The Effect of Teeth Extraction for Orthodontic Treatment on the Upper Airway

When an orthodontist pulls teeth to make room for the rest to line up, what happens to the airway behind those teeth? This review looked at seven studies to find out.

The answer depends on why the teeth were extracted. In children whose teeth stuck out significantly, pulling four premolars and pushing the remaining teeth back narrowed the airway. That makes intuitive sense — moving teeth backward pushes the tongue backward too, leaving less room for air to flow.

But in children with simple crowding (teeth that are crooked but don't stick out), extractions actually increased airway space, because the remaining teeth shifted in a way that gave the tongue more room.

The honest takeaway: we don't yet know for sure whether these changes actually affect a child's breathing in practice. None of the studies measured real breathing function. But the anatomical concern is real, and it's a question every parent should feel comfortable asking their orthodontist: "Will this treatment affect my child's airway?"