Baby teeth will have to be pulled if they did not fall off on time, in this case the baby teeth will be blocking the way for the permanent teeth to erupt. Pulling baby teeth will be decided by a general dentist or an orthodontist.

Why Permanent Teeth have to be Removed?

In many cases the orthodontist might recommend the removal of few permanent teeth (usually first permanent premolars), this will be decided if the size of the jaw bone is smaller than the teeth, or in cases where crowded teeth are present.  Usually this will be followed with an extensive orthodontic treatment to move the rest of the teeth into the space and improve the appearance.