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When Extraction Is Your Best Option

October 22nd, 2025

Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

  • Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

  • Tooth and Jaw Structure

Dr. Dennis Johnson and the team at Johnson Orthodontics carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

  • Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

  • Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Dr. Dennis Johnson will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

  • discuss the extraction procedure with you, including sedation options
  • numb the area 
  • gently loosen and then extract the tooth
  • provide options for pain management after the procedure
  • give you detailed instructions for aftercare
  • work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Johnson Orthodontics in Columbus, OH will coordinate a treatment plan to create your best—and healthiest—smile.

What is early intervention?

October 17th, 2025

Many developing orthodontic problems can be intercepted and corrected if diagnosed and treated at an early age. Dr. Dennis Johnson and our team at Johnson Orthodontics recommend children have their first orthodontic evaluation no later than age seven, or younger if the front four permanent teeth have replaced the baby teeth. Early treatment, also known as interceptive treatment or Phase I treatment, provides both timely detection of problems and greater opportunity for more effective treatment. Early intervention guides growth and development, preventing serious problems later.

If your child is showing these signs, it may be time to think about early orthodontic treatment:

  • Early or late loss of baby teeth (your child should typically start losing teeth around age five or six, and will have all their permanent teeth in around age 12 to 13)
  • Difficulty chewing and/or biting
  • Mouth breathing
  • Sucking his or her thumb
  • Speech impediment
  • Protruding teeth (the top teeth and the bottom teeth extend away from each other)
  • Crowded front teeth
  • Teeth that don't come together in a normal manner or even at all

Early intervention will greatly reduce the severity of your child’s case, and therefore reduce the length of treatment time and cost for a second phase of treatment when all of his or her permanent teeth have erupted. An evaluation at our Columbus, OH office will determine if your child’s dental and skeletal growth is proceeding properly or if interceptive treatment is needed. Many times, a more severe problem can be corrected using sophisticated removable appliances instead of traditional orthodontic treatment.

To schedule a consultation for your child to visit with Dr. Dennis Johnson, please give us a call! We will provide your child with an initial exam, and discuss with you the best steps to take toward caring for your child's smile.

TMD Problems and How You Can Prevent Them

October 17th, 2025

Temporomandibular joint disorders (TMD) describe a set of conditions that involve trouble with your jaw and face muscles. They result from a problem in the temporomandibular joint (TMJ), which is a hinge that connects the temporal bones, in your skull in front of each ear, to your jaw. The joint enables you to talk, yawn, and chew by letting your mouth move.

TMD can be very painful and interfere with functions such as eating and speaking. This what to watch for and how to try to prevent TMD.

Risk Factors for TMD

You are at higher risk for TMD if you are a women than if you are male. The disorder is most common among adults between the ages of 20 and 40 years. Other risk factors for TMJ disorders include the following.

  • Arthritis in the area, making movement more difficult
  • Excessive tooth grinding, because it increases stress on the joint
  • General stress, which can lead you to clench your teeth and strain facial muscles

Symptoms of TMD

Symptoms of TMD can last for just a short while, or for several years. Seeing Dr. Dennis Johnson is important if your symptoms make it impossible for you to eat regularly or if you have unbearable pain or discomfort. The following symptoms can occur on both or one side of your face.

  • Aching or very tired facial muscles
  • Jaws that are fixed open or shut without you being able to unlock them
  • Grating or popping sounds when you chew or close or open your mouth
  • Pain in the entire area, including the mouth, jaw, neck, or shoulders, that comes on when you chew or yawn

Preventing TMD

You can try to prevent TMD by focusing on reducing risk factors. If you grind your teeth at night, ask Dr. Dennis Johnson about wearing a mouthguard. If you are overly stressed, look into ways to better manage your stress and relax your muscles. Another strategy for trying to prevent the development of TMD is to avoid chewing gum, since that puts stress on your jaw.

If you have questions about TMD, don’t hesitate to contact our Columbus, OH office.

October Is Orthodontic Health Month!

October 16th, 2025

October’s here! A month when we celebrate the beauty of fall, the taste of pumpkin spice, the fun of Halloween in Columbus, OH, and the healthy smiles which orthodontic treatment makes possible!

Because October is Orthodontic Health Month, and it’s a great time to talk about how your orthodontist helps you create not just a more beautiful smile, but a healthier one. 

Straight, evenly spaced teeth are the visible benefit of treatment, but there are many health benefits which might not be quite as noticeable. Orthodontic treatment can:

  • Help You Prevent Cavities and Gum Disease 

When teeth are crowded or crooked, it’s hard for your toothbrush and floss to reach all of the plaque which builds up on and between your teeth. The bacteria in plaque create acids which start to dissolve tooth enamel. And a very small hole in the enamel surface can grow until it becomes a cavity. 

Plaque and bacteria also irritate the gums. When you can’t remove plaque completely, your gums are at risk for gingivitis. This early stage of gum disease causes redness, tenderness, swelling, and bleeding. Left untreated, gingivitis can develop into more serious gum disease. 

And, over time, plaque hardens and becomes tartar, which needs to be removed by a dental professional.

When your teeth are straight and evenly spaced, brushing and flossing are both easier and more effective, helping you keep your teeth and gums healthy and plaque-free.

  • Create a Better Bite

For a healthy bite, your teeth and jaws need to align correctly. The top teeth should slightly overlap the lower teeth, and the ridges of your upper molars should fit smoothly with the grooves of your lower molars. 

Malocclusions, or bad bites, can come in many forms, including overbites, underbites, open bites, cross bites, and overjets. A bad bite is bad for your dental health. Malocclusions can cause tooth grinding, worn enamel, and even cracked teeth. 

And bad bites don’t just affect your teeth. When your bite doesn’t align properly, you might suffer from problems such as headaches, jaw pain, indigestion, and sleep apnea. 

Orthodontic treatment creates a healthy, symmetrical, and pain-free bite.

  • Improve Your Self-Confidence

We can’t forget the invisible health benefits of orthodontic treatment! Your smile is a gift which you share with the world. But if you’re hesitating to smile because of self-consciousness about your teeth or bite, orthodontic treatment can make a world of difference.

Dr. Dennis Johnson can help you achieve straighter teeth, a bite which fits together properly, and, when malocclusions affect jaw symmetry, a more balanced facial profile. If you’re concerned about the appearance of your smile, ask Johnson Orthodontics for an orthodontic consultation. Today’s technology can even let you see what your future smile will look like!

Modern orthodontic treatment is more effective and takes less time to complete than ever before. And orthodontics offers patients of all ages more benefits than ever before: 

  • New types of braces are less noticeable and more comfortable than older styles. Smaller brackets, brackets which blend with tooth enamel, clear aligners, and lingual braces give you a variety of options to customize your treatment.
  • Early orthodontic treatment can guide jaw growth in younger children. 
  • Appliances can help with jaw alignment in older children, or, for more serious malocclusions, an orthodontist can coordinate treatment with an oral surgeon.
  • Treatment isn’t limited to the teen years. Adults make up a large and growing number of orthodontic patients. 

If you’ve been considering orthodontic treatment, October—or any month!—is a great time to schedule a visit with an orthodontist. An orthodontic evaluation will let you know just what your orthodontist can do to help you create a beautiful and healthy smile.