Orthodontic treatment is the treatment of malocclusion by means of forces generated by orthodontic appliances that act on the teeth, jawbone and craniofacial soft and hard tissues, causing histological alterations in the dental and jaw systems. In some of these cases, the doctor needs to remove a few relatively unimportant teeth. In fact, in orthodontic treatment, whether to extract teeth, the number of extractions, and the timing of extractions are the issues that orthodontists are more concerned about and constantly think about. Orthodontic treatment is generally divided into extraction treatment and non-extraction treatment, and some marginal cases may need to go through a period of conservative treatment. The purpose of extracting teeth in orthodontic treatment is to create a gap, release crowding, improve the protruding arch, adjust the occlusal relationship of molar or anterior teeth, etc. With the improvement of treatment methods and techniques, there is a trend of reducing the number of extractions. In China, about 60% of orthodontic treatment cases are extracted. Westerners have a lower extraction rate than our patients due to the jaw and facial shape. Malocclusion is a malformation of the teeth, dental arch and jaws caused by genetic or non-genetic factors during the growth and development of children. Orthodontic patients are mostly teenagers and children, and the treatment time is usually about 2 years, some longer, there is still a certain amount of growth and development, the jaw bone and dental arch are still changing during the treatment process, so there are great individual differences in orthodontic treatment, with the characteristics of complexity, variability, long treatment course, the need for good patient cooperation, and possible changes with growth and development during the treatment process. The goals of orthodontic treatment are aesthetics, function, health and stability, which are the principles for developing orthodontic treatment plans. Orthodontists need to consider many factors when diagnosing and formulating treatment plans, such as misalignment, degree of arch crowding, degree of protrusion, appearance, facial shape, growth and development potential, aesthetic concepts, treatment techniques, patients’ opinions, etc. These test the orthodontist’s basic knowledge, orthodontic philosophy, clinical experience and technique. Especially in marginal cases, the timing of extraction and the choice of whether to extract teeth and the location of extraction are important. Although the treatment plan is the same and the same extraction pattern is chosen, the treatment results may vary from one doctor to another due to the handling of some details during the treatment, the technique and the different emphasis and understanding of aesthetics, function, health and stability. Therefore, if the extraction is not handled properly, such as the severe loss of branch resistance, it will add a lot of trouble to further treatment and the result may be irreversible. In clinical practice, we often encounter some patients who need to be treated by tooth extraction, but they are treated by slicing several teeth because they do not want to be extracted, and as a result, the arch protrudes and the teeth bite abnormally. In conclusion, the issues involved in extraction or not are multifaceted and complex. Orthodontists need to consider all factors, analyze the advantages and disadvantages, and make individual analysis according to different patients, fully consider the relationship and balance between aesthetics, function, stability and coordination, and seek and listen to the reasonable opinions of patients, as well as make reasonable treatment plans according to their technical ability and level. Therefore, we hope that our patients and friends will go to the standard orthodontic department to find professional orthodontists for orthodontic treatment. If you are not satisfied with a piece of clothing or an item, you can throw it away and buy it again, but a mouthful of teeth is, after all, a big issue related to your lifetime health and beauty.