Serial Extraction or Serial Guidance: The Clinical Decision

The most important question to ask when creating a treatment plan for a patient with crowding is: “Do we extract adult teeth or do we not extract adult teeth?”

When crowding is diagnosed early, there are two methods used to alleviate the crowding of the incisors, as well as to allow non-erupted permanent canines and bicuspids to guide themselves into improved positions. These two methods are Serial Extraction and Serial Guidance.

The Serial Extraction method includes the removal of certain deciduous teeth and specific adult teeth (such as bicuspids) to maintain a proper ratio between the tooth size and available arch space. The main goal with serial extraction is to reduce the need of lengthy appliance therapy and usually includes a single-phase late orthodontic treatment beginning at age 12 to 15. The results of completing this type of treatment usually includes a reduced arch length, as well as tongue space. This may affect the overall health and well being in a person’s life.

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Anna Kalmanovich


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