When I received some patients seeking orthodontic treatment, some patients and parents often have doubts and misunderstandings about the need to extract teeth for orthodontic treatment. The popular argument among the public nowadays is that since teeth are born to parents, they should not be altered, and tooth extraction will hurt the bones and lead to loosening of the whole mouth and decrease in oral function, which will eventually damage the health of the whole body. In fact, modern orthodontics has experienced more than a century of technical development and clinical practice, fully verified the feasibility of tooth extraction in orthodontics and its important role in improving orthodontic efficacy, orthodontic clinicians have used tooth extraction as a routine means to treat some patients with serious dental disorders. Through the regular treatment of professional physicians, the gap between the extracted teeth on the dental bed can be completely closed, and there is no talk of setting dentures again; and in some cases where the dental bed is more protruding and the teeth are crowded, the gap between the extracted teeth is used to collect the protruding front teeth backward, which achieves the purpose of improving the patient’s dental alignment and facial aesthetics. For some patients who are able to have a timely follow-up, the serial extraction method (starting with the extraction of baby teeth on each side and ending with the extraction of a permanent tooth) can sometimes be used, which is a more advanced method to reduce the difficulty of treatment and shorten the time the patient has to wear braces. Patients with extracted teeth will benefit more from the orthodontic system as the alignment and occlusion can be reestablished stably after treatment. A number of clinical problems caused by tooth extraction are often the result of improper orthodontic design and treatment errors. The relative lag in the registration and certification of orthodontic specialists in China has led to a large number of general dentists getting involved in the field of orthodontics, often extracting patients’ teeth at will and recklessly closing the extraction gap, resulting in worse alignment and occlusion at the end of treatment. Therefore, it is not the extraction itself that is the problem, but the indiscriminate treatment by amateurs that is of greater concern to patients and their families. With the introduction of new orthodontic techniques and materials, such as the implantation of bone-supported pins to retract and move teeth, or the widening of the dental bed through distraction osteogenesis to align all teeth, the proportion of patients requiring extraction has been gradually decreasing. According to the latest animal studies by European scientists, excessive extraction of teeth in rats may affect their memory, which will remind orthodontists to be more careful when deciding to extract teeth in their patients.