Missing Teeth



If you fail to replace an extracted back tooth with a false tooth, you could lose all of your teeth. The following information explains why?

Each tooth consists of two parts: the crown and the root(s). Only the crown is visible in the mouth. The roots are in the bone, under the gums. The gums are a protective type of skin that clings to the necks of the teeth and covers the bone holding the teeth. Molars are back teeth. They have two or three roots. Most other teeth have one root.


Recent extraction of a lower molar has created space X. Upper tooth 6 is now useless because it no longer has a tooth to chew against. Therefore, losing one tooth can result in the loss of the use of two. Losing two teeth can result in the loss of the use of four, and so on.


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 over-erupting. This patient had a tooth extracted from space X. Upper tooth 6 has over-erupted. The resulting unevenness among the upper back teeth has created areas between these teeth that trap debris. It is very difficult to keep spaces between uneven teeth clean, despite your best efforts at brushing and flossing. Unclean teeth usually cause inflammation of the surrounding gums. They decay more readily too.

Food debris trapped between uneven teeth-

Over-erupted Lower molar 7 is jamming food in between over-erupted upper 6 and 7 during eating (arrow). This pressure between upper 6 and 7 has caused upper 7 to move backward and separate slightly from upper 6. It has created a space between these teeth (arrow). Food can pack into this space with great force during chewing. This creates a serious inflammation of the gum. Note that over-eruption of upper 6 has caused some of its root to become exposed. Exposed root decays faster than the crown of a tooth, as we will see later.


Back teeth have a lifetime tendency to tilt (lean over) toward the front of the mouth. They also have the potential to drift (move) toward the front of the mouth. 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 as you chew on it.


A tooth tilted over will develop a gum pocket along its forward root, as shown here. 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, even with the best brushing and flossing. The debris and bacteria that collect in a pocket lead to ever worsening inflammation of the gums adjacent to the pocket.


When an area of the gums is constantly inflamed, as you see in this gum pocket, the bone immediately adjacent to it can become inflamed too. Inflamed bone softens, and slowly begins to disappear. This process of gum inflammation and loss of the bone holding a tooth is called periodontal disease.


Lower molar 7 has drifted and tilted so far forward that upper 7 no longer bites on it. This allows upper 7 to over-erupt too. Arrows show advancing gum pockets, gum inflammation, and bone loss. Decay has begun on upper teeth 6 and 7, particularly on the exposed portions of the roots of 6 and 7. Exposed roots are especially prone to decay. Deep decay has allowed bacteria enter and infect the pulps (""nerves"') A upper 6 and 7. These two teeth have abscessed (become seriously infected). They are so badly damaged by that they must be extracted. Because of inflammation from the gum pocket of lower 7, bone loss has spread around the front root of this tooth and extended to part of the back root too. This tooth has lost so much bone support that it is now loose and must be extracted.  Because all the molars on this side of the mouth have been removed, the upper and lower 5 have no support behind them and are forced backward by the action of chewing. Food jams between the separated teeth (arrows). Gum inflammation has begun. Gum pockets will follow, along with bone loss and decay. Eventually the 5 will have to be extracted. After the loss of the upper and lower 5, the destructive process can move farther forward. The front teeth will start to spread apart, gum pockets will form, and decay will begin. Now you may lose your front teeth too.


Failure to replace a single molar tooth may start a chain of events: over eruption, tilt, drift, gum pockets, decay, bone loss. Over the years this chain of events can lead to the loss of all of your teeth. Inserting a false tooth today will avoid grief and greater expense tomorrow.