Extracting teeth for braces isn’t nearly as common as 30 years ago. But, in certain cases, we still need to remove teeth.
The two main reasons to remove teeth are: 1) severe crowding, as in image above, and 2) very full profile (can’t close lips well). Every orthodontist is different, and each provider practices with at least a slightly unique philosophy — even relating to extractions. However, most orthodontists still remove teeth when they feel space must be created.
Before brackets were glued on teeth — an innovation adopted by most in the 1980s — orthodontists used to place bands on all the teeth (see image above with a real “metal mouth”).
These days, if any bands are used at all, bands are placed only around the very back teeth or molars (see image above with metal ring or band around back molar and regular braces on other teeth more in front). Placing bands took up lots of space, requiring orthodontists to remove teeth to create room for bands. This, along with a higher awareness of preserving (popular) full profiles, has driving down extraction rates.
So, yes, we still remove teeth. But not at the rate of orthodontists from the more-distant past. We will happily review other aspects of this question at a free consultation.