How important is it to have a missing tooth replaced, if it doesn’t show?

I have had full mouth dental porcelain veneers. The second tooth from the upper left hand corner had a fracture in the root and had to be pulled . How important is it to have an implant done and replacing the tooth in the back when you can not see it?
– Bertie from California

It would be a shame to not replace this tooth after all the money you have invested in your mouth, with your porcelain veneers which have hopefully given you a beautiful smile. Let me explain why this is important.

Have you ever wondered how all of your teeth seem to get into the right positions? Each tooth touches the teeth on either side with just the right amount of force to keep food from packing in those spaces. And then when you close your mouth, each tooth on your upper jaw meets each tooth on your lower jaw at exactly the same time, so they all fit and you can clench all your teeth together. The way your body accomplishes this is that there are drifting forces built into the positions of the teeth. When your teeth erupt, they keep going until they hit something, and then they stop. And then your back teeth have a tendency to drift forward until they hit something, which keeps the adjacent teeth touching each other.

If you have a missing tooth, that completely screws up the system. So what happens, if you’re missing an upper first molar (which is the second tooth from theĀ  back) is that the tooth behind it will tip into that space, and the lower first molar will drift up looking for its mate on the upper jaw. This has several bad effects. First of all, it throws your bite out of harmony, and this is one of the main causes of TMJ disorder. It can result in spasms of the jaw muscles and headache pain. Second, it affects the long-term health of these other teeth. When the lower tooth super-erupts, it comes out of the bone somewhat and now that tooth is weaker because it has much less bony support. And when teeth start to tip, they form food traps and create other difficulties in keeping the teeth clean. Additionally, this creates unnatural angled stresses on the teeth which leads to vertical bone loss, which also weakens the teeth.

The first molars are anchor teeth, and when one of them is allowed to stay missing, it will disrupt your entire bite on that side of the mouth. If a second molar is missing, it may only compromise the companion tooth on the opposite arch. The reason for that is that there is no tooth behind it to tip into the space.

But you don’t have to replace the missing tooth with a dental implant. A dental bridge would also work fine. And if that is too expensive for you, I would at least put in a removable clip-in tooth, such as a flipper or other type of removable partial denture.

Do dental implants cause your bone to erode?


I’ve heard that dental implants can cause bone erosion. I am 60 years old and have always been in pretty good dental health. But a few years ago, I had to have two teeth extracted. And now it seems like I have one tooth standing all by itself and there is space on each side and the gum looks like it is receding in the area around the lone tooth. Do you think I should get a dental bridge?

– Janice from Michigan


Dental implants actually prevent the erosion of bone or what is otherwise known as bone resorption. But you are correct that when you are missing teeth your body resorbs the minerals to be used elsewhere in the body which in turn causes bone loss. This process also contributes to the receding of your gumline that you mentioned and is not surprising after you have been missing teeth for a couple of years.

One of the great things about a dental implant is that when it is used to replace a tooth, the body senses the implant is there and will not dissolve away the bone. So implants actually prevent bone loss.

Although, based on what you have described it doesn’t necessarily mean that dental implants are your best option. There are many factors that will come into play like how much bone you actually have left in that area, the location of surrounding nerves, where your sinuses are, and other issues. It would be beneficial in your decision-making process to meet with an experienced implant dentist. He or she would be able to give you specific recommendations for your case. If the implant doesn’t sound like it will work well, a dental bridge should work just fine.

This post is sponsored by Cleveland implant dentist Hylan Dental Care.

Related links: facial collapse, dental implant vs. bridge

I only have three teeth left.

I only have three bottom teeth left in my mouth and I was wondering if a Snap-on Smile would work for me?

– Shannon in California


A Snap-on Smile is a temporary smile makeover that works well under certain circumstances. Unfortunately if all you have left is three teeth and if they happen to be in the front, then it will not work well for you. The Snap-on Smile may be used when an individual is missing several missing teeth but not if the majority of teeth are missing. The appliance would put too much stress on the few that were left.

Another option that is relatively similar in fee to a Snap-on Smile is a removable partial denture. There are types of partial dentures out there that can work if you are missing almost all of your teeth because it rests mainly on soft tissue. This means it won’t put any added stress on the remaining teeth.

The ideal solution for your case would likely be dental implants. They tend to be more expensive but are a permanent, natural-looking way to replace your missing teeth. There are affordable dental implants called mini implants that may be another option for you. Just be very careful when price shopping for dental implants. If a dentist cuts corners on the quality of implants, they could fail leaving you with a greater expense in the long run. Dentists vary in fees so they can be more affordable, just don’t go for cheap implants. Call around and be sure to check out the dentist’s credentials and experience in placing dental implants.

This post is sponsored by Cleveland implant dentist Hylan Dental Care.

Related link: dental implant failure