I 'need' braces - I have very severely crowded teeth. To give you an idea of how crowded, if you tupe into Google 'severely crowded teeth', well, the search results are nowhere near as crowded as my teeth. I also have bimaxillary protrusion.

My orthodontist says I need my first four premolars extracted for successful treatment. I have asked her if there is another option such as expansion, but she says that expansion would worsen the bimaxillary protrusion and be less stable than if extractions are carried out.

I also asked her if extracting premolars causes TMJ disorder or sleep apoea, however, she says not in my case because the extractions are being carried out in order to fix bimaxillary protrusion, and that there is only a high incidence of TMJ in cases where bimaxillary protrusion is not present, and the mandible is forced backwards.

My question is: is she right? Or does premolar extraction always cause TMJ disorder?