The argument about extracting or not extracting teeth has been around since the early days of orthodontics over 100 years ago. The answer lies in the middle ground. In many cases extractions can be kept to a minimum or avoided altogether. Over-expanding the jaws for the sole purpose of avoiding extractions can produce an unattractive result that will also be unstable. Where there are large teeth, small jaws, very crowded or protrusive teeth it is possible that some extractions of permanent teeth may be required.