Extract Teeth or Expander for 8 Yr. Old?

Updated on September 05, 2012
T.M. asks from Trumbull, CT
16 answers

Hello everyone.

My daughter is 8yrs old. She has overcrowding of teeth in her mouth. As of right now, her pediatric dentist suggests extracting two of her teeth on top, to make room for teeth that have yet to come down. He doesn't like the expanders because he says that sometimes it can alter the look of the child's mouth in the long run. I have a couple of friends of mine whose orthodontists prefer expanders to extracting . . . but I'm just wondering if it's a preference or if one way is actually better than the other. I had overcrowding when I was her age and had about four teeth extracted back then. My husband's bottom teeth are very overcrowded and crooked .. . he never had any teeth extracted when he was younger ... I do trust her dentist. I went to him from about the time I was 15 yrs. old to about 22 yrs. and then reluctantly, had to go to an adult dentist. He did extensive work when I was in my teens and saved me a lot of headaches at that time. But that was over 20 years ago. I'm sure there's been advancement in dentistry since then . . . I'm just wondering whether he's just sticking with what he knows . . . or if he really believes extracting is the way to go.

Have any of you had experience with both the extracting of teethand/or expanders to make more room in your child's mouth? My daughter has an appointment in a couple of weeks for the extractions and I'm stressing over it.

Thank you in advance for your help.


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So What Happened?

Hi everyone,

Thank you for your answers and advice. I decided to go with the extractions. They were baby teeth that were in the way of the adult teeth. You were able to see the adult teeth in the x-ray and that they had no where to go because of these baby teeth. She doesn't have any other issues with her teeth or mouth as of right now .. . so he said she should be fine for a while and the new teeth should be coming in real soon. The procedure only took a few minutes and she was fine afterwards. So I believe I did the right thing in this case. Thanks again for all of your responses. :)

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answers from Tulsa on

As a teenager, I had an expander for my upper jaw and had one extraction from my bottom jaw. Both were correct in my case. My upper jaw was shaped incorrectly and expanding it allowed for my teeth to align (with braces). The bottom jaw was already shaped correctly, so expanding would have messed it up. Taking out the one tooth in the bottom was enough to get the teeth lined up well.

If they are talking about pulling baby teeth, go ahead. If they are talking permanent teeth, I'd definitely try expanding first and revisiting extraction if the expansion isn't working.

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answers from Oklahoma City on

I always think that people who used the expanders looked like they were a thumb sucker and their teeth pointed out at just the tiniest angle.

I think that with this child's genetic dental code I would go with the extraction. It will be over in a few minutes and he'll get well quickly. The other way he'll have to use the bionater or what ever device you use for a lengthy time.

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answers from Jacksonville on

Could you take her to your preferred orthodontist for an consult? There is not charge for the consult (including xrays), at least where we go. Well respected practice.

I would venture to say that the preference is probably dictated by WHY the procedure is needed. Our daughter had 4 teeth pulled this summer, per recommendation by her ortho. She has lost very few baby teeth, and has 4 permanent ones that are/were not turned upwards beneath the baby teeth. So,their roots were not being resorbed and hence no loose teeth. In addition, they were beginning to push against the roots of the permanent teeth she DOES have, next to them. Which could severely damage the roots of those teeth.
All of this was shown to us on xrays and explained by the ortho. She had 4 pulled and we are waiting, hoping, that the new teeth turn and come up in the now open spaces (path of least resistance and all that...).

Rather than speculate, why not go get a 2nd opinion from an ortho? After he tells you his/her recommendation, ask what he thinks of extraction, and why your daughter's dentist might have suggested doing that in stead.

Remember too, an extraction by the dentist pays the dentist. An expander by the ortho pays the ortho. (Just to be realistic, it helps to remember these things). In our case, the ortho recommended work that they don't do, it would be done by the dentist. Our daughter will eventually be an ortho patient for her overbite. But that is some time in the future when she gets her permanent teeth. (Still waiting...lol)

But get explanations as to WHY one treatment option is better than the other. Don't just accept the recommendation without the underlying basis for it being the better option.

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answers from Kansas City on

I would set up consultations with 2 or 3 orthodontists. Get references from your dentist and also from friends or co-workers. The consultations should be free, they will look at your daughters mouth, take some x-rays and give you their "game plan" for her.

My hubby took my older son to his consultation appointments. The first guy had this horrible device he wanted to install in my son's mouth (it looked like something from the 13th century!!!) to make room and correct overbite, the second guy had a much more reasonable approach. We had a third appointment scheduled but my hubby felt so comfortable with the 2nd guy that's who we went with.

Get several opinions, go with what makes the best sense to you.

Good Luck!


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answers from Chicago on

My nephew was supposed to have teeth pulled to make room. They ended up not doing it and when the time came for braces, he actually was fine. When my kids were younger, the dentist wanted to fit them for an expander but the insurance did not covere and I did not have the money. The dentist also suggested pulling teeth. I took my kids to the dentist to check out their teeht for braces (next year) and was told they have plenty of room to shift the teeth with the braces. I am glad I did not ahve the teeth pulled. I would take her to another dentist for a 2nd opinion first to see what they say. From what I have been told, an expander can help if the teeth just need a bit of extra room.

A coworker told me her son had 2 teeth pulled and an expander and turned out the teeth could have stayed.


answers from Dallas on

I was in this exact same situation last year. Dentist said 'extract', and orthodontist said 'expand'. I felt more comfortable with the orthodontist's approach, and she explained it to me best. The expansion seems much safer to me. If you don't fix the crowding issue, the roots of the teeth (the parts that you can't see but are there nonetheless) are mashing up against each other and causing damage. Yes, expansion DOES change the shape of a child's mouth. It makes it look like it's SUPPOSED to look.

My daughter is 8, and got her expander in March of this year. Then, she got braces on to pull her teeth into place and to make room for adult teeth that are due to come in. If we hadn't gotten the expander, she could have potentially had major root damage, and it is very possible that her adult eye teeth would have never grown in (there was no room for them).

Even the best dentists need to make money, and they can't make money by referring you to an orthodontist to fix it correctly rather than extract. If you start extracting, you have to keep extracting, but if the problem is overcrowding, why not treat the problem and not the symptoms?

My suggestion would be (and the thing that eased my mind is) to see an orthodontist. Ours offers free consultations, so it cost us absolutely nothing to go in, get our first sets of x-rays, and get a detailed treatment plan. It was SO worth it, because she really made me comfortable with what we needed to do to give my daughter the best chances at a perfect smile.



answers from Chicago on

We are going to speak with the dentist about palate expansion for my 7 year old next week. If you are talking about pulling baby teeth that is one thing but if you mean pulling perm teeth then I would definitely say do the expansion. My sister had her two fang teeth pulled due to overcrowding back in the day and she still hates how her smile seems unbalanced to her because it doesn't have all of the normal teeth.


answers from Chicago on

The key here to me is that your dentist said "sometimes it CAN alter the look..."

And sometimes it is the right thing to do. How can you know for sure without at least consulting a couple of orthodontists? We aren't looking at your child's mouth and we aren't professionals. All I know is that we all have to live with our teeth for a lifetime so we need to take care of them properly.

My daughter had a palate expander. Her dad (in his teen years) had teeth extracted because there were no palate expanders back then. She seems to have the same jaw/facial structure as her dad. And her smile is beautiful and looks great. She's 24.

I would never skimp on my kids' oral health. We went to two orthodontists and got their opinions before moving forward with her expander and braces. I think you should consult a couple of orthodontists in order to make an informed decision. Now is the time to do it, while her upper palate is still moveable. You said yourself that your dentist has been in practice a long time. Perhaps he isn't the best judge of your child's issue, even if you do trust him.


answers from Grand Forks on

My kids have had several teeth pulled partly due to overcrowding, but mainly because the baby teeth wouldn't come out on their own. My ten year old is getting an appliance this month. It is to move the teeth back into place that were out of place due to baby teeth not falling out, but I think it is to make room for adult teeth as well. I'm not sure if this is the same as an expander?



answers from Minneapolis on

I think the current preference is for expanders. Extracting teeth is generally considered out of date and a last case scenario. I had four permanent teeth pulled before I had braces over 30 years ago. My son successfully had an expander at age 9. I interviewed 5-6 orthodontists before I selected the one we use. You can always get another opinion, but I think expanders are preferred.



answers from New York on

In 3 kids worth of braces,only 2 really needing them, I have learned, dentists always opt for extraction and once you see the ortho, he'll tell you otherwise. My stepdaughter's mom opted for extraction and that went on to be a hot mess. I opted for no extractions and it went well until it bacame necessary for my son, as he has huge, beautiful teeth. I am sometimes of the "if it ain't broke, don't fix it" mentality. Seek a 2nd, 3rd, 4th and 5th opinion if you have any doubts.



answers from Pittsburgh on

Our family dentist has stated no orthodontic work until much later...all of her teeth aren't even on yet! I'd wait.


answers from Chicago on

Hmm, I had expanders as a kid (20 yrs ago). I wore headgear to bed every night for 2 years to make room for my eye teeth to come down.
Apart from the inconvenience of wearing the headgear, it was non invasive and really not very painful.
I went to the orthodontist for it.

My mouth looks no different than it every did.

I can't imagine voluntarily pulling out teeth when you don't need to.



answers from Orlando on

my daughter had an expander for a different reason - because her top jaw did not line up with her bottom jaw. she had it for probably 6 months or so. her mouth looks fine to me :)



answers from Los Angeles on

I think really the question is, why?
If they're simply saying there's not enough room in the mouth, and the shape of the palate is correct, then yes, pulling makes sense. Because otherwise you're going to expand that palate and make it bigger and it may alter the look of her face, profile, etc.
If the palate is too small/narrow and they need to expand it to accomodate the teeth she has, then yes, an expander makes sense. Two of my kids had expanders. My daughter's palate was VERY narrow, not nice and "U" shaped like it should be, and my son's palate was literally shaped like a "V", not a "U". So pulling teeth would accomplish nothing. She shape would still be wrong.
But, in general, I think expanders is the more common way to do things these days, not pull teeth.
AND, on top of that, she's only 8, so she may be kinda young. I would ONLY do it now if it's necessary for the teeth coming in. My daughter is 10 and just got hers now. The ortho said if she could wait, he'd prefer it; but he MUST reshape it and make room for the adult teeth coming in - they literally have no room to come in!


answers from Kalamazoo on

Baby teeth right?
yes, pull them. Just had two of my 10yr old's baby teeth pulled and one of my 8yr old's. They were just hanging in there way too long and needed to make room for the adult teeth to come in so as not to damage the permanent teeth!

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