Missing teeth – Should we replace them?
By Dr Oh Xue Ling BDS (Adelaide)
There are many reasons that can cause a tooth to be extracted, such as decay, gum disease, fractured tooth. After a tooth extraction, many are left with a question- what now? Most ask if they should replace the tooth that is gone; afterall, there are still other teeth in the mouth. What happens if nothing is done to replace these gaps?
Effects of missing teeth
- Daily function can be affected, such as speech and eating
Depending on where the gap is, some daily functions can be affected. For instance, if the gap is in the upper front teeth, certain sounds can become hard to pronounce. Missing teeth can also reduce the eating function of a person, particularly if multiple back teeth are missing on one side. Many patients who have lost teeth report having to make several dietary changes, such as avoiding tougher meats and certain vegetables. In the long term, this will affect the type and amount of nutrients that they are getting.
- Tilting of neighbouring teeth
Over time, if the missing teeth are not replaced, physiological movement of the neighbouring teeth will result in tilting of teeth. This makes it harder to replace the gap in the future as the space is being lost. Furthermore, teeth that are tilted are harder to clean and have an increased risk of getting decay.
- Overeruption of the opposing tooth
Without a corresponding tooth to bite on, the opposing tooth may grow longer. This poses a problem as the tooth will grow into the space of the missing tooth, making future replacement of the missing tooth difficult.

- Bone resorption
Overtime, as there is no longer any tooth to support the surrounding bone, bone around the area will be resorbed by the body. This presents as a concavity, shown in the picture below. If implants are considered to replace the tooth in the future, more work will be needed to build the bone back in order for implants to be able to be placed.

Ways to replace missing teeth or gaps
- Implants
Implants involve a minor surgery procedure to place a titanium replacement into your jaw bone, emulating your natural teeth. Of all the replacement options, implants impart the greatest chewing function, and do not require the anchorage of other teeth unlike a dental bridge. That being said, not everyone is suitable for implants as the success of treatment is largely dependent on the individual’s health.

- Dental bridges
A more permanent way of replacing missing teeth is by doing a dental bridge. It bridges the gap between at least 2 healthy teeth by joining false teeth to the neighbouring teeth. It also does not require removal for cleaning, unlike dentures. However, not all gaps are suitable for a dental bridge, and your dentist will advise you accordingly.

- Dentures
One of the more traditional ways to replace missing teeth is dentures. Dentures are replacement teeth that can be taken in and out to clean. They can serve as a good replacement if multiple teeth are missing and are the most affordable option.

Picture from https://unsplash.com/photos/Er3c9JVvUZM
Conclusion
For a healthy lifestyle and confident smile, it is advisable to replace missing teeth, particularly if they are impairing on function. A thorough consultation and examination with a dentist will be needed to decide on a suitable replacement option.