By Dr. Marco Benigni
Specialist Oral Surgeon

The consequences of leaving a gap caused by a missing tooth depends on the patient and the specific area of that patient’s mouth.

MISSING TEETH PROBLEMS

If the gap is left alone, there’s a lot that can change over time including the amount of jaw bone.

If the tooth is no longer in place, there’s no function on the bone so the bone is going to shrink.

There are two scenarios to consider.

Scenario 1. You want to wait and replace the tooth in the future.

If you want to eventually have implants but are not ready to commit right now…

… then that’s going to be a problem because there will be less bone.

So, instead of a potentially straightforward, basic, easy, fast dental implant treatment, you may now need a bone graft.

That would be more expensive, more uncomfortable treatment that would take longer.

So, for example, after the early procedures you may have to wait longer – perhaps several months longer – before the final crown can be placed.

WHAT HAPPENS IF YOU DON'T GET A TOOTH IMPLANT

Scenario 2. You have no plans to replace a tooth.

So what happens if you are happy to leave the gap as it is and say, “right, I don’t care if I lose a little bit of bone in that area because I don’t want an implant”.

Most likely this will still be a problem.

If one tooth is missing then the surrounding teeth will not stay in their original position. They will effectively try to close the gap.

So, by the time the gap gets narrower, there will be new spaces that open around the surrounding teeth. 

Those spaces can lead to more deposits in those areas because the gap is now bigger.

More food will get stuck, which means problems like gingivitis and gum disease. 

This in turn can lead to gum recession and bone loss with even more deposits. And on it goes.

At the same time, the teeth on the upper arch can move.

Missing molar tooth

So, for example, a lower molar should be in contact with an upper molar.  

If the lower molar is missing, the upper molar can also start to move down – or over erupt.

The spaces surrounding the upper molar can then also get bigger.

So, again, food gets stuck in there and it becomes more difficult to clean. 

Do I need to replace second molar?

So now there is the possibility of gum disease for the upper teeth as well as the lower teeth.

So if one tooth is missing it can mean problems for other teeth – if not the whole mouth.

And, obviously, the bigger the gap, the more problems.