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Can An Orthodontist Pull Teeth?

Posted Feb 10th, 2020

All orthodontists are dentists, which means they have the same training as any other dentist. But an orthodontist takes on a special role in diagnosing and correcting teeth misalignments. They have gone through extra years of schooling and training to be able to perform the specific job of straightening teeth. 

Being a dentist means that yes, an orthodontist can perform tooth extractions. But that doesn’t mean an orthodontist will always pull the teeth themselves, and sometimes another expert is needed to do more extensive work.

 

When Does An Orthodontist Need To Perform A Tooth Extraction?

On your first appointment with an orthodontist, they will assess the situation and explain the recommended treatment you’ll need to correct the malocclusion. This can include removing teeth, and people with severely overcrowded teeth may need one or several teeth extracted so that other teeth can move into place. If the teeth are crowded or if one or two are badly out of position, orthodontists may recommend extraction as part of their diagnosis. 

Orthodontists will sometimes perform dental procedures that include tooth removal, usually for tooth crowding in particular. But many orthodontists focus on work related to the alignment of teeth and save other jobs for other specialists. They’ll recommend that their patients get a tooth pulled by their regular dentist.

Most tooth extractions are simple procedures. For teeth that are fully grown, a dentist or orthodontist will use a tool called an “elevator” to loosen the tooth from its socket. They will then remove the tooth with forceps. For more complicated problems, like impacted wisdom teeth or teeth broken at the gum line, a surgical extraction might be necessary. This will require the work of another specialist, usually an oral surgeon. 

 

Referrals To Other Dental Professionals

Some malocclusions need the skills of other dental specialists before an orthodontist can install the braces. Wisdom teeth often require surgical extraction when they have not erupted above the gum line, and bone and tissue might need to be cut before a dentist can remove them. Broken teeth or teeth with long-curved roots may also need treatment performed by an oral surgeon.

Some patients may need orthognathic surgery, better known as jaw surgery, if their upper and lower jaws have major differences in position. This type of malocclusion often results in an over-jet or an underbite that won’t be solved with braces alone. If the orthodontist thinks a patient needs jaw surgery, they will refer the patient to an oral and maxillofacial surgeon.

Whether a tooth is pulled or not depends on the patient’s needs. If some teeth are crowding others out, the removal of one or more might be necessary before an orthodontist can install braces. Some orthodontists avoid performing the extraction themselves and will recommend that you see your dentist for the removal. While they can pull the teeth, it might not be a focus in their practice!