What is the difference between extraction and non-extraction orthodontics?
Each tooth has a fixed width, and there is a limit to how much space the jawbone can hold. If teeth are forced into a spot where that space is lacking, they overlap or get pushed forward. The two approaches differ in where they create the missing space.
| Category | Extraction orthodontics | Non-extraction orthodontics |
|---|---|---|
| How space is made | Removing teeth such as premolars | Interproximal reduction, expansion, moving molars back |
| Suitable cases | When the shortage is large or protrusion needs to be reduced a lot | When the shortage is small and protrusion is mild |
| Change in the mouth’s profile | Can be large | Tends to be small |
| Duration | Includes closing the extraction spaces | Can be shorter; similar if molars move back a lot |
| Cautions | Pulling back too much can look sunken | Forcing it can cause front teeth to protrude and strain the gums |
When is extraction orthodontics done?
When the total width of the teeth greatly exceeds the space in the jawbone, when forward-tilted front teeth need to be moved back a lot, and when that space cannot be opened by other methods. I often hear “I’m so scared of having teeth pulled,” but extraction is not the default. We do not remove teeth just because they look crowded.
Extraction orthodontics adds the process of closing the space, so the teeth travel a longer distance overall. That allows a large degree of control over how far the front teeth move back, so it is the method used for mouths where protrusion needs to be clearly reduced. The extraction spaces are closed by moving the teeth during treatment, so they do not remain at the end. How the mouth’s profile changes after extraction is covered separately in changes in the mouth after extraction orthodontics.
When is non-extraction orthodontics done?
When the missing space is not large and can be opened by the following methods.
- Moving molars back: a small screw is placed in the jawbone as an anchor and the dental arch is moved back. There is a limit to how far it can move back.
- Arch expansion: widening a narrow arch. Forcing it puts strain on the gums.
- Interproximal reduction: when the shortage is very small, the sides of the teeth are thinly reshaped.
Tools like screws are only a means of opening space; the name of the tool does not change who is a candidate. Why screws are used is explained in why mini-screws are used in orthodontics, and the conditions for non-extraction are explained in when non-extraction orthodontics is possible.
What happens if you insist on non-extraction?
If teeth are kept despite a lack of space, the front teeth look protruded and the protrusion cannot be reduced as much as you want. Forced expansion makes the gums recede, and gums do not grow back. On the other hand, if teeth are removed from a mouth that does not protrude and pulled back too much, it looks sunken. If something cannot be done, I tell you so first.
How we do it at Wonjin Dental
At the consultation, I first look at how much space is missing. Then I set the extraction plan and the non-extraction plan side by side and explain, with photos and measurements, where the front teeth will sit in each and whether the teeth will stay in place after treatment. Some mouths can go non-extraction with clear aligners, but I first check whether the appliance can achieve the required amount and direction of movement.
Orthodontic diagnosis is ₩100,000, orthodontic mini-screws are ₩100,000 each, full orthodontics (Clippy C) is ₩5,000,000, and clear aligners (Seraphin) are ₩2,500,000 (as of September 2026). Other items are on the full fee schedule.
Frequently asked questions
Is extraction orthodontics more painful?
Apart from a few extra days of discomfort after the day teeth are pulled, pain during treatment tends not to differ much between the two approaches. In most cases, there is some soreness for 2–3 days after the appliance is adjusted.
Does removing only wisdom teeth count as extraction orthodontics?
Extraction orthodontics usually means removing premolars to make room for alignment. Wisdom teeth may also be removed in a non-extraction plan to make room for moving the molars back.
Every consultation tells me something different about extraction vs. non-extraction.
The person making the diagnosis may have different goals. It is easier to decide if you hear how the front tooth position, lip line, and bite change under each plan and compare them.
Will my teeth shift again after non-extraction treatment?
They tend to shift again if you stop wearing the retainer or if the arch was widened in a direction the bone cannot support. Widened arches tend to go back, so you need to wear the retainer consistently.
