Does Invisalign treatment require premolar extraction?

Doctor's Answers 1

It depends. As with any orthodontic treatment plan, the decision to extract teeth (premolars or otherwise) depends on a few factors:

1) The patient's presenting complaint: if there is concern about protruded upper front teeth, then extractions may be considered to gain space to correct the incisor angulation.

2) The severity of crowding: the worse the amount of overlaps between the teeth, the more severe the crowding.

3) The bite pattern: a shallow overjet or overbite may require extractions to correct crowding without worsening

4) The presence of compromised teeth: very severely decayed, extensively repaired or root canal-treated teeth may be removed preferentially if the treatment plan requires extractions.

5) To camouflage an underlying skeletal proportion issue non-surgically. For example, removing 2 upper premolars for a patient with an underlying skeletal class 2.

Other options for space creation without extractions include distalization and interdental reduction (IPR). These options may be suitable for a case that does not have high space requirements (on the mild/moderate end of the spectrum).

The aim of orthodontic treatment is NOT to eliminate overbite and overjet but to optimise it. Having an overbite and overjet is IDEAL at the end of any orthodontic case, so each case has to be judged individually.

Similar Questions

Do braces change your facial profile?

You have asked a very interesting question and I am afraid the answer is yes and no! I will try to explain it as best I can. Braces CAN change profiles: Braces can change profiles only when the orthodontists and the patient plan to get it changed from the START of the treatment. A good example is when patients complain that when taking photographs, they notice that their side profile is sticking out and they have a very full smile (most patients use the terms, I look like a horse!) In this case, braces can help to retract the teeth to allow the patient to have a softer, gentler profile.

Photo of Dr Sylvia Tan

Answered By

Dr Sylvia Tan


Should I do my dental crown or braces first?

It is better to get your braces done first before your crown. This is because the tooth and gum position will move and it may affect the final crown work. The crown surface may also be damaged during braces work (risk is small) which means that you may need a new crown after braces. If you want to be treated with subsidy you will need a polyclinic referral letter. However please note that there are no subsidies for any orthodontic treatment. You can be seen by the postgraduate students at NUS for a slightly reduced price for braces if you wanted to.

Photo of Dr Sylvia Tan

Answered By

Dr Sylvia Tan


Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox