Extraction vs. Non-Extraction- Part 7: How cost of treatment will affect this decision

When making a decision to either extract teeth-usually four premolars-or expand the dental arches to alleviate crowding, consideration of cost of orthodontic treatment is a major factor in this decision making process. The primary determinant of treatment cost is length of treatment time. In general, the more severe the crowding, the longer the treatment time involved. Particularly if teeth are blocked-out of the dental arch and space must be created to allow their normal eruption into the mouth, this space must be created prior to the eruption of the tooth that is blocked-out. This creates the need to start treatment often before all of the permanent teeth have erupted and requires treatment until the last permanent tooth has erupted, and the length of time it takes for a tooth to erupt can be highly variable. Sometimes it can take as long as two years just for a tooth to erupt! This waiting period can have a significant impact on treatment length and cost.

The extraction option generally allows a later start to treatment because removal of teeth to allow the eruption of a blocked-out tooth does not require braces. As a result, braces can be placed after all permanent teeth have fully erupted instead of waiting with braces on the teeth for teeth to erupt. This is a more predictable scenario and a much shorter treatment time as well. Suffice it to say that when there is severe crowding, the extraction option, if initiated early during the eruption of the permanent teeth, would cost less to treat versus the non-extraction option. In these cases, treatment times are not much longer than a year versus two and a half years to three years for the non-extraction option!

I hope that this on-going discussion helps to decide which treatment course is the best treatment option for your child. Each case must be considered based on all of the factors discussed and you as a parent should be able to help with the decision based on the information in these blog posts. In my next blog, I will delve into the cost of orthodontic treatment and what factors you should consider when evaluating the cost of treatment!