Should I get 4 teeth removed and/or a palate expander?

P

palate-braces

Newbie
I am in the process of getting (lingual) braces.
They recommended pulling 4 teeth. The 4th teeth on the top and below. The doctor said she would not recommend palatal expansion, for aesthetic reasons.
I would like to ask the community what they think. I would like to share my pictures, scans of teeth and medical data. I hope the community can help me.

(25y old male)
feel free to ask any questions you have

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you will have to remove /* c e n s o r e d */  to view the images
 
First of all, we can't see the pics.
Second, if you want a good opinion on whether what your ortho is proposing is the correct solution, then Mr Google and Mr Braces Forum are not the correct people to ask: go to another ortho, and get a second opinion.
 
Up to you. Personally, absolutely no way would I ever do that. I have braces, and i've been recommended extractions tons of times by ortho's I enquired with and the ones I've worked with, but I still won't do it. Orthodontists generally still believe a small mouth and crooked teeth is due to genetics when it isn't. It's enviromental and to do with what we do as we grow up.

You need to correct your tongue posture, and body posture (look up mewing, oral posture, etc), which will slowly expand you pallet naturally. If you can get adult pallet expansion that works, great. That's better than ripping things out of your head which were supposed to be there (despite the BS orthos will say). They mostly all recommend extractions because they don't understand why the mouth is too small and want to rip your teeth out so they can charge you for it and use braces to smash your teeth back into your face which constricts your airway leading to health problems. and makes you less attractive.

Despite all the orthos recommending me extractions of 4 teeth, I'm also nearly there with no extractions. I'm going to change ortho again to someone that will finish my case without constantly banging on about extractions. I know it's possible. I'm almost there when they said it wouldn't happen. So, there's my take.
 
"Dr. Mike Mew is a controversial British orthodontist known for "mewing," a technique focusing on tongue posture and oral habits to improve facial structure. He promotes "Orthotropics," focusing on jaw growth over traditional braces. In 2024, the UK's General Dental Council suspended him, citing risks to public safety and "unnecessary" treatment".

If you think about it, how much effect will "mewing" for,say, 60 minutes a day have, when it takes weeks and months of constant pressure for expanders and braces to move teeth. Removable appliances typically have to be worn >22hrs daily to be effective
 
At 25, both extraction-based orthodontic plans and expansion approaches can still be valid, but they depend heavily on the underlying diagnosis rather than a one-size-fits-all preference. Premolar extractions are commonly recommended when there is significant crowding, protrusion, or when the goal is to achieve stable alignment without compromising gum health or bite function. On the other hand, palatal expansion in adults is more limited compared to adolescents, and when it is considered, it often involves specialised techniques such as MARPE or surgically assisted expansion rather than simple widening.

Getting clarity from an experienced clinician who regularly handles complex adult cases can make a real difference in understanding the trade-offs. A practice such as St Leonards Green Dental may be worth considering as part of a broader second-opinion process, particularly to review whether the proposed extraction plan aligns with facial profile goals, airway considerations, and long-term stability in your specific case.

Ultimately, the decision should come down to detailed measurements, cephalometric analysis, and treatment objectives rather than generalised opinions online. If there is uncertainty, a second orthodontic opinion is often the most reliable way to compare whether expansion-assisted options or extractions better suit the clinical situation.
 
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