ChatGPT answers, unedited

• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Kunik Orthodontics Austin - 11821 Rock Rose Ave Ste 140, Austin, TX 78758, United States

Yes. For a second opinion specifically on whether teeth should be extracted to make room for braces, I’d actually consider getting two perspectives:

1. A different orthodontist — to reassess whether extraction is necessary for the overall bite, tooth positioning, facial profile, and long-term orthodontic plan.
2. An oral & maxillofacial surgeon (OMS) — if the extraction itself is being recommended, particularly if the teeth are impacted or the procedure may be complicated. AAOMS specifically describes orthodontic extractions as an area where orthodontists and OMSs coordinate. AAOMS

Austin options I'd investigate

• Austin Orthodontics: Seth R Briggs DDS — North Austin. Their practice specifically advertises second opinions, and their orthodontic materials discuss treatment planning around extractions and surgical orthodontics. Austin Orthodontics
• Arboretum & Westlake Orthodontics — Northwest Austin. They specifically list surgical orthodontic treatment coordination, which is relevant if the extraction recommendation is part of a more complicated plan.
• Limestone Hills Orthodontics — Northwest Austin. They explicitly offer second-opinion consultations and say they review the existing treatment plan and records rather than assuming the original recommendation is correct. Limestone Hills Orthodontics
• Central Texas Oral Surgery Associates — Central Austin. This is an OMS practice that handles extractions and lists board-certified oral surgeon Franklin S. Bonasso among its doctors.
• South Austin Oral Surgery — South/Central Austin. Their listed services specifically include premolar extractions for orthodontic treatment, so this is particularly relevant if you're being told to remove premolars before braces.
• North Austin Oral Surgery — North Austin. They handle surgical extractions and specifically note orthodontic patients among the people they serve.

For an oral surgeon, I'd look for ABOMS board certification rather than choosing solely from online ratings. ABOMS provides a public directory for finding board-certified oral and maxillofacial surgeons. ABOMS ABOMS

One important point

If your orthodontist is recommending healthy premolars be removed because of crowding, I'd get the orthodontic second opinion before having anything extracted. Extraction is irreversible, while an orthodontic treatment plan can potentially have alternatives depending on your anatomy and goals. The AAO notes that whether extraction is appropriate depends on things such as the bite, jaw size, tooth position, facial structure, and treatment goals. American Association of Orthodontists

If you tell me your age, which teeth they want to extract (e.g. upper/lower first premolars), and whether you're being told you have severe crowding, an overbite, protrusion, or impacted teeth, I can narrow this to 2–3 Austin doctors I'd specifically consider for this kind of second opinion and explain what I'd ask each one.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Kunik Orthodontics Austin - 11821 Rock Rose Ave Ste 140, Austin, TX 78758, United States
• Rise + Smile Orthodontics - 6012 W William Cannon Dr Ste D103, Austin, TX 78749, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• Austin Institute of Dental Medicine - 1401 Philomena St Ste 200, Austin, TX 78723, United States
• Kunik Orthodontics Austin - 3423 Bee Caves Rd C202, West Lake Hills, TX 78746, United States

Yes. If the recommendation is to remove permanent teeth specifically to create space before braces, I’d get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the specialist who can evaluate whether extraction is actually necessary for the overall bite and tooth-position plan; an oral surgeon is usually the specialist who performs the extraction once the orthodontic plan calls for it. The AAOMS specifically describes orthodontists and oral surgeons as collaborating on orthodontic extractions. AAOMS American Association of Orthodontists

Austin options I’d consider

• Limestone Hills Orthodontics — This is particularly relevant because the practice explicitly offers second-opinion consultations and says its goal is to clarify whether the existing treatment plan is appropriate. It is in northwest Austin. Limestone Hills Orthodontics
• Austin Orthodontic Arts — Central/north Austin option for an independent orthodontic evaluation.
• Kunik Orthodontics Austin — Has Austin/Westlake-area offices and specifically sees patients seeking second opinions.
• Rise + Smile Orthodontics — Southwest Austin option; the practice identifies itself as emphasizing conservative treatment recommendations.
• For the actual extraction, Central Texas Oral Surgery Associates or Widner Elite Oral Surgery & Dental Implants are established Austin oral-surgery options. The ADA's specialist directory lists oral and maxillofacial surgeons at both practices. findadentist.ada.org

I wouldn't choose the extraction surgeon until you've settled the orthodontic question: “Do these teeth really need to come out, and why?” Extraction is irreversible, so a second orthodontic opinion is quite reasonable.

What to bring to the second opinion

Ask your current orthodontist for copies of:

• Panoramic X-ray
• Cephalometric/side-profile X-ray, if taken
• Intraoral/face photographs
• 3D scan or CBCT, if one was done
• Written treatment plan identifying which teeth they want removed
• Your proposed braces/orthodontic plan

And ask the second orthodontist these exact questions:

1. “Do you agree that these teeth need to be extracted?”
2. “What problem are the extractions solving—crowding, protrusion, bite, or something else?”
3. “What are the realistic non-extraction alternatives in my case?”
4. “If we don't extract, what compromises or risks would there be?”
5. “Can you show me on my X-rays exactly what you're trying to accomplish by removing these teeth?”
6. “Which teeth would you remove, and why those particular teeth?”

If you tell me your age, which teeth they've recommended removing (e.g. four premolars, two upper premolars, wisdom teeth), and whether you're in North/Central/South Austin, I can narrow this down to 2–3 specific Austin specialists and explain what makes each relevant to an extraction second opinion.

If you’re being told to remove healthy teeth before braces, getting a second opinion is a reasonable step because extractions are irreversible and the decision depends heavily on your bite, facial profile, crowding amount, tooth position, and growth pattern. A good second opinion should review your photos, panoramic X-ray, cephalometric X-ray (side profile), scans, and the exact reason for extraction—not just look at your teeth for five minutes. Austin Periodontal Associates Capital Family Orthodontics

For an Austin second opinion, I’d consider seeing both:

1. A different orthodontist (to challenge the treatment plan)

A second orthodontist is usually the most important stop because they can answer: “Do I actually need extractions, or are there alternatives?”

• Limestone Hills Orthodontics — offers second-opinion/transfer evaluations and specifically discusses reviewing outside treatment plans and records. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Tomblyn Family Orthodontics — another Austin orthodontic option that offers second opinions and evaluates bite/jaw relationships, not just tooth straightening. Tomblyn Family Orthodontics
• Sonrisas Orthodontics — another established Austin orthodontic practice that advertises second-opinion consultations. Austin Orthodontics

2. An oral & maxillofacial surgeon (especially if you’re unsure about the extraction itself)

An oral surgeon can confirm whether the teeth recommended for removal are appropriate to remove and discuss surgical considerations. They usually won’t redesign your braces plan, but they can give another perspective on the extraction portion.

Options in Austin:

• North Austin Oral Surgery — handles routine and complex extractions and other oral/maxillofacial procedures.
• Oral Surgery Specialists Of Austin — provides oral and maxillofacial surgery, including extractions and complex surgical care.
• Central Texas Oral Surgery Associates — another Austin oral surgery group with board-certified oral surgeons.

Questions I’d bring to the consult

Ask the orthodontist:

1. “What problem are the extractions solving?”

• Crowding?
• Protruding teeth (“flaring”)?
• Bite correction?
• Avoiding gum/bone problems?
• “What are the non-extraction alternatives in my specific case?”

• Expansion?
• Interproximal reduction (IPR)?
• Distalization?
• Different mechanics?
• Accepting a different final tooth position?
• “Can you show me on my X-rays why extraction gives a better long-term result?”
• “If I don’t extract, what exactly changes in the final result?”

A couple of details would help me narrow the recommendation:

• Are you being told to extract premolars (bicuspids) or wisdom teeth?
• How old are you?
• Is this for crowding, overbite/overjet, or teeth that stick out?
• Which Austin orthodontist recommended the extraction (if you’re comfortable sharing)?

• Sonrisas Orthodontics - 1217 W Slaughter Ln #100, Austin, TX 78748, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Austin Institute of Dental Medicine - 1401 Philomena St Ste 200, Austin, TX 78723, United States
• Vincent Cavaretta, DDS - 3423 Bee Caves Rd, Bldg C, Ste 201, Austin, TX 78746

If an orthodontist has recommended removing teeth before braces, I’d get a second opinion before committing to the extraction. Extractions for orthodontic space can be completely appropriate in some cases (for example, significant crowding, protrusion/flaring, or bite correction), but removing healthy permanent teeth is irreversible, so it’s reasonable to have another orthodontist review the diagnosis and records first. Capital Family Orthodontics MyOMS

For an Austin second opinion, I’d consider seeing both:

1. A second orthodontist (to question the treatment plan)

You want someone who will review:

• panoramic X-ray
• cephalometric (side profile) X-ray
• photos/scans
• bite relationship
• facial profile goals
• alternatives (expansion, IPR, distalization, different mechanics, or no extraction)

Some Austin options:

• Limestone Hills Orthodontics — offers second-opinion consultations and transfer evaluations, with emphasis on reviewing records and treatment planning. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Sonrisas Orthodontics — another established orthodontic practice that advertises second opinions. Austin Orthodontics

2. An oral & maxillofacial surgeon (if extraction is still recommended)

An oral surgeon usually does not decide whether extraction is needed for braces—that’s primarily the orthodontist’s treatment-planning decision—but they can:

• confirm whether the teeth are straightforward to remove
• discuss risks (roots, nerves, bone, healing)
• advise if the surgical aspect is appropriate

Austin oral surgery options:

• North Austin Oral Surgery — oral and maxillofacial surgery practice handling extractions and more complex jaw-related procedures.
• Central Texas Oral Surgery Associates — oral surgery practice in central Austin.
• Oral Surgery Specialists Of Austin — South Austin oral surgery practice offering routine and complex extractions.

Questions I’d ask the second orthodontist

Bring your records and ask:

1. “What specific problem are the extractions solving?”

• crowding?
• overjet?
• lip prominence?
• bite stability?
• “What happens if we don’t extract?”

• Would teeth simply be less straight?
• Would the bite be unstable?
• Would the profile change?
• “Are there non-extraction options in my case?”
• “Can you show me the measurements that make extraction the preferred choice?”

If you tell me:

• your age,
• how many teeth they want removed (2? 4? which teeth?),
• whether they are wisdom teeth or premolars,
• whether the issue is crowding, overbite/overjet, or “protruding teeth,”
• and which Austin orthodontist recommended it,

I can help you judge whether a second orthodontic opinion vs. oral surgeon consult should be your next step.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Rise + Smile Orthodontics - 6012 W William Cannon Dr Ste D103, Austin, TX 78749, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States

Yes. Because the recommendation is to remove healthy teeth specifically to make room for braces, I’d get the second opinion from another orthodontist first, not just an oral surgeon. The orthodontist can assess whether the extractions are actually necessary and compare alternatives such as expansion, enamel reduction (IPR), different tooth-movement mechanics, or accepting a different treatment endpoint. An oral surgeon is the right second opinion for whether/how the teeth should be surgically removed, but generally isn't the person deciding whether extraction is the best orthodontic strategy.

Austin options I'd consider

• Limestone Hills Orthodontics — my first pick for this particular second opinion. They explicitly offer second-opinion consultations and say they review the existing treatment plan and records rather than assuming the original recommendation is wrong. Their orthodontist, Dr. Rodrigo Viecilli, also has a PhD focused on orthodontic biomechanics and treats extraction cases. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Austin Orthodontics: Seth R Briggs DDS — another reasonable option, particularly if you're in North Austin. The practice specifically invites patients who have already seen another orthodontist to seek a second opinion. Austin Orthodontics
• Rise + Smile Orthodontics — southwest Austin option; the practice emphasizes conservative recommendations and says Dr. Mathue Faulkner is board-certified.
• If the second orthodontist agrees that extraction is appropriate and you want a separate surgical opinion, South Austin Oral Surgery specifically lists premolar extractions for orthodontic purposes among its services. South Austin Oral Surgery
• In central Austin, Central Texas Oral Surgery Associates is another established oral/maxillofacial surgery option.

What I'd bring to the second opinion

Ask your current orthodontist for copies of everything, preferably electronically:

• Panoramic X-ray
• Cephalometric/lateral X-ray
• Any CBCT/3-D scan
• Intraoral and facial photographs
• Written treatment plan
• Which teeth they want removed and why
• The proposed braces/aligner mechanics after extraction

And I'd specifically ask the second orthodontist:

“If these were your teeth, would you extract them? What specific problem does each extraction solve, and what are the realistic non-extraction alternatives?”

Also ask whether extraction is intended to correct crowding, protrusion/overjet, bite relationship, or simply to create space. That's important because “we need room” by itself isn't a sufficient explanation.

If you tell me your age, which teeth they're recommending extracting (e.g. four premolars), and what the orthodontist said the reason was, I can help you figure out how strong the case for extraction sounds and which type of Austin specialist I'd prioritize.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Tomblyn Family Orthodontics - 4407 Bee Caves Rd Bldg 2, Unit 220, Austin, TX 78746, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Ortho 360 Orthodontics - 1600 W 38th St #321, Austin, TX 78731, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Smile Doctors Orthodontics - Austin Research - 8754 Research Blvd, Austin, TX 78758, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• RJ Orthodontics - Orthodontist in Austin, TX - 6911 N FM 620 Suite A-200, Austin, TX 78730, United States
• Rise + Smile Orthodontics - 6012 W William Cannon Dr Ste D103, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States

Yes. For a second opinion before committing to extraction for braces, I’d start with another orthodontist, not an oral surgeon. The orthodontist should independently decide whether the extractions are actually necessary and what alternatives exist; an oral surgeon is the right second opinion for the surgical part once the orthodontic plan is settled.

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for this particular question. Dr. Rodrigo Viecilli is board-certified in orthodontics with a PhD in orthodontic biomechanics. The practice specifically advertises second opinions and says it evaluates alternatives to extraction when appropriate. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Austin Orthodontics: Seth R Briggs DDS — a good independent comparison, particularly if you're in North Austin. Their practice explicitly invites second-opinion consultations. Austin Orthodontics
• Tomblyn Family Orthodontics — another Austin option with a strong local reputation; their practice also coordinates oral-surgery care when needed. Tomblyn Family Orthodontics

If you want an oral surgeon's opinion too

If the proposed extractions are premolars specifically for orthodontic space, I'd get the orthodontic second opinion first. If both orthodontists agree that extraction is appropriate, then you can choose the surgeon.

A few Austin options:

• Central Texas Oral Surgery Associates — central Austin, with board-certified oral/maxillofacial surgeons.
• South Austin Oral Surgery — specifically lists premolar extractions for orthodontic purposes among its services. South Austin Oral Surgery
• North Austin Oral Surgery — highly reviewed local practice for surgical extractions and broader oral/maxillofacial procedures.

One important thing: don't let the oral surgeon be the person who decides whether you need the extractions for orthodontic reasons. That's primarily an orthodontic treatment-planning question.

At the second-opinion appointment, bring the original orthodontist's X-rays/CBCT, photos, scan/models, treatment plan, and the exact teeth they want removed. Ask:

“If you were treating this case from scratch, would you extract these teeth? If yes, what specific problem does the extraction solve, and what are the realistic non-extraction alternatives?”

If you tell me your age, which teeth they're recommending extracting (e.g. 4 premolars, two upper premolars, wisdom teeth), and what the orthodontist said the reason is, I can help you assess whether the recommendation sounds routine or worth being especially cautious about.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• Tomblyn Family Orthodontics - 4407 Bee Caves Rd Bldg 2, Unit 220, Austin, TX 78746, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Ortho 360 Orthodontics - 1600 W 38th St #321, Austin, TX 78731, United States
• Smile Doctors Orthodontics - Austin Research - 8754 Research Blvd, Austin, TX 78758, United States
• Sonrisas Orthodontics - 1217 W Slaughter Ln #100, Austin, TX 78748, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States

Yes. For a second opinion on whether teeth actually need to be extracted to make braces work, I would see another orthodontist first—not an oral surgeon. The orthodontist is the person who should determine whether extraction is necessary and what the alternatives are; the oral surgeon is usually the person who performs the extraction once that plan is established. Austin practices specifically describe premolar extraction as part of orthodontic treatment. South Austin Oral Surgery Kola Dentistry

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for this particular second opinion. Dr. Rodrigo Viecilli is a board-certified orthodontist with a PhD in orthodontic biomechanics, and the practice explicitly offers second-opinion consultations. They say they evaluate extraction cases as well as alternatives and use 3D CBCT imaging in treatment planning. Limestone Hills Orthodontics Limestone Hills Orthodontics

limestonehillsorthodontics.com

• Arboretum & Westlake Orthodontics — another strong option, particularly if you're in North/West Austin. Their practice specifically handles surgical orthodontic cases and complex bite treatment, and they have experience with patients seeking second opinions.
• Tomblyn Family Orthodontics — good option in Westlake. They emphasize personally seeing patients through treatment and offer both braces and coordinated oral-surgery care. Tomblyn Family Orthodontics

If the second orthodontist agrees you need extractions

Then I'd get the actual extraction done by an oral & maxillofacial surgeon, particularly if multiple premolars are being removed or you have impacted teeth.

• South Austin Oral Surgery — specifically lists premolar extractions for orthodontic purposes and offers IV/oral sedation. South Austin Oral Surgery
• North Austin Oral Surgery — particularly convenient if you're in North Austin; they specifically work with orthodontic patients needing extractions and offer multiple anesthesia options.
• Central Texas Oral Surgery Associates — central Austin option with board-certified oral-surgery expertise and extensive extraction experience.

One important thing: don't let the oral surgeon's consultation become the thing that determines whether you need the extraction. Ideally, take your orthodontic X-rays/scans and proposed treatment plan to a second orthodontist and ask:

1. Exactly what problem are the extractions solving?
2. Which teeth would be removed and why those teeth?
3. What happens if we don't extract?
4. Could expansion, IPR, distalization, or another approach accomplish the same goal?
5. How will extraction affect my facial profile and lip position?
6. Can you show me on my X-rays/scan where the space is needed?

If you tell me your age, which teeth they're recommending extracting (e.g. 4 premolars, 2 upper premolars, wisdom teeth, etc.), and whether you're being treated for crowding, overbite, protrusion, or something else, I can narrow this down to 2–3 Austin orthodontists I'd choose for your specific situation and tell you what I'd ask each one.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Becher Orthodontics - 4464 Frontier Trail, Austin, TX 78745, United States
• Kunik Orthodontics Austin - 11821 Rock Rose Ave Ste 140, Austin, TX 78758, United States

Yes. If the extraction is being recommended specifically to create space before braces, I’d get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the person who can assess whether the extraction is actually necessary and compare it with alternatives such as expansion, IPR, distalization, or a different orthodontic plan. An oral surgeon is then the right specialist to perform the extraction if it remains indicated.

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for the second orthodontic opinion. Dr. Rodrigo Viecilli is board-certified and has a PhD in orthodontic biomechanics. The practice specifically advertises second-opinion consultations, 3D CBCT imaging, and evaluation of extraction vs. non-extraction approaches. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Nantz Orthodontics — another reasonable option, particularly if you're in South Austin. Dr. J.L. Nantz is board-certified and treats adults as well as children. Nantz Orthodontics
• Arboretum & Westlake Orthodontics — worth considering if you're in North/Northwest Austin; they specifically list surgical orthodontic coordination and second-opinion-type cases among their services.
• If the extraction is ultimately recommended, Oral Surgery Specialists Of Austin is one oral-surgery option I'd consider. It's led by board-certified oral surgeons and handles both routine and complex extractions. OSSAustin
• North Austin Oral Surgery is another strong option if you're north of downtown; they specifically see orthodontic patients needing extractions and offer multiple anesthesia options.

What I'd do in your shoes

Don't have the teeth extracted yet. Take your existing records—panoramic X-ray, cephalometric X-ray, photos, scans/models, and the orthodontist's proposed treatment plan—to a second orthodontist.

Ask them these exact questions:

1. “Do you agree that these teeth need to be extracted?”
2. “Which teeth, and why those particular teeth?”
3. “What happens to my facial profile if we extract them?”
4. “What non-extraction options could work in my case, and what would I be giving up with each?”
5. “Is the extraction necessary because of crowding, my bite, tooth inclination, or something else?”
6. “Can you show me on my X-rays/scan exactly what problem the extraction is solving?”
7. “If I were your family member, would you recommend extraction?”

One particularly useful thing is to ask the second orthodontist to review the original treatment plan before you tell them whether you're uncomfortable with extraction. That reduces the chance that you're simply getting another opinion tailored to what you want to hear.

If you tell me your age, which teeth they want to remove (e.g. four premolars, two upper premolars, wisdom teeth), and what the orthodontist said the reason was, I can also help you assess whether the recommendation sounds routine vs. something I'd definitely get a second opinion on.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Kunik Orthodontics Austin - 11821 Rock Rose Ave Ste 140, Austin, TX 78758, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States

Yes — for a second opinion on whether extractions are really necessary before braces, I would see another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the person who can assess whether creating space by extraction is actually the best way to achieve the desired bite and facial result. The oral surgeon is primarily the person who performs the extraction once the orthodontic plan is settled.

My Austin shortlist

• Limestone Hills Orthodontics — This would be my first choice for a true second opinion. Dr. Rodrigo Viecilli is a Diplomate of the American Board of Orthodontics with a PhD in orthodontic biomechanics, and the practice specifically handles second-opinion cases. They also offer 3D CBCT imaging and explicitly say the purpose of a second opinion is to clarify whether the original plan is appropriate. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Austin Orthodontics: Seth R Briggs DDS — Another strong option, particularly if you're in North Austin. Dr. Briggs is board-certified, and the practice explicitly invites patients who have already seen another orthodontist for a second opinion. Austin Orthodontics Austin Orthodontics
• Kunik Orthodontics Austin — Worth considering if you're near the Domain. They specifically describe working with patients seeking a second opinion after another orthodontic consultation. Reddit
• Arboretum & Westlake Orthodontics — Another reasonable choice, especially for a more complicated bite or if you're concerned about how extraction might affect facial profile; they handle surgical orthodontic cases as well.

If the second orthodontist agrees you need extractions

Then I'd get the extraction consultation separately. Some Austin options include:

• North Austin Oral Surgery — particularly convenient if you're north of downtown; they specifically list orthodontic patients among the people they treat.
• Central Texas Oral Surgery Associates — central Austin, with board-certified oral and maxillofacial surgeons.
• Oral Surgery Specialists Of Austin — South Austin, with experience in routine and complex extractions.
• East Austin Oral Surgery — specifically lists extractions for orthodontic preparation among its services. East Austin Oral Surgery

One important thing I'd ask the second orthodontist

Don't just ask “Do I need extractions?” Take the original X-rays/photos/scan and treatment plan and ask:

“If you were treating this case from scratch, would you extract these teeth? What specific problem are the extractions solving, and what are the realistic non-extraction alternatives? How would each option affect my bite, facial profile, and long-term stability?”

Also ask whether the proposed extractions are premolars vs. wisdom teeth, because those are very different situations.

If you tell me your age, which teeth they're recommending removing (e.g. 4 upper/lower premolars), and whether the concern is crowding, overbite, protrusion, or something else, I can help you figure out how concerning the recommendation is and which type of Austin specialist I'd prioritize for the second opinion.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Kunik Orthodontics Austin - 11821 Rock Rose Ave Ste 140, Austin, TX 78758, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Eggleston Oral and Facial Surgery - 1209 W 5th St #100b, Austin, TX 78703, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States

Yes. If the proposed extractions are to make room for braces, I would get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the person who should determine whether extraction is actually necessary and whether alternatives could achieve the same bite/profile goals. An oral surgeon is then the appropriate specialist to perform the extraction if you decide to proceed. Some Austin orthodontic practices explicitly coordinate orthodontic extractions with oral surgeons. Capital Family Orthodontics South Austin Oral Surgery

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for a true extraction second opinion. Their consultation is specifically designed for second opinions, includes a specialist orthodontic exam and 3D CBCT, and they say they will review another orthodontist's plan without assuming you'll switch. Dr. Rodrigo Viecilli is a board-certified orthodontist with a PhD in orthodontic biomechanics. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Arboretum & Westlake Orthodontics — another good option, particularly if you're in North/West Austin. They specifically handle complex orthodontic and surgical cases and have experience with second opinions.
• Austin Orthodontics: Seth R Briggs DDS — North Austin option; the practice explicitly invites patients who have already seen another orthodontist for a second opinion. Austin Orthodontics
• Kunik Orthodontics Austin — worth considering if you're near the Domain/North Austin and want another orthodontic opinion before committing to extraction.

If the second orthodontist agrees you need extractions

For the actual surgery, I'd consider:

• Central Texas Oral Surgery Associates — established Austin oral-surgery practice with board-certified oral/maxillofacial surgeons and experience with extractions. Central Texas Oral Surgery Associates
• South Austin Oral Surgery — particularly relevant because they explicitly list premolar extractions for orthodontic purposes and offer sedation options. South Austin Oral Surgery
• Eggleston Oral and Facial Surgery — central Austin option for surgical extractions.

One important point: don't let the oral surgeon be the person who decides whether you need the extractions for orthodontic reasons. Their job is primarily to determine how to safely remove the teeth. The key question is whether removing those particular teeth improves your bite, tooth position, facial profile, and long-term stability compared with reasonable non-extraction alternatives.

If you tell me your age, which teeth they want to remove (e.g. upper/lower first premolars #5/#12/#21/#28), and whether you're getting braces or Invisalign, I can help you assess how reasonable the recommendation sounds and give you a very specific Austin second-opinion plan.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Tomblyn Family Orthodontics - 4407 Bee Caves Rd Bldg 2, Unit 220, Austin, TX 78746, United States
• Ortho 360 Orthodontics - 1600 W 38th St #321, Austin, TX 78731, United States
• Smile Doctors Orthodontics - Austin Research - 8754 Research Blvd, Austin, TX 78758, United States
• RJ Orthodontics - Orthodontist in Austin, TX - 6911 N FM 620 Suite A-200, Austin, TX 78730, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Rise + Smile Orthodontics - 6012 W William Cannon Dr Ste D103, Austin, TX 78749, United States

Yes. For a second opinion on whether teeth should be extracted before braces, I would start with a second orthodontist, not an oral surgeon. The orthodontist is the specialist who determines whether creating space through extraction is actually the best way to correct your bite and tooth position; an oral surgeon is primarily the person who performs the extraction if it is ultimately needed. The AAO specifically recommends getting a second orthodontic opinion when you're uncertain about a treatment recommendation. American Association of Orthodontists MyOMS

Austin options I'd consider

• Limestone Hills Orthodontics — my first choice for this particular question. Their practice specifically advertises second-opinion consultations and says they review the existing treatment plan, X-rays/scans, and alternatives without assuming the original plan is wrong. They also specifically discuss cases involving extraction mechanics and surgical coordination. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Austin Orthodontics: Seth R Briggs DDS — North Austin option; the practice lists orthodontic and surgical-orthodontic treatment among its services.
• Nantz Orthodontics — South Austin option if that's more convenient.
• Parmer Lane Orthodontics — North Austin; led by board-certified orthodontist Dr. Dip Desai. Parmer Lane Orthodontics

If the second orthodontist agrees that extraction is appropriate, then I'd get the extraction done by an oral/maxillofacial surgeon rather than simply having it done by a general dentist. For example:

• Central Texas Oral Surgery Associates — Central Austin, with board-certified oral surgeons and experience with extractions.
• Widner Elite Oral Surgery & Dental Implants — near 38th Street; offers extractions and 3D imaging.
• LoneStar Oral & Maxillofacial Surgery — Central Austin; specifically lists orthodontic space-creation extractions.

The American Association of Oral and Maxillofacial Surgeons notes that OMSs commonly perform extractions as part of orthodontic treatment. MyOMS

What I'd ask at the second opinion

Bring your panoramic X-ray, cephalometric X-ray, photographs, scan/impressions, and the written treatment plan from the first orthodontist. Then ask:

1. Which teeth are you recommending I extract, and exactly why?
2. What problem does the extraction solve—crowding, protrusion, bite, or something else?
3. What happens if we don't extract?
4. Are expansion, IPR, distalization, or other approaches realistic in my particular anatomy?
5. How will extraction affect my facial profile and lip position?
6. Can you show me on my X-rays/scan where the space is needed?
7. If you disagree with the first orthodontist, what specifically in the records leads you to a different conclusion?

I would not have the teeth extracted until you've had that second orthodontic opinion, unless there's a separate urgent dental reason for extraction.

If you tell me your age, which teeth they want to extract (e.g. upper first premolars #5 and #12), whether you're an adult/teen, and what the orthodontist said the reason was, I can also give you a more targeted second opinion about why that extraction plan might or might not make sense and which Austin specialist I'd prioritize.

• Austin Institute of Dental Medicine - 1401 Philomena St Ste 200, Austin, TX 78723, United States
• Sonrisas Orthodontics - 1217 W Slaughter Ln #100, Austin, TX 78748, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Eggleston Oral and Facial Surgery - 1209 W 5th St #100b, Austin, TX 78703, United States

If an orthodontist has recommended premolar extraction (or another tooth extraction) before braces, a second opinion is reasonable—especially because extractions can permanently change space, tooth position, and sometimes facial profile. I’d generally get the second opinion from an orthodontist who is comfortable treating extraction and non-extraction cases, and/or an oral & maxillofacial surgeon (OMS) if you want a separate opinion on the surgical part. Oral surgeons typically do the removal; they usually don’t decide whether the orthodontic plan needs extractions. MyOMS

In Austin, a few places I’d consider:

Orthodontic second opinion (whether extraction is truly needed)

• Austin Institute of Dental Medicine — A multi-specialty practice that includes orthodontic and oral surgery services, which can be useful if you want coordinated opinions.
• Sonrisas Orthodontics — Orthodontic-focused practice; useful for a bite/extraction-plan review.

Oral surgeon second opinion (if the extraction itself is the question)

• Central Texas Oral Surgery Associates — Oral & maxillofacial surgery practice in central Austin; handles extractions and coordinates with referring dentists/orthodontists.
• Widner Elite Oral Surgery & Dental Implants — Oral surgery practice with experience in surgical tooth removal and 3D imaging/planning.
• South Austin Oral Surgery — Focuses heavily on extractions and dentoalveolar surgery, including orthodontic-related extractions. South Austin Oral Surgery

Questions I would ask at the second opinion

Bring your X-rays/photos/orthodontic treatment plan and ask:

1. “What is the exact reason for extracting teeth?”

• crowding?
• overjet/overbite correction?
• bite stability?
• impacted teeth?
• avoiding jaw surgery?
• “What happens if we do not extract?”

• Can expansion, enamel reduction (IPR), distalization, or different mechanics work?
• What are the tradeoffs?
• “Which teeth would you remove and why those specifically?”
• “How will extraction affect my profile and lip support?”
• “Is this a case where two experienced orthodontists could reasonably disagree?”

A helpful detail: if these are wisdom teeth, the decision is usually different than if they are premolars for orthodontic space. Wisdom teeth are often handled by an oral surgeon and timing varies; premolar extractions are much more tied to the orthodontic diagnosis. Austin Oral Surgery

If you tell me:

• your age,
• which teeth they want removed (e.g., upper first premolars, wisdom teeth),
• whether this is for braces or Invisalign,
• and whether they mentioned “overbite,” “crowding,” “protrusion,” or “jaw surgery,”

I can help you judge what kind of second opinion would be most useful.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Dolman Oral Surgery - 16 E 52nd St #402, New York, NY 10022, United States
• Mid-Manhattan Oral Surgery, PC - 36 West 44th Street, Suite 600 Between, 5th and 6th Avenue, New York, NY 10036, United States
• Oral & Maxillofacial Surgery of New York City - 501 Madison Ave, New York, NY 10022, United States
• Fellow Orthodontist - 49 E 18th St, New York, NY 10003, United States
• Leading Edge Oral Surgery Midtown - 307 E 49th St, New York, NY 10017, United States
• Upper East Oral and Maxillofacial Surgery - 205 E 64th St #503, New York, NY 10065, United States
• Dr. Harrison L. Chen - 30 E 60th St #1401, New York, NY 10022, United States
• Gramercy Orthodontics - 200 E 15th St Ste PRB, New York, NY 10003, United States
• All County Oral & Maxillofacial Surgery - Wall Street - 42 Broadway #1501, New York, NY 10004, United States
• Park Avenue Oral Maxillofacial & Implant Surgery: James Choi, MD, DMD, FACS - 531 Park Ave, New York, NY 10065

Yes. For a recommendation to extract permanent teeth specifically to make room for braces, I’d get the second opinion from another orthodontist first—not an oral surgeon. The orthodontist is the person who can determine whether extraction is actually necessary and compare it with alternatives such as expansion, enamel reduction (IPR), or different tooth-movement mechanics. The oral surgeon is primarily the person who performs the extraction if you ultimately decide to proceed.

For Austin, these are the ones I’d put on your shortlist:

• Limestone Hills Orthodontics — Dr. Rodrigo Viecilli. This would be my first choice for an extraction second opinion. He is an ABO board-certified orthodontist with a PhD in orthodontic biomechanics, and the practice specifically advertises second-opinion consultations and says it will review another orthodontist's treatment plan and records. Limestone Hills Orthodontics Limestone Hills Orthodontics limestonehillsorthodontics.com
• Austin Orthodontics: Seth R Briggs DDS — Dr. Seth Briggs. Another reasonable option, particularly because the practice explicitly offers second opinions and Dr. Briggs is board certified. Austin Orthodontics Austin Orthodontics austinorthodontics.com
• Parmer Lane Orthodontics — Dr. Dip Desai. He is board certified by the American Board of Orthodontics and has substantial orthodontic experience. Parmer Lane Orthodontics American Association of Orthodontists parmerlaneortho.com
• Nantz Orthodontics — Dr. J.L. Nantz. Also board certified, and worth considering for another independent orthodontic opinion. Nantz Orthodontics nantzorthodontics.com

If you ultimately need the extraction

I'd use a board-certified oral and maxillofacial surgeon, particularly if these are permanent premolars rather than wisdom teeth. For example, Oral Surgery Specialists Of Austin specifically lists premolar extractions for orthodontic purposes among its services. South Austin Oral Surgery southaustinoralsurgery.net

One important thing: don't let the oral surgeon be the person who decides whether the teeth should be extracted for orthodontic reasons. Get the orthodontic diagnosis independently first.

At the second-opinion appointment, I'd ask:

1. Exactly which teeth are you recommending removing, and why?
2. What problem does each extraction solve—crowding, protrusion, bite correction, etc.?
3. What happens if we don't extract them?
4. Could expansion, IPR, distalization, or another approach work in my particular anatomy?
5. Can you show me on my X-rays/scan where the teeth will end up with and without extraction?
6. Is there any concern about the teeth being moved too far forward/backward or outside the supporting bone?
7. If you were treating your own child/yourself with this exact anatomy, would you extract? Why or why not?

If you tell me your age, which teeth they want to extract (e.g. upper first premolars #5 and #12), and what your orthodontist said the reason is, I can help you assess whether the recommendation sounds routine or whether it's particularly worth getting a second opinion.

1. Exactly which teeth are you recommending removing, and why?
2. What problem does each extraction solve—crowding, protrusion, bite correction, etc.?
3. What happens if we don't extract them?
4. Could expansion, IPR, distalization, or another approach work in my particular anatomy?
5. Can you show me on my X-rays/scan where the teeth will end up with and without extraction?
6. Is there any concern about the teeth being moved too far forward/backward or outside the supporting bone?
7. If you were treating your own child/yourself with this exact anatomy, would you extract? Why or why not?

If you tell me your age, which teeth they want to extract (e.g. upper first premolars #5 and #12), and what your orthodontist said the reason is, I can help you assess whether the recommendation sounds routine or whether it's particularly worth getting a second opinion.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Kunik Orthodontics Austin - 3423 Bee Caves Rd C202, West Lake Hills, TX 78746, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Midtown Oral and Maxillofacial Surgery - 901 W 38th St #410, Austin, TX 78705, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• Becher Orthodontics - 4464 Frontier Trail, Austin, TX 78745, United States
• Tomblyn Family Orthodontics - 4407 Bee Caves Rd Bldg 2, Unit 220, Austin, TX 78746, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Sonrisas Orthodontics - 1217 W Slaughter Ln #100, Austin, TX 78748, United States
• Rise + Smile Orthodontics - 6012 W William Cannon Dr Ste D103, Austin, TX 78749, United States
• Capital Springs Orthodontics - 2500 W William Cannon Dr STE 102, Austin, TX 78745, United States
• Ortho 360 Orthodontics - 1600 W 38th St #321, Austin, TX 78731, United States

Yes. If the extraction was recommended specifically to create space before braces, I’d get the second opinion from another orthodontist first—not an oral surgeon. The orthodontist is the person who can reassess whether the teeth actually need to be removed and whether there are reasonable alternatives.

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for this particular question. Dr. Rodrigo Viecilli is board-certified in orthodontics, has a PhD in orthodontic biomechanics, and the practice specifically accepts second-opinion cases. They say the purpose is to review the existing treatment plan and consider alternatives rather than simply sell treatment. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Kunik Orthodontics Austin — another strong option, particularly if you're in Westlake/Central Austin. Local Austin discussion has multiple recommendations for Dr. Kunik, including for second opinions. Reddit
• Arboretum & Westlake Orthodontics — worth considering if you're looking for another independent treatment plan; the practice handles more complex cases and coordinates with oral surgeons when needed.
• Parmer Lane Orthodontics — Dr. Dip Desai is board-certified by the American Board of Orthodontics, according to the AAO. American Association of Orthodontists

When I'd add an oral surgeon

If the orthodontist's recommendation involves surgically difficult teeth, impacted teeth, unusual roots, or a question about whether a particular tooth can/should be removed, then I'd get an oral surgeon's opinion too.

For example, Midtown Oral and Maxillofacial Surgery has multiple oral and maxillofacial surgeons, including board-certified surgeons, and specifically performs tooth extractions and surgical exposure of impacted teeth. Midtown Oral & Maxillofacial Surgery

One important thing

Don't have the teeth extracted until you're comfortable with the orthodontic plan. Extraction can be entirely appropriate in some orthodontic cases—particularly significant crowding, protrusion, or bite problems—but the key question is why these particular teeth, and what happens to the bite/profile if they're removed?

At the second-opinion appointment, I'd explicitly ask:

1. Why do I need extractions?
2. Which teeth would you remove, and why those teeth?
3. What happens if we don't extract?
4. Could expansion, IPR, distalization, or another approach work in my case?
5. How will extraction affect my facial profile and lip position?
6. Can you show me on my X-rays/scan exactly where the space is needed?
7. Would you recommend extraction if I were your family member?

If you tell me your age, which teeth they want to extract (e.g., 4 premolars / 2 upper premolars), and whether you have the orthodontist's X-ray or treatment plan, I can help you evaluate the recommendation and tell you which type of Austin specialist I'd seek for the second opinion.

Don't have the teeth extracted until you're comfortable with the orthodontic plan. Extraction can be entirely appropriate in some orthodontic cases—particularly significant crowding, protrusion, or bite problems—but the key question is why these particular teeth, and what happens to the bite/profile if they're removed?

At the second-opinion appointment, I'd explicitly ask:

1. Why do I need extractions?
2. Which teeth would you remove, and why those teeth?
3. What happens if we don't extract?
4. Could expansion, IPR, distalization, or another approach work in my case?
5. How will extraction affect my facial profile and lip position?
6. Can you show me on my X-rays/scan exactly where the space is needed?
7. Would you recommend extraction if I were your family member?

If you tell me your age, which teeth they want to extract (e.g., 4 premolars / 2 upper premolars), and whether you have the orthodontist's X-ray or treatment plan, I can help you evaluate the recommendation and tell you which type of Austin specialist I'd seek for the second opinion.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Kunik Orthodontics Austin - 3423 Bee Caves Rd C202, West Lake Hills, TX 78746, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Vincent Cavaretta, DDS - 3423 Bee Caves Rd, Bldg C, Ste 201, Austin, TX 78746
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Becher Orthodontics - 4464 Frontier Trail, Austin, TX 78745, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States

Yes. If the question is “Do I really need extractions before braces, and are there reasonable alternatives?”, I’d get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the person who should determine whether removing teeth is necessary for the overall bite and final tooth position; the oral surgeon is generally the person who performs the extraction once that plan is established.

My Austin shortlist

• Limestone Hills Orthodontics — This would be my first choice for a true second opinion. They specifically advertise second-opinion consultations and say they will review your existing treatment plan, X-rays/scans and explain whether the original plan is appropriate or whether another approach makes sense. Dr. Rodrigo Viecilli is board-certified and has a PhD in orthodontic biomechanics. Limestone Hills Orthodontics Limestone Hills Orthodontics

limestonehillsorthodontics.com

• Kunik Orthodontics Austin — Another strong option, particularly if you're an adult or have been told elsewhere that your case is difficult. Local Austin recommendations specifically mention Dr. Kunik for second opinions and complex cases. Reddit
• Austin Orthodontics: Seth R Briggs DDS — Dr. Seth Briggs is board-certified, and the practice explicitly offers second-opinion evaluations. Austin Orthodontics

If the second orthodontist agrees that extraction is necessary, then I'd get the extraction done by a board-certified oral and maxillofacial surgeon rather than choosing the surgeon independently. For example:

• Central Texas Oral Surgery Associates — central Austin, with board-certified oral surgeons and experience with extractions. Central Texas Oral Surgery Associates
• Vincent Cavaretta, DDS / Hill Country Oral Surgery — particularly relevant if the teeth are impacted or the extraction is more complicated; they also specifically coordinate surgical exposure of impacted teeth with orthodontists.
• Oral Surgery Specialists Of Austin — another full-scope oral/maxillofacial surgery practice in South Austin.

What I'd ask the second orthodontist

Don't just ask “Do I need extractions?” Ask:

1. Which teeth are you recommending removing, and exactly what problem does each extraction solve?
2. What happens to my facial profile/lip position if we extract vs. don't extract?
3. Could expansion, IPR (enamel reduction), distalization, or another approach accomplish the same goal?
4. Is the issue primarily dental crowding, or is there a jaw/skeletal discrepancy?
5. Can you show me on my X-rays/scan where the teeth would end up with and without extraction?
6. If we don't extract, what compromise would you expect?
7. Are you recommending extraction because it's necessary for a stable bite, or primarily because it's the easiest way to create space?

And don't have the teeth removed until you're comfortable with the orthodontic plan. Once a healthy permanent tooth is extracted, you can't undo that decision.

If you tell me your age, which teeth they want to extract (e.g. 4 premolars, two upper premolars, etc.), why they said you need them out, and whether you've already had X-rays/CBCT, I can give you a much more specific second opinion on whether the recommendation sounds routine or worth questioning.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Kunik Orthodontics Austin - 11821 Rock Rose Ave Ste 140, Austin, TX 78758, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• RJ Orthodontics - Orthodontist in Austin, TX - 6911 N FM 620 Suite A-200, Austin, TX 78730, United States
• Vincent Cavaretta, DDS - 3423 Bee Caves Rd, Bldg C, Ste 201, Austin, TX 78746
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Eggleston Oral and Facial Surgery - 1209 W 5th St #100b, Austin, TX 78703, United States
• Becher Orthodontics - 4464 Frontier Trail, Austin, TX 78745, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Rise + Smile Orthodontics - 6012 W William Cannon Dr Ste D103, Austin, TX 78749, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• Ortho 360 Orthodontics - 1600 W 38th St #321, Austin, TX 78731, United States
• Pure Smiles Orthodontics - 4301 W William Cannon Dr Ste E-300, Austin, TX 78749, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States

Yes. If the extraction is being recommended specifically to create space for braces, I’d get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The orthodontist can determine whether extraction is actually necessary and what alternatives exist; the oral surgeon is the right specialist to perform the extraction if you ultimately decide to do it.

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for this particular second opinion. Dr. Rodrigo Viecilli is a board-certified orthodontist with extensive orthodontic/biomechanics training, and the practice explicitly accepts second-opinion cases. Their consultation approach includes reviewing the existing treatment plan and records and considering alternatives before committing to treatment. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Kunik Orthodontics Austin — another strong option, particularly if you're looking for an orthodontist known locally for detailed treatment planning. Austin-area recommendations specifically mention Dr. Kunik for difficult/complex orthodontic cases and concurrent treatment needs. Reddit
• Austin Orthodontics: Seth R Briggs DDS — established North Austin option that specifically advertises second opinions and has a board-certified orthodontist. Austin Orthodontics
• RJ Orthodontics - Orthodontist in Austin, TX — worth considering if you're in the Four Points/Steiner Ranch area, particularly if the question involves bite/jaw relationships rather than just crowded teeth.

If you also want an independent oral-surgery opinion

If the orthodontist confirms that extraction makes sense, I'd consider:

• Vincent Cavaretta, DDS / Hill Country Oral Surgery — board-certified oral and maxillofacial surgeon; the practice specifically handles extractions and orthodontically related procedures such as impacted-canine exposure. Zocdoc
• Central Texas Oral Surgery Associates — central Austin option for simple through complex extractions and coordination with orthodontists. Central Texas Oral Surgery Associates
• East Austin Oral Surgery — another option, particularly if you want a surgeon who emphasizes discussing alternatives and the surgical/anesthesia plan before proceeding. East Austin Oral Surgery

What I'd ask at the second-opinion appointment

Bring all your existing X-rays/scans, photos, and the written orthodontic treatment plan. Then ask:

1. Why exactly are the teeth being extracted? Is it crowding, protrusion, bite correction, or something else?
2. Which teeth, and why those particular teeth?
3. What happens if we don't extract them?
4. Are there realistic alternatives such as expansion, enamel reduction (IPR), distalization, or simply accepting a different tooth position?
5. What will the extraction change about facial profile/lip position and the final bite?
6. Can you show me on my X-rays/scans exactly where the space is needed and how it will be used?
7. If you were treating your own family member with this exact case, would you extract?

Most importantly, don't let the oral surgeon's willingness to extract become evidence that extraction is necessary. The key clinical question is whether the orthodontic treatment plan genuinely requires the space.

If you tell me your age, which teeth they want to extract (e.g. upper/lower first premolars), whether you have crowding/overbite/protruding teeth, and whether you're already in braces, I can help you figure out what kind of second opinion would be most useful and narrow this Austin list down to 2–3 doctors.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Capital Springs Orthodontics - 2500 W William Cannon Dr STE 102, Austin, TX 78745, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Harry P. Casmedes, III, MD, DDS - 901 W 38th St #410, Austin, TX 78705, United States
• Midtown Oral and Maxillofacial Surgery - 901 W 38th St #410, Austin, TX 78705, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Airway Health Austin - 500 E Ben White Blvd Ste D-400, Austin, TX 78704, United States
• Naples Oral + Facial Surgery - 1950 Round Rock Ave, Round Rock, TX 78681, United States
• RJ Orthodontics - Orthodontist in Austin, TX - 6911 N FM 620 Suite A-200, Austin, TX 78730, United States
• Round Rock Oral Surgery & Dental Implants - 7200 Wyoming Springs Dr #1000, Round Rock, TX 78681, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• The Airway Dentists - 5601 Brodie Ln, Ste 1325, Sunset Valley, TX 78745
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Bee Cave Orthodontics - 11412 Bee Caves Rd #300, Austin, TX 78738, United States
• Stephen B. Bookmyer, DDS, MD - 2100 Round Rock Ave #4010, Round Rock, TX 78681, United States

Yes. For a second opinion on whether teeth should be extracted before braces, I would see another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the specialist who can assess whether extraction is actually necessary for the overall bite, tooth position, facial profile, and stability. An oral surgeon is the right second opinion for whether/how the teeth can safely be removed once the orthodontic plan calls for it.

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for this particular question. Dr. Rodrigo Viecilli is a board-certified orthodontist with a PhD in orthodontic biomechanics. The practice explicitly offers second opinions and says it evaluates extraction mechanics against alternatives such as expansion when appropriate. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Capital Springs Orthodontics — a good independent second orthodontic opinion, particularly if you're in South Austin. They use 3D CBCT imaging for complex orthodontic planning.
• South Austin Oral Surgery — if the orthodontist confirms extraction is appropriate and you want an independent surgical opinion, this is a reasonable oral-surgery option for straightforward extractions.
• Harry P. Casmedes, III, MD, DDS / Midtown Oral and Maxillofacial Surgery — another strong option, particularly if the extraction is complicated or involves impacted teeth. The practice lists board-certified oral/maxillofacial surgeons and handles extractions as well as orthodontic exposure procedures. Midtown Oral & Maxillofacial Surgery
• Central Texas Oral Surgery Associates — centrally located and another option for an independent surgical evaluation; its surgeons perform simple through complex extractions. Central Texas Oral Surgery Associates

One important point: I wouldn't choose an oral surgeon simply because they're willing to extract the teeth. If you're questioning the necessity of extraction, you want the second orthodontist to independently review the original X-rays/CBCT, photos, bite, and treatment plan before anything is removed.

At the second-opinion appointment, I'd specifically ask:

1. Which teeth are being recommended for extraction, and exactly why?
2. What happens if we don't extract them?
3. Could the same result reasonably be achieved with expansion, IPR, distalization, or different orthodontic mechanics?
4. Will extraction change my facial profile/lip position?
5. Is there significant crowding, protrusion, or a skeletal discrepancy that actually makes extraction necessary?
6. Can you show me on the X-rays/scan where the space is needed and what the final tooth positions are expected to be?

If you tell me your age, which teeth they want to extract (e.g. four premolars), and what the orthodontist told you the reason was, I can help you assess whether the recommendation sounds routine or whether I'd be particularly inclined to get a second opinion.

• Kunik Orthodontics Austin - 3423 Bee Caves Rd C202, West Lake Hills, TX 78746, United States
• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Vincent Cavaretta, DDS - 3423 Bee Caves Rd, Bldg C, Ste 201, Austin, TX 78746
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Becher Orthodontics - 4464 Frontier Trail, Austin, TX 78745, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States

Yes. If the extraction is being recommended specifically to make room for braces, I would get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the person who can tell you whether removing healthy permanent teeth is actually necessary for the overall bite and facial result, and whether there are reasonable alternatives.

Austin orthodontists I’d put on your shortlist

• Kunik Orthodontics Austin — A long-established Austin practice with multiple locations. Local Austin discussion specifically mentions Dr. Kunik as a strong choice for second opinions and complex treatment planning. Reddit
• Limestone Hills Orthodontics — Probably my first call for your particular situation. Their site specifically discusses cases involving braces + extractions, and they offer second-opinion/transfer evaluations. Limestone Hills Orthodontics
• Austin Orthodontics: Seth R Briggs DDS — Dr. Briggs' practice explicitly offers second opinions and says the consultation includes examination, digital X-rays/images, and a customized treatment plan. Austin Orthodontics Austin Orthodontics
• Arboretum & Westlake Orthodontics — Another reasonable option, particularly if you're in North/West Austin; they handle more complex cases and coordination with oral surgeons.

If the extraction itself needs a second opinion

Once you've had an orthodontist independently confirm that extraction is appropriate, I'd consider:

• Central Texas Oral Surgery Associates — Board-certified oral/maxillofacial surgeons and specifically advertise consultations for patients seeking a second opinion. Central Texas Oral Surgery Associates
• Vincent Cavaretta, DDS / Hill Country Oral Surgery — Particularly relevant if the teeth are difficult/impacted or the extraction has surgical complexity.
• South Austin Oral Surgery — They explicitly list premolar extractions for orthodontic purposes among their services. South Austin Oral Surgery

One important thing

Before agreeing to extraction, I'd ask the second orthodontist:

“If these teeth weren't extracted, what would happen to my bite, tooth position, gum/bone health, and facial profile? What alternatives did you consider, and why are they inferior in my particular case?”

I'd also ask which exact teeth are being removed and whether the recommendation is primarily because of crowding, protrusion/“flaring,” bite correction, or something else.

If you tell me your age, which teeth they're recommending extracting (e.g. 4 premolars, upper 2 premolars, wisdom teeth, etc.), and whether you're in North/Central/South Austin, I can narrow this down to 2–3 specific doctors I'd choose for the second opinion, including who I'd see first.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Kunik Orthodontics Austin - 3423 Bee Caves Rd C202, West Lake Hills, TX 78746, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Arboretum & Westlake Orthodontics - 11410 Jollyville Rd Suite 2102, Austin, TX 78759, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Becher Orthodontics - 4464 Frontier Trail, Austin, TX 78745, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States

Yes. For a proposed extraction specifically to make room for braces, I would get the second opinion from another orthodontist first—not an oral surgeon. The orthodontist is the person who can tell you whether the teeth actually need to come out, whether there are reasonable alternatives, and how extraction would affect your bite and facial profile. An oral surgeon is the right second opinion after you've established that extraction is indicated and you want an independent opinion about the surgical removal itself.

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for this particular question. Dr. Rodrigo Viecilli is a board-certified orthodontist with a PhD in orthodontic biomechanics, and the practice explicitly offers second-opinion consultations. They also advertise 3D CBCT imaging and treatment planning, including evaluation of extraction versus other approaches. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Kunik Orthodontics Austin — another strong option, particularly if you're in West Austin. Local Austin recommendations specifically mention Dr. Kunik for difficult/complex cases and second opinions. Reddit
• Austin Orthodontics: Seth R Briggs DDS — North/Northwest Austin option; Dr. Briggs' office specifically offers second opinions and comprehensive imaging/examination. Austin Orthodontics Austin Orthodontics
• Arboretum & Westlake Orthodontics — another good choice if you're looking around the Arboretum/Westlake area, particularly for a second opinion involving more complicated orthodontics.

If the second orthodontist agrees that extraction is necessary, then I'd get the actual extraction done by an oral & maxillofacial surgeon rather than simply having a general dentist remove permanent premolars. For example, South Austin Oral Surgery specifically lists premolar extractions for orthodontic purposes among its services. South Austin Oral Surgery

One important thing I'd ask

Don't just ask, “Do I need extractions?” Take your X-rays/scan and ask the second orthodontist:

“If these teeth are removed, what specific orthodontic problem are we solving, and what are the realistic alternatives—expansion, IPR, distalization, or simply accepting some residual crowding?”

Also ask them to show you on your X-rays and side-profile measurements why extraction is necessary and what they expect to happen to your incisors, bite, and facial profile afterward.

If you tell me your age, which teeth they're recommending removing (e.g. four premolars, two upper premolars, wisdom teeth), and whether you're in North/Central/South Austin, I can narrow this down to 2–3 orthodontists I'd personally choose for the second opinion and explain why.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Tomblyn Family Orthodontics - 4407 Bee Caves Rd Bldg 2, Unit 220, Austin, TX 78746, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Kunik Orthodontics Austin - 3423 Bee Caves Rd C202, West Lake Hills, TX 78746, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States
• Niva Dental Specialists - 15141 Ronald Reagan Blvd Suite 516, Leander, TX 78641, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Ortho 360 Orthodontics - 1600 W 38th St #321, Austin, TX 78731, United States
• Wisdom Teeth Guys - 11416 N FM 620 Ste. K-1, Austin, TX 78726, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Rise + Smile Orthodontics - 6012 W William Cannon Dr Ste D103, Austin, TX 78749, United States

Yes — for a recommended extraction before braces, I’d get the second opinion from another orthodontist first, rather than starting with an oral surgeon. The orthodontist is the person who can determine whether removing teeth is actually necessary for the overall bite and treatment plan. If extraction is ultimately indicated, then an oral surgeon can handle the procedure.

My Austin shortlist

• Limestone Hills Orthodontics — my first choice for this particular second opinion. Dr. Rodrigo Viecilli is board-certified in orthodontics and has a PhD in orthodontic biomechanics. The practice specifically accepts second opinions and says it evaluates alternatives to extraction when appropriate. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Tomblyn Family Orthodontics — another good option, particularly if you're in West Austin. They explicitly offer second-opinion consultations and evaluate bite, jaw position and function rather than just tooth straightening. Tomblyn Family Orthodontics
• Austin Orthodontic Arts — established Central/North Austin option for an independent orthodontic assessment.
• Kunik Orthodontics Austin — worth considering if you're in West Lake Hills/West Austin and want another orthodontic opinion.

For the actual extraction, if it ends up being necessary, I'd consider Central Texas Oral Surgery Associates in Central Austin or Oral Surgery Specialists Of Austin in South Austin. Central Texas OMS specifically handles simple and complex extractions and coordinates with orthodontists. Central Texas Oral Surgery Associates

What I'd ask the second orthodontist

Don't just ask, “Do I need extractions?” Take your X-rays and proposed treatment plan and ask:

1. Which teeth are you recommending removing, and exactly why?
2. What problem does the extraction solve — crowding, overjet, protrusion, bite, or something else?
3. What happens if we don't extract?
4. Are expansion, IPR (enamel reduction), distalization, or other approaches realistic in my particular case?
5. Will extraction change my facial profile or lip support?
6. Can you show me on my X-rays/scan where the additional space is needed?
7. Do you agree with the first orthodontist's treatment sequence?

Most importantly, don't have the teeth removed until you've gotten the second orthodontic opinion. Once a tooth is extracted, you can't undo that decision.

If you tell me your age, which teeth they want to extract (e.g. upper 1st premolars), and whether the reason is crowding/overbite/protruding teeth, I can narrow this down to the 2–3 Austin orthodontists I'd choose specifically for your situation and tell you what I'd want the second opinion to address.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Tomblyn Family Orthodontics - 1814 W 35th St, Austin, TX 78703, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Eggleston Oral and Facial Surgery - 1209 W 5th St #100b, Austin, TX 78703, United States
• North Austin Oral Surgery - 12210 Pecan St, Austin, TX 78727, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• Austin Institute of Dental Medicine - 1401 Philomena St Ste 200, Austin, TX 78723, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States
• Wisdom Teeth Guys - 11416 N FM 620 Ste. K-1, Austin, TX 78726, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Oral Surgery Specialists of Buda - 119 Cimarron Park Loop Ste c, Buda, TX 78610, United States

If you’re getting a recommendation to have teeth removed before braces, I’d get a second opinion from another orthodontist first (to confirm whether the extraction is actually needed), and then an oral surgeon if extraction is confirmed. The key question is usually: “Is the extraction creating necessary space for a stable bite, or is there another reasonable way to achieve the same result?” Limestone Hills Orthodontics AAOMS Oral and Maxillofacial Surgeons

In Austin, I’d consider these options:

Orthodontic second opinions

• Limestone Hills Orthodontics — Worth considering if you want a detailed treatment-planning review. They specifically offer second-opinion consultations and review outside records/X-rays and treatment plans. Limestone Hills Orthodontics
• Austin Orthodontics: Seth R Briggs DDS — Another established orthodontic practice that advertises second-opinion evaluations. Austin Orthodontics
• Tomblyn Family Orthodontics — Offers orthodontic consultations and second opinions, including for braces/Invisalign planning. Tomblyn Family Orthodontics

Oral surgeons (if extractions are recommended)

For orthodontic extractions, you generally want a board-certified oral and maxillofacial surgeon who regularly handles premolar extractions, impacted teeth, and coordination with orthodontists. AAOMS Oral and Maxillofacial Surgeons Some Austin-area options:

• Central Texas Oral Surgery Associates — Handles surgical dental procedures including extractions and orthodontic-related coordination.
• Oral Surgery Specialists Of Austin — South Austin oral surgery practice focused on surgical tooth removal and related procedures.
• Eggleston Oral and Facial Surgery — Central Austin oral surgery practice offering surgical extractions and other oral surgery services.
• North Austin Oral Surgery — Another option for oral surgery consultations and extractions.

Questions I would ask the orthodontist before agreeing to extraction

Bring your X-rays/photos and ask:

1. Which teeth are you recommending removing, and why those teeth?
2. Is the goal to fix crowding, overjet, bite relationship, or jaw discrepancy?
3. What happens if we don’t extract?
4. What alternatives were considered (expansion, enamel reduction/IPR, moving teeth differently, waiting)?
5. Can you show me on the X-ray how the extraction improves the final bite?
6. Have you treated similar cases without extractions, and what determines the choice?

If you tell me:

• your age,
• which teeth they want removed (e.g., upper first premolars, wisdom teeth, etc.),
• whether this is for crowding, overbite/overjet, or jaw alignment,
• and which Austin orthodontist recommended it,

I can help you judge whether a second orthodontic opinion vs. an oral surgeon consult is the better next step.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Lone Star Pediatric Dental & Braces - Oral Surgery Central Austin - 1015 W 34th St, Austin, TX 78705, United States
• Tomblyn Family Orthodontics - 4407 Bee Caves Rd Bldg 2, Unit 220, Austin, TX 78746, United States
• Kunik Orthodontics Austin - 3423 Bee Caves Rd C202, West Lake Hills, TX 78746, United States
• Luv Braces - 1700 W Parmer Ln Ste 250, Austin, TX 78727, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Sonrisas Dental Center - 505 W Louis Henna Blvd Suite 110 A, Austin, TX 78728, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Dr. Craig Taylor - 1015 W 34th St, Austin, TX 78705, United States

Yes. If the question is “Do I really need teeth extracted before braces?”, I would get the second opinion from another orthodontist first, not just another oral surgeon. The orthodontist decides whether extraction is necessary as part of the overall bite/space plan; the oral surgeon is the specialist who performs the extraction if you ultimately need it.

My Austin shortlist

• Limestone Hills Orthodontics — Dr. Rodrigo Viecilli

This would be my first choice for the second opinion, particularly if the proposed extractions are premolars. Dr. Viecilli is board-certified in orthodontics, has a PhD in orthodontic biomechanics, and the practice specifically advertises second-opinion consultations and 3D imaging. They also state that they evaluate alternatives such as expansion, MARPE and selective extraction mechanics rather than automatically assuming extraction is necessary. limestonehillsorthodontics.com limestonehillsorthodontics.com limestonehillsorthodontics.com

• Austin Orthodontics: Seth R Briggs DDS — Dr. Seth Briggs

Another reasonable independent orthodontic opinion. Dr. Briggs is board-certified, and the practice explicitly offers second opinions. Austin Orthodontics

• Parmer Lane Orthodontics — Dr. Dip Desai

A third option if you're in North Austin. Dr. Desai is board-certified and treats both adults and children. parmerlaneortho.com

If the extraction itself is recommended

Once you've established that extraction actually makes sense, I'd consider a board-certified oral surgeon such as:

• Central Texas Oral Surgery Associates — Central Austin; their surgeons are board-certified and the practice handles extractions and complex oral surgery. Central Texas Oral Surgery Associates
• East Austin Oral Surgery — Dr. Matthew Largent — board-certified, dual DDS/MD oral and maxillofacial surgeon. eastaustinoralsurgery.com
• South Austin Oral Surgery — specifically lists premolar extractions for orthodontic purposes among its services. South Austin Oral Surgery

I would not have the teeth removed until the second orthodontist has reviewed the actual treatment records.

For the second opinion, bring your panoramic X-ray, cephalometric X-ray, photographs, intraoral scan/models, and the original orthodontist's written treatment plan. Ask:

1. Which teeth are you recommending extracting, and exactly what problem does each extraction solve?
2. What happens if I don't extract them?
3. Could expansion, IPR, distalization, or another approach accomplish the same goal?
4. Are my front teeth currently protrusive/flared, and what will their final position be with vs. without extraction?
5. Can you show me the predicted final tooth positions on my X-rays/scans?
6. Are you recommending extraction because of crowding, bite correction, facial profile, or a combination?

If you tell me your age, which teeth they want to extract (e.g. four premolars), and whether the orthodontist said you have crowding, an overbite/overjet, or protruding teeth, I can narrow this down to the 2–3 Austin orthodontists I'd choose specifically for your situation.

• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Austin Orthodontic Arts - 5718 Balcones Dr, Austin, TX 78731, United States
• Ortho 360 Orthodontics - 1600 W 38th St #321, Austin, TX 78731, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Rise + Smile Orthodontics - 6012 W William Cannon Dr Ste D103, Austin, TX 78749, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Eggleston Oral and Facial Surgery - 1209 W 5th St #100b, Austin, TX 78703, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Austin Institute of Dental Medicine - 1401 Philomena St Ste 200, Austin, TX 78723, United States
• Lakeway Orthodontics - 1007 Ranch Rd 620 S #201, Lakeway, TX 78734, United States
• East Austin Oral Surgery - 2832 E Martin Luther King Jr Blvd Suite 102, Austin, TX 78702, United States
• RJ Orthodontics - Orthodontist in Austin, TX - 6911 N FM 620 Suite A-200, Austin, TX 78730, United States
• Oral Surgery Specialists of Buda - 119 Cimarron Park Loop Ste c, Buda, TX 78610, United States

If you’re being told you need tooth extractions before braces, I’d get a second opinion from another orthodontist first, and if the extraction plan involves anything beyond routine premolar removal (impacted teeth, jaw issues, surgical concerns), also get an oral surgeon’s opinion. The key question is why the teeth are being removed and whether there are reasonable alternatives (expansion, enamel reduction/IPR, different mechanics, delaying extraction, etc.). Extractions can be the right plan in some cases, but the diagnosis matters. Capital Family Orthodontics MyOMS

For Austin, these are the types of offices I’d consider:

Orthodontic second opinions (to reassess the whole braces plan)

• Austin Orthodontics: Seth R Briggs DDS — North Austin; a dedicated orthodontic practice that offers consultations and treatment planning. Austin Orthodontics
• Austin Orthodontic Arts — Central Austin orthodontic office for braces and aligner treatment.
• Ortho 360 Orthodontics — Central Austin orthodontic practice focused on bite and alignment correction.
• Nantz Orthodontics — South Austin orthodontic office.
• Rise + Smile Orthodontics — Southwest Austin orthodontic office.

A particularly relevant type of consult would be an orthodontist who will review your actual records (panoramic X-ray, cephalometric X-ray, photos, bite scan) and explain:

• Which teeth they want removed and why
• What problem the extraction solves (crowding, protrusion, bite correction, facial profile)
• What the non-extraction options are and their tradeoffs

Oral surgeons (if you want a surgical/extraction-focused opinion)

• Central Texas Oral Surgery Associates — Austin oral and maxillofacial surgery practice handling extractions and surgical dental procedures.
• Oral Surgery Specialists Of Austin — South Austin oral surgery practice.
• Widner Elite Oral Surgery & Dental Implants — Central Austin oral surgery practice.
• Eggleston Oral and Facial Surgery — Central Austin oral and maxillofacial surgery practice.

Questions I’d ask at the second opinion

1. “If these teeth are extracted, what exact measurement or diagnosis shows that it’s necessary?”
2. “Are you recommending extraction because of space, bite correction, or facial profile?”
3. “What would happen if we tried a non-extraction approach?”
4. “Can I see the before/after simulation or treatment objectives?”
5. “Would you personally extract these teeth in this case?”

If you tell me:

• your age,
• which teeth they want removed (e.g., upper premolars, wisdom teeth, etc.),
• whether this is for braces or Invisalign,
• whether you have crowding, overbite/overjet, or protruding front teeth,
• and which Austin orthodontist recommended it,

I can help you judge whether a second orthodontist vs. oral surgeon is the more useful next step.

Yes. If the recommendation is to extract healthy teeth specifically to create space before braces, I’d get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the person who can assess whether extraction is actually necessary and compare it with alternatives such as expansion, enamel reduction (IPR), or different tooth-movement mechanics.

My Austin shortlist

1. Best fit for an extraction second opinion: Limestone Hills Orthodontics
Dr. Rodrigo Viecilli is a board-certified orthodontist with a PhD in orthodontic biomechanics. His practice specifically says it welcomes second opinions and evaluates extraction cases, including whether non-extraction approaches are viable. They also use 3D CBCT imaging. limestonehillsorthodontics.com
Limestone Hills Orthodontics

2. Another strong orthodontic opinion: Austin Orthodontics: Seth R Briggs DDS
Dr. Seth Briggs is board-certified and the practice explicitly advertises second opinions. This would be a good independent comparison rather than simply asking the surgeon who was referred to perform the extraction. austinorthodontics.com
Austin Orthodontics

3. If the extraction itself needs a surgical opinion: Central Texas Oral Surgery Associates
They have board-certified oral and maxillofacial surgeons and specifically offer consultations for patients seeking a second opinion about surgical treatment. centraltexasoms.com
Central Texas Oral Surgery Associates

4. Another oral-surgery option: Oral Surgery Specialists Of Austin
They perform both routine and surgical extractions and are in South Austin. I'd use an oral surgeon primarily to answer "If these teeth really should come out, who should remove them and how?", rather than "Do I actually need them removed?"

What I'd do in your position

Before agreeing to extraction, get the second orthodontist the actual X-rays/CBCT, photographs, dental scan/models, and written treatment plan from the first orthodontist. Ask:

• Why exactly do these teeth need to be extracted?
• Which teeth, and how much space is needed?
• What happens to my facial profile/lip position if they're removed?
• Could expansion, IPR, distalization, or different mechanics accomplish the goal?
• What are the disadvantages of not extracting?
• Is the recommendation based primarily on crowding, bite correction, protrusion, or something else?
• Can you show me on my X-rays/scan where the problem is and what the extraction fixes?

One important point: extraction before braces isn't automatically a red flag. There are cases where removing premolars is the most predictable way to correct significant crowding or protrusion. The question is whether your particular anatomy and treatment objectives justify irreversible removal of healthy teeth.

If you tell me which teeth they want to extract (e.g., #5, #12, #21, #28), your age, whether you're an adult, and what the orthodontist said the reason was, I can give you a much more targeted second-opinion framework—and tell you whether I'd prioritize another orthodontist, an oral surgeon, or both.

Yes. If the question is “Do I really need teeth extracted before braces?”, I’d get the second opinion from another orthodontist first, not just an oral surgeon. The orthodontist is the specialist who can assess your bite, crowding, facial profile, tooth positions, and whether there are reasonable non-extraction alternatives. The oral surgeon is the right person to evaluate whether the actual extraction is appropriate/safely performed once the orthodontic plan is settled. The AAO specifically recommends seeing an orthodontic specialist for treatment planning. aaoinfo.org

Austin options I'd consider

• Dr. Seth Briggs / Austin Orthodontics — particularly worth considering because the practice explicitly offers second-opinion consultations. austinorthodontics.com
• Dr. Rodrigo Viecilli / Limestone Hills Orthodontics — listed by the ADA as an Austin orthodontic specialist. findadentist.ada.org
• Dr. Stephan Ramsay / Ramsay Orthodontics — another established Austin orthodontic specialist listed by the ADA. findadentist.ada.org
• Dr. Jonathon Kimes / Circle C Orthodontics — another Austin orthodontic specialist; independent patient-review sources also show a substantial history of positive reviews. findadentist.ada.org

For the actual extraction, I'd want an oral/maxillofacial surgeon rather than simply having the orthodontist pull the teeth. Austin Oral Surgery has multiple surgeons, including Andrea Quaroni, Najy Zarroug, Thomas Weil, Travis Kern, and Matthew Popp, and the ADA also lists Austin OMS specialists such as J. Steven Widner and Todd Eggleston. austinoralsurgery.com

AAO — Find an Orthodontist
AAOMS — Find an Oral Surgeon

Before you agree to extraction, I'd specifically ask the second orthodontist:

1. Exactly which teeth are being recommended for extraction, and why?
2. What problem does extraction solve in my particular bite?
3. What happens if we don't extract?
4. Are expansion, IPR, distalization, TADs, or simply accepting some residual crowding viable alternatives in my case?
5. Can you show me on my X-rays/photos where the extractions are necessary?
6. How will extraction change my facial profile and lip position?
7. If you were treating your own child/spouse with this exact case, would you extract? Why or why not?

One important point: extraction before braces isn't inherently a red flag. In some cases—particularly significant crowding, protrusion, or specific bite relationships—removing premolars can be the most appropriate treatment. The concern is whether your particular anatomy actually requires it, rather than whether extractions are “good” or “bad” in general.

If you tell me your age, which teeth they want to remove (e.g. four premolars), whether they're upper/lower, and why the first orthodontist recommended them, I can help you assess how strong the rationale sounds and narrow this down to 2–3 Austin orthodontists I'd choose for the second opinion.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• Kunik Orthodontics Austin - 3423 Bee Caves Rd C202, West Lake Hills, TX 78746, United States
• Hill Country Oral Surgery - 3423 Bee Caves Rd Bldg C, Suite 201, Austin, TX 78746, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• Capital Springs Orthodontics - 2500 W William Cannon Dr STE 102, Austin, TX 78745, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Dell Children's - Orthodontics North - 9010 N Lake Creek Pkwy #201, Austin, TX 78717, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Bee Cave Orthodontics - 11412 Bee Caves Rd #300, Austin, TX 78738, United States
• Wisdom Teeth Guys - 3724 Jefferson St Ste 100 - A, Austin, TX 78731, United States
• Buckman Orthodontics - 8500 Bluffstone Cove # A104, Austin, TX 78759, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Wisdom Teeth Guys - 11416 N FM 620 Ste. K-1, Austin, TX 78726, United States
• Bala Smiles Orthodontics - 3421 W William Cannon Dr #143, Austin, TX 78745, United States

Yes. If the recommendation is to extract permanent teeth specifically to make room for braces, I’d get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The orthodontist is the person who should determine whether extraction is actually necessary and what alternatives would accomplish the same treatment goal.

My Austin shortlist

• Limestone Hills Orthodontics — Dr. Rodrigo Viecilli, DDS, PhD. This would be my first choice for a true extraction second opinion. He is board-certified in orthodontics, has a PhD in orthodontic biomechanics, and specifically says his consultations evaluate alternatives such as expansion, selective extraction mechanics, and surgical approaches. The practice offers 3D CBCT imaging and explicitly welcomes second opinions. Limestone Hills Orthodontics Limestone Hills Orthodontics
• Ramsay Orthodontics — another option I'd consider if you want a second independent orthodontic opinion, particularly for a more complicated adult case. The local listing specifically notes experience with complex treatment planning and second opinions.
• Kunik Orthodontics Austin — worth considering if you're in West Austin. Local Austin recommendations specifically mention Dr. Kunik for difficult cases and second opinions. Reddit

When I'd add an oral surgeon

If the orthodontist confirms that extraction really is appropriate, then I'd have the oral surgeon evaluate the actual extraction, especially if the teeth are impacted, close to nerves/sinuses, or you're concerned about sedation.

For that, I'd consider Hill Country Oral Surgery in Westlake or Oral Surgery Specialists Of Austin in South Austin. Another established option is LoneStar Oral & Maxillofacial Surgery in Central Austin. An oral surgeon's role is different: they can tell you whether the teeth can/should be removed safely, but they generally aren't the person I'd use to decide whether your overall orthodontic plan needs those teeth removed.

What I'd ask at the second-opinion appointment

Take the original orthodontist's X-rays/CBCT, photos, treatment plan, and written extraction recommendation. Then ask:

1. “Do you agree that these specific teeth need to be extracted?”
2. “What problem are the extractions solving—crowding, protrusion, bite, jaw relationship, or something else?”
3. “What are the realistic alternatives?” Ask specifically about expansion, IPR (enamel reduction), distalization, or different orthodontic mechanics where applicable.
4. “What happens to my facial profile if we extract versus don't extract?”
5. “Can you show me on my X-rays exactly where the space is needed and why?”
6. “If we don't extract, what compromises or risks would there be?”

I would not have permanent teeth extracted until you've had that second orthodontic opinion, unless there's an urgent dental reason for removal.

If you tell me your age, which teeth they want to extract (e.g. upper/lower first premolars), and whether you're already in braces or haven't started yet, I can narrow this down to the 2–3 Austin orthodontists I'd choose for your particular situation and explain what I'd want them to evaluate.

• Limestone Hills Orthodontics - 7300 Ranch to Market Rd 2222 Bldg 5, Suite 217, Austin, TX 78730, United States
• Ramsay Orthodontics - 6850 Austin Center Blvd #220, Austin, TX 78731, United States
• Austin Orthodontics: Seth R Briggs DDS - 11743 Jollyville Rd, Austin, TX 78759, United States
• Central Texas Oral Surgery Associates - 3200 Red River St suite 400, Austin, TX 78705, United States
• Oral Surgery Specialists Of Austin - 5301 Davis Ln #102, Austin, TX 78749, United States
• LoneStar Oral & Maxillofacial Surgery - 4306 Medical Pkwy #2, Austin, TX 78756, United States
• South Austin Oral Surgery - 706B W Ben White Blvd Ste 194, Austin, TX 78704, United States
• Austin Institute of Dental Medicine - 1401 Philomena St Ste 200, Austin, TX 78723, United States
• Pediatric Dental Professionals - 9015 Mountain Ridge Dr #320, Austin, TX 78759, United States
• Becher Orthodontics - 4464 Frontier Trail, Austin, TX 78745, United States
• Sonrisas Orthodontics - 1217 W Slaughter Ln #100, Austin, TX 78748, United States
• Widner Elite Oral Surgery & Dental Implants - 1500 W 38th St #51, Austin, TX 78731, United States
• Parmer Lane Orthodontics - 2121 W Parmer Ln #111, Austin, TX 78727, United States
• Capital Family Orthodontics - 9015 Mountain Ridge Dr Ste 320b, Austin, TX 78759, United States
• Nantz Orthodontics - 3901 S Lamar Blvd Suite 420 Fourth Floor, Austin, TX 78704, United States
• Capital Springs Orthodontics - 2500 W William Cannon Dr STE 102, Austin, TX 78745, United States

Yes. For a second opinion on whether orthodontic extractions are actually necessary before braces, I’d see another orthodontist first—not just an oral surgeon. The orthodontist is the person who can reassess the overall treatment plan: crowding, bite, tooth inclination, facial profile, and whether alternatives such as expansion, IPR, or different mechanics could accomplish the goal. An oral surgeon is especially useful if you want an independent opinion on the surgical necessity/risks of the actual extraction. AAOMS specifically recognizes independent OMS second opinions and notes that OMSs commonly perform extractions as part of orthodontic treatment. AAOMS Oral and Maxillofacial Surgeons AAOMS

Austin options I'd consider

1. Limestone Hills Orthodontics — Dr. Rodrigo Viecilli

• Northwest Austin, 7300 Ranch Rd 2222.
• Board-certified orthodontist with a particularly diagnostic/biomechanics-oriented approach.
• Their practice describes handling complex cases and coordinating surgical orthodontics.
• This would be my first call for an orthodontic second opinion, particularly if you're questioning the rationale for removing healthy premolars. Limestone Hills Orthodontics

2. Ramsay Orthodontics

• North Austin.
• Specifically has experience with complex treatment planning and surgical orthodontics.
• The business listing includes a patient who sought Dr. Ramsay specifically for a second opinion involving major orthodontic/surgical planning.

3. Austin Orthodontics: Seth R Briggs DDS

• North Austin/Jollyville.
• Dr. Seth Briggs is board-certified, and the practice handles complex orthodontic cases and coordinates with oral surgeons when needed.

If you want the extraction itself independently evaluated

I'd look at:

Central Texas Oral Surgery Associates — Central Austin, 3200 Red River St.
They have board-certified oral and maxillofacial surgeons and specifically perform orthodontic extractions and other dentoalveolar surgery. Their website also explicitly says they welcome surgical second opinions. Central Texas Oral Surgery Associates

Oral Surgery Specialists Of Austin — South Austin.
Another reasonable OMS option for an independent surgical assessment.

LoneStar Oral & Maxillofacial Surgery — Central Austin.
Another established OMS practice that handles routine and complex extractions.

What I'd actually do

If this were me, I'd pause before having any permanent teeth removed and get:

1. A second orthodontist consultation — ask: “If this were your patient, would you extract? Why? What are the realistic non-extraction alternatives, and what are their compromises?”
2. Bring your panoramic X-ray, cephalometric/lateral X-ray, photos, and proposed treatment plan from the first orthodontist.
3. If the second orthodontist also recommends extraction, then see an independent board-certified oral & maxillofacial surgeon to discuss the actual extraction and risks.

You can also verify an OMS through the aboms.org and an orthodontist through the aaoinfo.org.

If you tell me your age, which teeth they're recommending removing (e.g. upper/lower first premolars), how much crowding you have, and what your orthodontist said the extraction is supposed to accomplish, I can help you figure out whether the recommendation sounds routine vs. something particularly worth getting a second opinion on, and I can narrow this to 2–3 Austin doctors I'd prioritize.

If this were me, I'd pause before having any permanent teeth removed and get:

For a second opinion on a recommended tooth extraction before braces, the right choice depends on why extraction was recommended:

• Orthodontist: best for evaluating whether extraction is actually necessary for the braces treatment plan, and whether there are non-extraction alternatives.
• Oral & maxillofacial surgeon: best if extraction is already considered necessary, especially for impacted, difficult, or surgical extractions.

I can help you identify well-regarded orthodontists and oral surgeons in Austin, but I need your location first because your current location sharing is off.

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If you share Austin (or your actual city), I can compare specific specialists, including credentials, reviews, specialties, and which I'd prioritize for a true second opinion.

Yes. If the recommendation is “extract teeth to make room before braces,” I’d actually get two opinions: one from an orthodontist who is comfortable treating extraction and non-extraction cases, and one from an oral surgeon only if the extraction itself is confirmed to be necessary.

For Austin, these would be my first calls:

My picks for the orthodontic second opinion

1. Limestone Hills Orthodontics — Dr. Rodrigo Viecilli
Northwest Austin. He is a Diplomate of the American Board of Orthodontics and specifically advertises second opinions. His practice also shows cases involving braces + extractions, and he says he will recommend against treatment or refer when another approach is more appropriate. limestonehillsorthodontics.com
Limestone Hills Orthodontics

2. Austin Orthodontics: Seth R Briggs DDS — Dr. Seth Briggs
North/Northwest Austin. He's board-certified, and the practice explicitly invites patients who have already seen another orthodontist to obtain a second opinion. austinorthodontics.com
Austin Orthodontics

3. Ramsay Orthodontics
Also worth considering, particularly if this is a more complicated adult bite/crowding case. Their business listing specifically notes patients seeking second opinions for complex treatment planning.

If you want an independent opinion on the actual extraction

I'd consider Widner Elite Oral Surgery & Dental Implants or Oral Surgery Specialists Of Austin. Both are oral/maxillofacial surgery practices; the latter specifically states that it welcomes surgical second opinions. centraltexasoms.com

The important distinction is: the oral surgeon can tell you whether the teeth are reasonable/appropriate to remove surgically, but the orthodontist should be the person deciding whether removing them is necessary for the orthodontic plan.

What I'd ask before agreeing to extraction

Take your existing X-rays/scans and treatment plan and ask the second orthodontist:

• Which teeth do you want to remove, and why those teeth?
• What happens if we don't extract them?
• Can you achieve the same functional/bite result without extraction?
• If you recommend extraction, how will the spaces be closed?
• Will extraction change my facial profile or lip support?
• Is the recommendation based primarily on crowding, bite correction, tooth protrusion, or something else?
• Can you show me the predicted result with vs. without extraction?
• Are there any teeth that are questionable enough that you would wait or monitor rather than remove them?

The AAO recommends an in-person orthodontic evaluation with comprehensive diagnostic records—including X-rays, examination of the bite/jaw relationship, photos, and digital scans/impressions—before treatment decisions. www.aaoinfo.org

If you tell me your age, which teeth they want to extract (e.g. “four premolars”), whether you're an adult, and why the first orthodontist says you need them out, I can help you assess whether getting a second opinion is especially warranted and narrow this to the best 2–3 Austin doctors.

For an extraction before braces, I’d get the second opinion from an orthodontist first (to confirm whether the extraction is truly needed and whether there are alternatives), and then an oral surgeon if the extraction itself is moving forward. The key question is usually not “can the tooth be removed?” but “is removing it the best orthodontic plan for my bite, facial profile, and long-term stability?”

In Austin, these are the types of specialists I’d consider:

Orthodontic second opinions (to question the extraction plan)

• Austin Orthodontics: Seth R Briggs DDS — a board-certified orthodontic practice in North Austin; a good option if you want another orthodontist to review your records and treatment rationale.
• Austin Orthodontic Arts — another Austin orthodontic practice for an independent braces/extraction-plan review.
• Nantz Orthodontics — South Austin orthodontic option for another treatment plan perspective.
• Limestone Hills Orthodontics — their consultations specifically discuss reviewing outside treatment plans and second opinions. limestonehillsorthodontics.com

Oral surgeons (if you want the extraction evaluated by a surgical specialist)

• Widner Elite Oral Surgery & Dental Implants — Austin oral surgery practice with a focus on surgical tooth removal and related procedures.
• Oral Surgery Specialists Of Austin — South Austin oral and maxillofacial surgery practice.
• LoneStar Oral & Maxillofacial Surgery — Central Austin oral surgery practice.
• Hill Country Oral Surgery — West Austin option.

Before agreeing to extraction, I’d ask the orthodontist:

1. Which teeth are being removed and why? (Often premolars, but the reason matters.)
2. What problem is the extraction solving? Crowding? Overjet? Bite correction? Protrusion?
3. What are the non-extraction alternatives? (Expansion, enamel reduction/IPR, distalization, growth modification, etc.—depending on the case.)
4. Can I see the cephalometric X-ray measurements and predicted outcome?
5. Will extraction change my facial profile or lip support?

If you tell me:

• your age,
• which teeth they want extracted (e.g., upper first premolars, wisdom teeth, etc.),
• whether you have crowding, an overbite/overjet, or protruding teeth,
• and whether this is for a child/teen or adult,

I can help you judge whether a second opinion is especially warranted and what kind of specialist to prioritize.

Yes — for a second opinion on whether teeth should be extracted before braces, I would see another orthodontist first, not just an oral surgeon.

The reason is that the key question is usually not “Can these teeth be extracted safely?” but “Do I actually need the extra space, and is extraction the best way to create it while preserving my bite, facial profile, and long-term stability?” Orthodontists are the specialists who plan tooth movement and bite correction. Oral surgeons generally perform the extraction once that orthodontic decision has been made. myoms.orgaaoinfo.org

My Austin short list

1. Limestone Hills Orthodontics — my first choice for this particular second opinion

They're in Northwest Austin and specifically advertise second-opinion consultations. Dr. Viecilli says the goal is clarity rather than conversion and that he is comfortable telling patients when another treatment plan is appropriate. limestonehillsorthodontics.com

Limestone Hills Orthodontics

2. Austin Orthodontics: Seth R Briggs DDS

Another reasonable independent opinion in North Austin. Their practice explicitly offers second opinions, and Dr. Seth Briggs is a board-certified orthodontist. austinorthodontics.com

Austin Orthodontics

3. Ramsay Orthodontics

I'd consider this one particularly if your case involves a significant bite issue, jaw discrepancy, or potentially complex treatment. Their patient reviews include adults who sought second opinions for complex orthodontic/surgical planning.

Then, if extraction still looks appropriate

I'd get the surgical opinion from a board-certified oral & maxillofacial surgeon, rather than having the extraction done before you've settled the orthodontic plan.

A good Austin option is Central Texas Oral Surgery Associates. Their surgeons include board-certified OMS Dr. Franklin Bonasso, and they specifically perform orthodontically relevant procedures such as extractions and expose-and-bond procedures. They also state that they welcome second opinions. centraltexasoms.com

Central Texas OMS

Another option is Hill Country Oral Surgery in the Westlake/Bee Cave area; the practice lists board-certified oral surgeons and specifically handles impacted teeth in coordination with orthodontic treatment.

What I'd ask the second orthodontist

Take your panoramic X-ray, cephalometric X-ray, photos, 3-D scan, and written treatment plan from the first orthodontist. Then ask:

• Exactly which teeth are you recommending extracting, and why?
• What problem does the extraction solve — crowding, overjet, protrusion, bite, or something else?
• What happens if we don't extract?
• Could expansion, IPR/enamel reduction, distalization, or another approach accomplish the same goal?
• Will avoiding extraction cause the front teeth to become excessively protrusive?
• How will extraction affect my facial profile and lip position?
• Is there a risk of the teeth being moved too far inward?
• Can you show me on my X-rays/scan where the teeth would finish with and without extraction?
• Is this a recommendation you would make if I were your family member?

And importantly, don't let anyone extract the teeth simply because “that's how we usually do braces.” Extraction can absolutely be the right treatment in some orthodontic cases, but the decision should be tied to the specific anatomy and treatment objectives. The AAO notes that orthodontists have specialized training in tooth movement, bite, and jaw relationships. myoms.orgaaoinfo.org

If you tell me your age, which teeth they want to extract (e.g. four premolars, wisdom teeth, etc.), what your orthodontist said the reason is, and whether you're in Austin proper/North Austin/Westlake/etc., I can narrow this down to 2–3 Austin orthodontists I'd choose specifically for your situation and tell you what I'd want the second opinion to address.

Yes — for a second opinion on whether an extraction is actually necessary before braces, I’d see a different orthodontist first, rather than going straight to an oral surgeon.

The reason is that the key question is usually not “Can these teeth be extracted safely?” but “Does this orthodontic treatment plan genuinely require extraction, and what are the reasonable alternatives?” Orthodontists are the specialists who determine tooth movement, space requirements, bite correction, and whether options such as expansion, IPR, or different mechanics could work. An oral surgeon is then the appropriate specialist if extraction is ultimately indicated. myoms.org

Austin options I'd put on the shortlist

• Dr. Kunik / Kunik Orthodontics — This would be one of my first calls for a true second opinion. Austin-area parents specifically describe Dr. Kunik as thorough and willing to tackle difficult cases, including cases where other orthodontists had recommended a particular approach. www.reddit.com
• Limestone Hills Orthodontics — Another reasonable second-opinion option; recent Austin discussion specifically mentions them for getting an independent treatment plan before committing to braces. www.reddit.com
• Pride Orthodontics — A recent patient specifically described going there for a second opinion and praised Dr. Romero's thorough assessment and clear communication. reviews.birdeye.com

I would not choose an orthodontist simply because they advertise “non-extraction orthodontics.” Extraction can absolutely be the right treatment in a crowded or protrusive case; the important thing is whether the diagnosis and treatment goals support it. www.reddit.com

What I'd ask at the consultation

Bring the original orthodontist's panoramic X-ray, cephalometric X-ray, photos, scans/models, and written treatment plan if you can get copies. Then ask:

1. “If this were your patient, would you extract the same teeth? Why?”
2. “What specifically is the extraction solving — crowding, protrusion, overjet, bite, or something else?”
3. “What happens if we don't extract?”
4. “Could expansion, IPR, distalization, or another approach accomplish the same goal?”
5. “Can you show me on my X-rays/measurements why extraction is or isn't appropriate?”
6. “What are the risks to the facial profile and bite with each option?”

If the second orthodontist independently reaches the same extraction recommendation and can explain the reason from your records, that's much more reassuring.

If you tell me your age, which teeth they want to extract (e.g. four premolars, two upper premolars, wisdom teeth), and whether this is for you or your child, I can narrow down what kind of second opinion you should seek and what questions matter most.

If you were told you need teeth extracted before braces, I’d get a second orthodontic opinion first (to confirm whether extraction is truly the best plan), and then use an oral surgeon for the actual extraction if it’s confirmed. Extractions can be a very reasonable part of orthodontic treatment in some cases, but the decision should be based on things like crowding, tooth position, bite, jaw relationship, facial profile, and X-rays—not just “making space.” www.capitalfamilyorthodontics.comaustinorthodontics.comlimestonehillsorthodontics.com

In Austin, I’d consider these options:

Second-opinion orthodontists

• Austin Orthodontics: Seth R Briggs DDS — A second orthodontic evaluation option in North Austin; they specifically offer orthodontic consultations and review of treatment plans. austinorthodontics.com
• Parmer Lane Orthodontics — North Austin orthodontic practice; another independent opinion can be useful if you want a comparison of extraction vs. non-extraction approaches.
• RJ Orthodontics - Orthodontist in Austin, TX — Northwest Austin option for another bite/treatment-plan review.
• Nantz Orthodontics — South Austin option for a separate orthodontic assessment.

A practice that specifically discusses second opinions and reviewing outside plans:

• Austin Orthodontic Arts — another Austin orthodontic office option. centraltexasoms.com
• Limestone Hills Orthodontics — their materials describe second-opinion consultations and reviewing existing records/treatment plans. limestonehillsorthodontics.com

Oral surgeons (if extraction is confirmed)

For premolars or complicated extractions before braces, I’d favor a board-certified oral & maxillofacial surgeon:

• Central Texas Oral Surgery Associates — Austin OMS practice handling extractions and coordinating with referring providers. centraltexasoms.com
• Oral Surgery Specialists Of Austin — South Austin oral surgery practice offering surgical and routine extractions.
• LoneStar Oral & Maxillofacial Surgery — Central Austin oral surgery option.
• Hill Country Oral Surgery — West Austin option for extractions and other oral surgery.

Before agreeing to extraction, I’d ask the orthodontist:

1. Which teeth are you removing and why those teeth? (e.g., first premolars?)
2. What problem does extraction solve? (crowding, overjet, bite correction, protrusion?)
3. What are the alternatives? (expansion, IPR, distalization, different mechanics)
4. Can you show me the X-ray measurements that support this plan?
5. Will extraction change my facial profile or lip support?

If you tell me:

• your age,
• which teeth they want removed (upper/lower, premolars vs wisdom teeth),
• whether you have crowding, an overbite/overjet, or “buck teeth,”
• and the orthodontist who recommended it,

I can help you judge whether a second opinion sounds especially important and which type of specialist is the best next stop.

A second opinion before premolar extraction for braces is a good idea, especially if the recommendation was based on crowding, bite correction, or concerns about facial profile. The key question is not just “can teeth be straightened?” but why extractions are needed and whether there are reasonable alternatives for your specific bite and jaw anatomy.

In Austin, I’d consider getting one more orthodontic opinion first (because the orthodontist is deciding whether the extraction fits the overall treatment plan), and then an oral surgeon consult if the extraction decision is still unclear or you want a surgical perspective.

Orthodontists I’d consider for an extraction second opinion

• Limestone Hills Orthodontics — Northwest Austin

Good option for a second opinion because they specifically advertise reviewing outside treatment plans and second opinions, and they use 3D imaging in consultations. limestonehillsorthodontics.com

• Austin Orthodontics: Seth R Briggs DDS — North Austin

Established orthodontic practice; they offer consultations that include exam and imaging review. austinorthodontics.com

• Kunik Orthodontics Austin — Westlake Hills / Austin area

Another established orthodontic office to compare treatment philosophies.

Oral surgeons to consider (if you want an extraction-focused opinion)

• Oral Surgery Specialists of Austin — South Austin

Oral and maxillofacial surgery practice that handles surgical extractions and complex cases.

• South Austin Oral Surgery — South/Central Austin

Focuses heavily on extractions and dentoalveolar surgery, including orthodontic-related premolar extractions. southaustinoralsurgery.net

• LoneStar Oral & Maxillofacial Surgery — Central Austin

Another established oral surgery option.

Questions I’d bring to the second opinion

Ask the orthodontist:

1. Which teeth are you recommending removing, and why those teeth?
2. Is the goal to fix crowding, overjet (“buck teeth”), bite, or jaw discrepancy?
3. What happens if we do not extract?
4. Could expansion, enamel reduction (IPR), distalization, or other mechanics work in my case?
5. Will extractions change my facial profile or lip support?
6. Can you show me my X-rays/cephalometric measurements that justify the plan?

If you tell me:

• your age,
• which teeth they want extracted (for example “two upper premolars”),
• whether you have crowding, overbite, underbite, or protruding teeth,
• and which Austin orthodontist recommended it,

I can help you judge whether the recommendation sounds typical and which type of second opinion would be most useful.

Yes. For a second opinion on whether teeth should be extracted specifically to make room for braces, I would see another orthodontist first, rather than an oral surgeon. The orthodontist is the person who can assess whether extraction is actually necessary for the bite, facial profile, crowding, and long-term stability. The AAO specifically recommends a second opinion from an orthodontist when there’s uncertainty about an orthodontic treatment plan. aaoinfo.org

Austin options I'd consider

• Limestone Hills Orthodontics — 7300 Ranch Rd 2222. This is particularly relevant because the practice explicitly offers second-opinion consultations and says it evaluates alternatives before recommending extraction. Their approach includes skeletal/bite analysis and CBCT when indicated. limestonehillsorthodontics.com
• Austin Orthodontics: Seth R Briggs DDS — 11743 Jollyville Rd. Another established orthodontic practice in North Austin and a reasonable independent opinion.
• Kunik Orthodontics Austin — 3423 Bee Caves Rd in Westlake. Worth considering if you're on the west side.

If the second orthodontist also recommends extraction, then I'd get the actual procedure done by an oral/maxillofacial surgeon rather than a general dentist. For example, Oral Surgery Specialists Of Austin or LoneStar Oral & Maxillofacial Surgery are Austin-area OMS practices.

One important distinction: if they're recommending extraction of premolars specifically to create orthodontic space, the key question is why those teeth need to come out. If they're recommending wisdom-tooth extraction, that's a somewhat different decision and an oral surgeon's opinion becomes more relevant.

Before the second appointment, bring your panoramic/cephalometric X-rays, photos, scans/impressions, and the written treatment plan. Ask the second orthodontist:

1. Do you agree these teeth need to be extracted?
2. What specific problem does extraction solve?
3. What are the realistic non-extraction alternatives?
4. How would each option affect my bite and facial profile?
5. If we don't extract, what are the downsides or risks?
6. Can you show me on my X-rays exactly why you recommend extraction?

If you tell me your age, which teeth they're recommending removing (e.g. four premolars, two upper premolars, wisdom teeth), and whether you're in North/South/Central/West Austin, I can narrow this down to 2–3 specific orthodontists and/or oral surgeons who make the most sense for your situation.

Yes. For a second opinion on whether teeth really need to be extracted before braces, I would see another orthodontist first—not an oral surgeon. The orthodontist is the specialist who can assess whether extraction is necessary for the bite, crowding, facial profile, and long-term stability. An oral surgeon is primarily the person who performs the extraction once that plan is established.

My Austin shortlist

1. Austin Orthodontic Arts — strong choice for an independent second opinion
They focus specifically on orthodontics and have multiple orthodontists, which can be useful for a genuinely different perspective.

2. Ramsay Orthodontics — particularly worth considering for a complicated case
The practice has experience with patients seeking second opinions involving complex treatment and surgical orthodontics.

3. Austin Orthodontics: Seth R Briggs DDS — another established option
Dr. Seth Briggs is board-certified, and the practice explicitly offers second opinions. austinorthodontics.com

4. Limestone Hills Orthodontics — my pick if you want a particularly detailed evaluation
Dr. Rodrigo Viecilli is board-certified by the American Board of Orthodontics and has a PhD in orthodontic biomechanics. The practice specifically advertises second-opinion consultations and uses 3D imaging in its evaluations. limestonehillsorthodontics.com

For the actual extraction, if the second orthodontist agrees that it's appropriate, I'd then use a board-certified oral & maxillofacial surgeon. For example, Oral Surgery Specialists Of Austin is in South Austin, while LoneStar Oral & Maxillofacial Surgery is centrally located. Both are oral-surgery practices; LoneStar's physicians include an American Board of Oral and Maxillofacial Surgery diplomate.

One important thing

If the recommendation is to remove healthy permanent premolars specifically to make room for braces, I would not have them extracted until you've gotten the second orthodontic opinion. Ask the second orthodontist:

• Exactly what problem are the extractions solving?
• Which teeth would be removed and why?
• What happens if we don't extract?
• Could expansion, IPR, distalization, or another approach work in my case?
• How will extraction affect my facial profile and lip position?
• Can you show me on my X-rays/3D scan why you think extraction is or isn't necessary?

If you tell me your age, which teeth they want to extract (e.g. upper first premolars), whether you have crowding/overbite/overjet, and what your orthodontist told you, I can help you assess whether the recommendation sounds routine or worth challenging—and narrow this down to the 2 Austin orthodontists I'd personally get opinions from.

Yes. If the question is “Do I really need teeth extracted before braces?”, I’d get the second opinion from another orthodontist first, not just an oral surgeon. The orthodontist is the specialist who determines whether extraction is necessary for the bite, crowding, facial profile, and long-term stability; the oral surgeon is the specialist who actually removes the teeth. The AAO specifically recommends seeing an orthodontist for orthodontic treatment and second opinions. aaoinfo.org

My Austin shortlist

1. Limestone Hills Orthodontics — my first choice for your situation

Dr. Rodrigo Viecilli is board-certified in orthodontics and has a PhD in orthodontic biomechanics. His practice specifically advertises second opinions, complex cases, 3D CBCT imaging, and evaluating alternatives such as expansion, MARPE, and selective extraction mechanics. That's particularly relevant when you're trying to determine whether extractions are genuinely necessary. limestonehillsorthodontics.com

Limestone Hills Orthodontics

2. Ramsay Orthodontics — another good independent orthodontic opinion

Their Austin practice treats adults and has experience with complex treatment planning. The local business information specifically includes an adult patient seeking a second opinion about jaw surgery who described Dr. Ramsay's assessment as thorough.

3. Austin Orthodontics: Seth R Briggs DDS — worth considering

Dr. Seth Briggs is a board-certified orthodontist, and his practice explicitly offers second-opinion consultations. austinorthodontics.com

If you want the extraction itself independently evaluated

I'd consider Central Texas Oral Surgery Associates or Hill Country Oral Surgery. Central Texas OMS explicitly says it welcomes second opinions on surgical recommendations and performs a clinical evaluation with imaging when indicated. centraltexasoms.com

Central Texas Oral Surgery Associates

But I'd do the orthodontic second opinion before consenting to extraction. Ideally, tell the new orthodontist: “My current orthodontist recommended extracting ___ teeth before braces. I haven't had them removed yet, and I want an independent assessment of whether extraction is necessary and what reasonable alternatives are.”

Bring your panoramic X-ray, cephalometric X-ray, CBCT if you have one, photos, treatment plan, and the exact teeth they've recommended removing.

If you tell me your age, which teeth they want to extract (e.g. four first premolars, upper premolars, wisdom teeth), and why they gave you for extracting them, I can also tell you what I'd specifically ask the second orthodontist and whether the recommendation sounds routine or worth scrutinizing.

Yes — for a recommended extraction before braces, I’d get the second opinion from another orthodontist first, rather than going straight to an oral surgeon. The key question is whether the teeth need to be removed as part of the orthodontic plan, not whether an oral surgeon can safely remove them.

My Austin short list

1. Best fit for a detailed orthodontic second opinion: Limestone Hills Orthodontics
Dr. Rodrigo Viecilli is a Diplomate of the American Board of Orthodontics and has a PhD in orthodontic biomechanics. The practice specifically accepts second-opinion cases and says it evaluates alternatives to extraction when appropriate. limestonehillsorthodontics.com
Limestone Hills Orthodontics

2. Another strong option: Ramsay Orthodontics
Dr. Stephan Ramsay is listed by the ADA as an orthodontic specialist, and the practice has experience with complex treatment planning and surgical-orthodontic cases. findadentist.ada.org

3. South Austin: Nantz Orthodontics
Dr. Johnny Nantz is board-certified by the American Board of Orthodontics and is listed in the AAO locator. aaoinfo.org

If you also want an oral surgeon's opinion

If the orthodontist confirms extraction is appropriate, then I'd have the actual extraction evaluated by an oral & maxillofacial surgeon. For example, Central Texas Oral Surgery Associates is in central Austin and specifically states that it welcomes surgical second opinions. aaoinfo.orgcentraltexasoms.com

Another option is Widner Elite Oral Surgery & Dental Implants, particularly if you're in central/north Austin.

What I'd ask the second orthodontist

Bring your panoramic X-ray, cephalometric X-ray/side-profile X-ray, photos, scans/models, and the original treatment plan. Ask:

• Which teeth are you recommending extracting, and exactly why?
• What problem does the extraction solve — crowding, overjet, protrusion, bite correction, etc.?
• What happens if we don't extract?
• Could expansion, IPR (enamel reduction), or different tooth movement accomplish the goal?
• Will extraction change my facial profile/lip support?
• How confident are you that extraction is necessary rather than simply one treatment option?
• Can you show me the measurements/X-rays that led to the recommendation?

If you tell me your age, which teeth they want to extract (e.g. four premolars), whether you're already in braces, and what the orthodontist said the reason is, I can help you assess whether the recommendation sounds routine or worth getting a particularly careful second opinion.