Today most orthodontic problems ie dental crowding and jaw size discrepancy can be treated without the extraction of teeth to produce a beautiful long lasting smile.This is facilitated in the case of children  by starting treatment before the last remaining baby molar teeth are lost. Using arch developing techniques, space can be created for otherwise crowded erupting permanent teeth. Functional or growth modifying appliances can be used in growing patients to correct prominent teeth or underdeveloped lower or upper jaws.

In the case of adolescent and adult patients, primary consideration must be given to the shape of the face in terms of smile ,tooth display, profile, extent of crowding of the teeth  before extractions are contemplated. In many situations space can be gained by expanding and uprighting tipped or trapped teeth, enamel reduction and the use of miniscrews or TADS (temporary anchorage devices).