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26 Feb, 2021
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Need A Tooth Replacement? – Ask Dr. Farooq Sorathia

Do I Need To Replace A Tooth That Was Extracted?

The short answer is… “it depends”. It depends on which teeth are extracted, whether they are the front teeth or the teeth at the back of the mouth, whether there are teeth adjacent to, or opposing the tooth that needs to be extracted. Routinely, wisdom teeth aren’t replaced with artificial teeth. The other remaining teeth can handle the chewing function. However, front teeth that are extracted either due to caries or trauma or bone loss, should be replaced. The front teeth are the first thing that anybody notices in a smile and a missing tooth that causes a gap in between the teeth, is very noticeable. These teeth should not only be replaced to give a nice and esthetic smile but it also helps in providing support for the lips. It also helps in the pronunciation of words. Teeth and their position have a vital role to play when it comes to word pronunciation.

Some may ask if ‘I lost a tooth at the back, do I need to replace it? Nobody can see the teeth at the back anyway!’ Once again, the short answer is, “it depends”. All teeth in the upper jaw or lower jaw are in contact with each other, and this is what keeps the teeth stable in a nice ‘U’ shaped arch. This side by side contact of the teeth provides support for the teeth so that they don’t move forwards or backwards when chewing forces are applied. They act as one unit. Now imagine, if one tooth was missing in an arch, then the forces generated during chewing would affect the tooth as an individual, and there would be no tooth nearby to provide support and this would translate to the tooth being pushed (over time) to a position where the forces acting on it is the least. This may be from a tooth moving into the space that the previous tooth occupied, or it could be that the tooth is pushed down from its normal height which may have complications with the underlying bone, or gums, or nerves.

The top and bottom teeth are naturally designed to mesh together to allow functions such as chewing. We have already talked about the effects of an adjacent tooth missing in the arch. However, the effects don’t only affect the single arch, but also affect the opposing arch. Assume we are missing a tooth on the top arch, and no teeth missing on the lower. Teeth get their support from adjacent teeth and opposing teeth. Teeth within an arch are in contact with one another, and the forces applied during chewing are transmitted through the whole arch. Now, when the tooth has an open space in the opposing arch, the adjacent teeth push the tooth towards the empty opposing space as this is the path of least resistance. This will result in the tooth being pushed upwards into the space previously occupied by a tooth. The forces exerted from the contacts on the adjacent teeth would extrude the tooth which then results in a change in the bite.

It is always important to discuss with your dentist the options of tooth replacement when a tooth is meant to be extracted. The dentist is best positioned to assess how your teeth work together, and also offer you options for tooth or teeth replacement.

 

Article Written by Dr. Farooq Sorathia (BDS – University of the Witwatersrand, Johannesburg)

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