Why Replace a Lost Tooth?

Author:  Howard M. Steinberg, DMD, MDS
Filed under:  Missing Teeth   Tags:  , ,

Throughout the course of life, teeth are lost for many reasons including cavities, gum disease, cracked roots and accidents. Missing teeth compromise your eating habits, speech and appearance. The loss of a front tooth will negatively affect the appearance of your smile and your self confidence. Losing a tooth in the back of your mouth can lead to numerous problems affecting your ability to chew, your ability to properly clean your teeth and the health of your remaining teeth. Replacing a lost tooth will prevent further destruction and save your remaining teeth.

One Lost Tooth Causes a Chain Reaction

The loss of a single tooth starts a chain reaction. After a back molar tooth is lost, a series of destructive events occurs including the eruption of other teeth, decay, tilt, drift and gum pocket formation. Eventually, bone loss and periodontal disease will cause further destruction. If you fail to replace a lost back tooth, you could eventually lose all your teeth. This article explains how.

Losing Teeth = Two for One

Missing Tooth

The extraction of a lower back tooth has created a space. See Figure 1. The tooth directly above the lost tooth is now useless, because it no longer has a lower tooth to chew against. Losing one tooth can result in the loss of the use of two teeth. The missing lower back tooth is obviously useless, and the tooth directly above it has become useless. In terms of losing teeth, this is what I call “two for one.”

Tooth Eruption = Exposed Roots

Erupted Tooth

Back teeth have a lifetime tendency to erupt (move farther into the mouth). Only the presence of a tooth to chew against keeps a back tooth from erupting. This patient had a tooth extracted from space X. The tooth immediately above the missing tooth has over-erupted. See Figure 2. This eruption has caused some of its roots to be exposed. Exposed root decays much faster than the crown of a tooth.

Uneven Teeth = Trapped Food Debris

Trapped Food Between Teeth

The resulting unevenness among the upper back teeth has created areas between these teeth that trap food debris. See Figure 3. It is very difficult to keep spaces between uneven teeth clean, despite your best efforts at brushing and flossing. The accumulation of food debris and the resulting bacteria cause inflammation of the surrounding gum tissue. The inability to easily remove the trapped food debris accelerates tooth decay.

Tilt & Drift

Tooth Tilt & Drift

When teeth are lost, the remaining adjacent teeth have a tendency to tilt (lean over) into the space the missing tooth once occupied. They also have the potential to drift or move. Now that a tooth has been extracted from position X, a space is left. This allows lower molar #7 to tilt and drift forward. Lower #7 will tilt farther and farther over time. Upper molar #7 no longer makes proper contact with the adjacent, erupted molar #6 or with tilted lower molar #7. This has caused upper molar #7 to tilt and drift backward. See Figure 4.

Gum Pocket Formation

Gum Pocket Formation

A tooth tilted over will develop a gum pocket along its forward root, as shown in Figure 5. Gum pockets are narrow, abnormal spaces or clefts that develop between the gums and the tooth root. These pockets trap food debris and bacteria. A gum pocket is a problem, because you can almost never keep it clean. The debris and bacteria that collect in a gum pocket lead to ever-worsening inflammation of the gums and the bone adjacent to the gum pocket.

Tooth Destruction Spreads

Tooth Destruction Spreads

Lower molar #7 has drifted and tilted so far forward that upper molar #7 no longer bites on it. This allows upper molar #7 to over-erupt. The adjacent upper molar #6 has already erupted. Decay has begun on upper teeth #6 and #7, particularly on the exposed portions of their roots. See Figure 6. The advancing gum pocket along the forward root of lower molar #7 causes chronic gum inflammation and eventual bone loss. Gum pockets also begin to form around the exposed roots of upper teeth #6 and #7 causing inflammation.

Eventual Bone Loss & Periodontal Disease

Periodontal Disease

When an area of the gums is constantly inflamed, as happens in a gum pocket, the bone immediately adjacent to the gum pocket also becomes inflamed. Inflamed bone softens, and slowly begins to resorb (disappear). See Fig. 7. Chronic gum inflammation and the eventual loss of underlying bone are symptoms of advanced periodontal disease. When left untreated, this condition will negatively affect your facial appearance and damage your remaining teeth.

Replacing Lost Teeth

There are a number of treatment options for replacing lost teeth:

  • Dentures – These are removable prostheses also known as false teeth.
  • Bridges – These are a series of crowns fixed onto adjacent natural teeth.
  • Implants – These are metal posts placed in the jawbone. A single crown, a full denture or a bridge is permanently screwed (fixed) on top of dental implants.

The most appropriate treatment will depend on the number of teeth you are missing, where they are in your mouth and the condition of your remaining teeth. A qualified dentist or dental specialist can help you decide which option is best for you.


If missing teeth are not replaced, a chain of damaging events may occur. Over time, one missing tooth can lead to bone loss, periodontal disease and the eventual loss of remaining teeth. Replacing a lost tooth today will avoid grief and greater expense tomorrow.


  1. Thanks for this marvelous posting! I’m 65 and do have several missing teeth. I need to do something about it soon. I don’t like the idea of dentures, so I’ll probably opt for implants. I will be sure to bookmark your blog and will contact you at some point. I want to encourage you continue your great work.

    Comment by Dwain Baker — April 10, 2011 @ 8:37 pm

  2. What a write! Very informative also easy to understand. Looking for more such posts on teeth and oral hygiene.

    Comment by Electrician — April 19, 2011 @ 7:14 am

  3. This is very interesting, You are a skilled blogger. I have joined your RSS feed and look forward to seeking more of your excellent post. Also, I’ve shared your web site in my social networks!

    Comment by Maude Reimel — April 29, 2011 @ 12:29 am

  4. A lot of thanks for your effort on this post. My mom took an interest in researching this topic, and your blog was most helpful. Your explanation, along with the illustrations, is easy to understand. You’ve explained the consequences of not replacing lost teeth very well here. Thank you.

    Comment by Deidra Villari — April 30, 2011 @ 12:26 am

  5. Some genuinely interesting points you have written. Helped me a lot, just what I was looking for. D.

    Comment by D. — May 6, 2011 @ 6:43 pm

  6. This is really interesting. You’re a very skilled blogger. I’ve joined your RSS feed and look forward to seeking more of your wonderful posts. Also, I have shared your web site in my social networks!

    Comment by Suzy Gaznes — May 31, 2011 @ 8:53 am

  7. I’m glad that you shared this useful information. I’m more worried about the cost of dental care these days and will probably live with missing teeth till I find an affordable dentist. Thanks for sharing.

    Comment by Gregg508 — June 11, 2011 @ 3:24 am

  8. After my dentist told me I needed laser gum surgery, I went into a total panic. I have been struggling with periodontal issues for most of my adult life, and have always had some 5 and 6 mm depth pockets in my mouth that have been of concern, but one of them finally flared up to a 9mm pocket. My dentist gave me a referral to a periodontist, and I was about 2 days away from my appointment when I decided to Google gum surgery to find out more.

    Comment by Peridontal Patient — June 14, 2011 @ 5:04 am

  9. Apparently, not replacing a lost tooth can result in some real problems with otherwise healthy teeth. Now, I’m wondering if my gum disease was caused by a couple missing back teeth that I never bothered to replace.

    Comment by Berlynn — June 20, 2011 @ 6:28 pm

  10. Excellent blog. Witty and informative. Keep up the good posting!

    Comment by Smile Krafters — June 23, 2011 @ 11:01 pm

  11. Nice blog here! Also your site loads up fast! What web host are you using? Can I get your affiliate link to your host? I wish my site loaded up as quickly as yours lol

    Comment by Jennique Adams — July 1, 2011 @ 11:49 pm

  12. Thanks for this post on missing teeth. I couldn’t have said it better. This will help me with ideas for my blog. Thanks a lot!!!

    Comment by Bethesda Dentist — August 8, 2011 @ 7:17 pm

  13. Really great article with very interesting information. You might want to follow up to this topic!?!

    Comment by Classy Massy — August 14, 2011 @ 4:37 pm

  14. Tooth health is a subject concerning many people, and there are many ways to take care of your teeth and improve your smile.
    More at cosmetic dentistry services

    Comment by John Hill — August 24, 2011 @ 9:10 pm

  15. One of the things I enjoy best about this entry “Why Replace a Lost Tooth?” is how nicely you outlined the facts in easy to follow terms and illustrations. Many thanks for making this important topic so simple to understand.

    Comment by Zirkles 47 — September 8, 2011 @ 1:14 pm

  16. Oh! I should replace my lost tooth then. I am really blessed to have read your post. Thank you very much.

    Comment by Cheers Finn — September 18, 2011 @ 9:19 pm

  17. Why Replace a Lost Tooth? This is the best weblog I found about this topic. You positively put a spin on a dental condition that affects nearly all of us. Nice stuff…really nice!

    Comment by J. Rosher — October 1, 2011 @ 12:47 pm

  18. Thank you for this great information! I’m writing a thesis on periodontal disease and this article certainly helped. =)

    Comment by Jim — October 13, 2011 @ 2:52 am

  19. I’m impressed. Rarely do I come across a weblog written by a dental specialist. Not enough dentists are talking about the consequences of losing teeth. I have recently lost a back tooth and am having trouble chewing. I’m happy I stumbled across this.

    Comment by Taren Antila — October 16, 2011 @ 7:15 pm

  20. Very detailed. It make sense to have such information in the waiting room in a dental office.

    Comment by Mesa Dentist — December 11, 2011 @ 5:54 pm

  21. What a relief to find a dentist who knows what to write about. You’ve definitely described the consequences of losing teeth, and I look forward to reading more from you.

    Comment by Merilee — January 1, 2012 @ 7:04 pm

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