Orthodontics without tooth extractions?

If you think getting your teeth straightened still means having to undergo painful surgery or extraction of teeth for braces, think again! Here, DR AMANDA KOH from Kohe Dental shares her thoughts on how orthodontics has evolved to offer gentler, more holistic options such as jaw expansion. 

Approaches in modern orthodontics

For many years, orthodontics (such as braces and aligners) often came with a difficult choice: remove healthy teeth to create space or undergo jaw surgery to correct bite problems. Understandably, these options can feel intimidating and even discouraging.

I have some good news: modern orthodontics has advanced far beyond “extraction or surgery”. Today, there are innovative ways to create space for braces and align your teeth without extraction or undergoing invasive jaw procedures.

Here are a few modern methods that we consider at Kohe Dental:

#1 Jaw expansion instead of extraction of teeth for braces

Your smile is shaped not just by your teeth, but also by the size of your jaws. That’s why jaw expansion has become an important topic in modern orthodontics.

Guided expansion with clear aligners: In many cases of mild to moderate crowding, modern clear aligners like Invisalign or Angel Aligner can gently expand your dental arches, creating more space for crowded teeth without extracting any.

Jaw expansion in children: For children below 12 years of age, I can use traditional palatal expanders or Invisalign palatal expanders to expand the palate and create more space for teeth to develop.

Jaw expansion in adults: Even adults can benefit from expansion techniques like MARPE (mini-implant assisted expanders).

This means you may be able to achieve a wider, more natural looking smile while keeping all your teeth.

#2 Tiny implants can make a big impact

Orthodontists today, including us at Kohe Dental, often use mini implants or temporary anchorage devices (TADs). They are small titanium anchors placed painlessly in the mouth that provide a secure “handle” for moving teeth more effectively, making it possible to shift back molars, open space or correct bite problems that used to require extractions. Think of them as invisible helpers that make braces or aligners much more powerful.

#3 Digital orthodontics and AI technology

Technology has completely changed the way orthodontists plan treatment. Thanks to 3D scans and simulations, I can now model your smile digitally and predict how your face, airway and bite will change.

Plus, AI-enhanced planning uses advanced software to forecast whether your teeth can be aligned without surgery or extraction, giving you more confidence in the outcome. These help us better devise a treatment plan that is personalised to your biology and lifestyle.

#4 Improving the body’s natural healing

Another exciting area of modern orthodontics involves stimulating your body’s natural ability to adapt. Microvibrations and ultrasound devices can speed up tooth movement and bone remodelling. Meanwhile, minimally invasive techniques like micro-perforations can make stubborn teeth move more easily, reducing the need for surgery. Even nutritional optimisation (like ensuring Vitamin D and collagen support) helps bones and gums adapt better to treatment.

#5 Whole-body, airway-focused orthodontics

In the past, orthodontics focused mainly on straightening teeth. Today, we at Kohe Dental also look at things such as breathing and airway health, facial balance and profile, and long-term stability. By widening arches and supporting the airway, many of my patients can avoid extractions and surgery while gaining better overall health.

Final thoughts

You no longer have to accept that the only way to straightening teeth is to “take teeth out” or undergo invasive jaw surgery. With today’s tools – clear aligners, digital planning, mini-implants, expansion and biologic support – many patients can achieve their dream smile in a far more natural and gentle way.

If you’ve ever been told you must extract teeth for braces or have surgery, it may be worth getting a second opinion. Orthodontics has changed dramatically, and the possibilities for a healthier, fuller smile are greater than ever.

About the dentist

Dr Amanda Koh is an aesthetic and full-mouth rehabilitation dentist who focuses on restoring beautiful smiles through orthodontics and dental implants. She has worked with children as young as seven years as well as adults to align, restore and beautify their smiles.

#03-01 The Oxley, 9 Oxley Rise 8952 0083 | 9178 8969
enquiries@kohedental.com | kohedental.com

This article on Kohe Dental, orthodontics, extraction of teeth for braces and jaw expansion first appeared in The February 2026 Expat Living magazine. You can buy the latest issue or an annual subscription or read the digital version free now.

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