This online reader may be getting bad advice:

“I have been informed by multiple ortho that the extraction of four bicuspid is necessary to adequately address my bite alignment (don’t remember if its class I or class II malocclusion), and overbite/deepbite, overjet, crowding and bi-maxillary protrusion. But after doing a little bit of research online, it seems like such an extraction will cause TMJ? Is this true, even if the teeth were to be aligned properly after extraction?

Extracting teeth would only be recommended if crowding is a major problem.  However, extracting four bicuspids almost always creates excess space that requires upper front teeth to be pushed too far back and arch width to be decreased in order to close the excess space. You must also remember that your face covers the teeth so if you pull your upper front teeth back too far your lower face goes with it. This will often cause your nose to appear large. The doctor who moves your teeth must pay close attention to how it will affect your face.

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