restore effectively.
  • Infection or Abscess: If an infection reaches the tooth's pulp and can't be treated with a root canal, or if the infection persists despite treatment, removal may be required to prevent further issues.
  • Advanced Gum Disease: Gum disease that destroys the bone around the tooth can make it loose. When the tooth no longer has sufficient support, extraction might be necessary to alleviate discomfort and prevent further damage.
  • Fractured Teeth: Teeth that are broken or fractured in a way that cannot be repaired with dental treatments need to be extracted. A severely fractured tooth can cause pain and may not be functional.
  • Impacted Teeth: Teeth that are stuck in the jaw and cannot erupt properly can cause pain, infection, or damage to adjacent teeth. Removing impacted teeth can prevent these complications and potential cyst formation.
  • Extra Teeth: Extra teeth, or supernumerary teeth, can cause crowding, misalignment, or interfere with the eruption of permanent teeth. Extraction of these additional teeth can help resolve these issues.
  • Orthodontic and Prosthetic Needs: Sometimes, teeth need to be removed to create space for orthodontic treatment or to ensure a better fit for dentures. This is often part of a planned approach to achieving proper dental alignment or prosthetic function.3

Each case should be evaluated individually by a dental professional to determine whether tooth extraction is needed based on the patient's dental condition.

Tooth Extraction for Aligners

When using clear aligners to straighten your teeth, most people don't need a tooth extraction. However, in some cases, extractions may be necessary. Here are some conditions where tooth extraction may be needed during aligner treatment:

  • Complex Malocclusions: In complex cases such as those of severe misalignment, extraction may be necessary for orthodontic correction. Deciding if a tooth should be removed during aligner treatment, although, needs careful thought. It's important to understand the forces that need to be applied by the aligners in order to close the extraction space. In some cases, auxiliary appliances such as power ridge or anchoring devices may be needed to assist the treatment when extractions are planned.4 Nonetheless, aligner therapy is successfully being used for some complex orthodontic cases, for instance:
  • Severe Crowding: If your teeth are extremely crowded and there's not enough space to align them properly, extractions might be necessary to create room for the teeth to move into their correct positions. Aligner treatment is being used to close space after lower incisor and premolar extractions.2,5,6
  • Bite Issues: In cases of severe misalignment or bite issues where the aligners alone cannot achieve the desired result, extractions might be required to help with proper alignment. Aligners can be used to align teeth which are in cross bite or with increased overjet (the space between upper and lower front teeth).2,6
  • Dental Problems: Sometimes, teeth need to be removed because of decay, infection, or other issues while planning or undergoing aligner therapy.
  • Orthodontic Treatment Goals: In some cases, to achieve specific orthodontic goals or address complex cases, extractions might be needed as part of a comprehensive treatment plan that includes clear aligners. 2,5

Aligners can work well even in cases where extractions are needed, as long as the treatment is planned properly. Good results depend on careful diagnosis, clear planning, and regular check-ups.2

Benefits of Aligners

Aligners offer several key advantages over traditional braces, especially when teeth need to be extracted. 

  • They are less noticeable than traditional braces.
  • They are more comfortable and reduce irritation.1,6
  • They are removable ensuring proper oral hygiene maintenance.
  • They used advanced technology that allows precise tooth movements.6
  • They usually require fewer visits to the dentist.7

In India, the teeth aligners cost typically ranges from ₹80,000 to ₹1,20,000, depending on the complexity of the case and the technology used. For a modern, discreet, and convenient orthodontic solution, consider investing in teeth aligners.8

Conclusion

Tooth extraction with aligners isn't always needed but can be necessary for complex cases with severe crowding or major misalignment. Many people can use aligners without extractions. But, even for cases requiring extractions, aligners can work well. The main considerations are to prepare a clear treatment plan and ensure proper follow-ups for best results. With these, aligners can offer a modern and comfortable solution for straightening teeth, even if teeth extractions are involved.