The fallacy of serial extractions.

Abstract

It is suggested that lingually-positioned lower lateral incisors in young children are anatomically correct and not a symptom of crowding. Primary canines with intact periodontal attachments have an important role to play as proprioceptors to encourage growth of the alveolar arch. Extractions of primary cuspids would deprive the alveolus of important growth stimuli. Clinical evidence suggests that serial extraction is counter-productive. The early extraction of primary cuspids will invariably result in crowding of the permanent cuspids. It is a common belief that serial extraction corrects the crowding of lower incisors but the procedure is not evidence based. In reality, the problem is maintained and the 'crowding' shifts to involve the permanent cuspids. Let us not forget the most basic canon of the health profession which is 'first do no harm, and if it is not broken, do not try to fix it'.