What happens if you don’t replace a missing tooth?

Losing a tooth may, at first, seem to be merely a cosmetic issue. If the gap isn’t visible and doesn’t cause any pain, it’s easy to put off seeing a dentist.

Over time, however, the absence of a tooth can affect the bone in that area, the position of neighbouring teeth and the way you chew. These changes do not occur in the same way in every case, but it is important to have the gap assessed even if it does not bother you.

Teeth work together. When one is missing, the others adapt to fill the gap.

Over time, several changes may occur:

• the bone around the missing tooth may shrink;
• neighbouring teeth may tilt or shift;
• the tooth on the opposite arch may change position;
• chewing may be transferred predominantly to the other side;
• the space may become more difficult to clean;
• the bite may change.

These effects do not necessarily occur, nor do they occur at the same rate in all patients. The outcome depends on the tooth that has been lost, its position, the time elapsed and the condition of the entire dentition.

“A gap is not always a stable situation. The neighbouring teeth may shift, and the bone in that area may gradually lose volume. That is why I recommend having a missing tooth assessed even if there is no pain.”

The tooth root transmits the pressure generated during chewing to the bone. After a tooth is lost, this stimulation ceases, and the bone in that area begins to remodel.

If bone volume decreases, replacing the tooth can become more complex. For example, if the dentist recommends a dental implant and there is insufficient bone support, bone regeneration may be necessary before the implant can be inserted.

Not every patient requires bone grafting. Bone volume and treatment options can only be determined through a consultation and imaging investigations.

In cases where bone loss is already significant, you can find out more about dental implant treatment for severe bone loss.

Yes. The teeth adjacent to the gap may gradually tilt or shift. The tooth on the opposite arch may also move as a result of losing the contact it previously had.

These changes may:

• reduce the space available for replacing the tooth;
• alter the way the two arches meet;
• encourage the build-up of food debris;
• make cleaning more difficult;
• increase the pressure on certain teeth.

The more advanced the changes are, the more stages the treatment plan may require.

The impact depends on the position and number of missing teeth. The absence of a single tooth can be temporarily compensated for by the rest of the teeth, which is why the change is not always noticed straight away.

You may find yourself:

• chew predominantly on the opposite side;
• avoid foods that are harder to chew;
• feel that your bite is no longer balanced;
• put excessive strain on your remaining teeth.

Molars play an important role in breaking down food. That is why even a single missing molar needs to be assessed, even if it isn’t visible when you smile.

The front teeth help with the pronunciation of certain sounds and with controlling airflow whilst speaking. Their absence can affect pronunciation or cause air to escape.

The effects are more noticeable in certain positions and when several teeth are missing. However, the ability to adapt varies from person to person.

A missing tooth can change the way a person smiles, speaks or behaves in certain situations.

Some people end up:

• avoid having their photograph taken;
• smile less;
• cover their mouth when they laugh;
• feel uncomfortable when eating in public;
• avoid certain professional or social interactions.

The impact varies from patient to patient. For some, the problem is mainly functional. For others, the effect on self-confidence and social life can be just as significant.

When several teeth are missing, the reduction in support provided by the teeth and bone can also affect the support of the lips or the appearance of the lower part of the face.

The cost of replacing a tooth does not depend solely on the treatment chosen. The condition of the area at the start of treatment also matters.

If the assessment is delayed:

• the bone may lose volume;
• neighbouring teeth may shift;
• the space available for restoration may decrease;
• your bite may change;
• additional treatment may become necessary.

This does not mean that every patient who delays treatment will require complex treatment. It means that the situation must be assessed before any changes that have occurred limit the available options.

“When we analyse the cost of treatment, we don’t just look at the price of the restoration that will replace the tooth. The changes that have occurred in the meantime – to the bone, the available space and the bite – also matter.”

Not every gap necessarily needs to be restored. The approach may differ in the case of a wisdom tooth, a gap closed by orthodontic treatment, or a situation where the dentist recommends monitoring.

The decision depends on:

• the missing tooth;
• the position and condition of the neighbouring teeth;
• the number of remaining teeth;
• the way you chew;
• bone volume;
• gum health;
• bite;
• overall health.

The consultation does not automatically lead to a recommendation for an implant. Its purpose is to identify any changes that may have occurred and to determine which options are suitable.

Depending on the clinical situation, options may include a dental implant, a dental bridge or a removable denture. In certain cases, orthodontic treatment or space maintenance may be considered.

Each option has its own indications and limitations. The choice is made following an assessment of the entire dentition, not just the site of the missing tooth.

You can find out more about the differences between dental implants and dentures separately. Information on the indications and stages of dental implant treatment is set out on the dedicated page.

The choice of a solution should not be based solely on the initial cost. The medical indication, the necessary procedures, the duration of treatment, maintenance requirements and the condition of the remaining teeth must all be taken into account.

It is advisable to book an appointment following the loss or extraction of a tooth, even if you are not in any pain.

Book an appointment, particularly if:

• you tend to chew mainly on one side;
• you notice that the neighbouring teeth have shifted position;
• food frequently gets stuck in the gap;
• you feel that your bite has changed;
• several teeth are missing;
• you have difficulty pronouncing words;
• your dentures are no longer secure.

Your dentist may recommend an X-ray or a CT scan to check the bone and surrounding structures.

An assessment can reveal whether there have been any changes to the bone, gums, neighbouring teeth or bite. Your dentist will explain the options best suited to your situation.

1. World Health Organisation. Global oral health status report: towards universal health coverage for oral health by 2030.
2. National Institute of Dental and Craniofacial Research. Tooth Loss.
3. Tooth Loss and Edentulism Are Associated with a Poorer Quality of Life: A Systematic Review and Meta-Analyses.