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Every effort is made to save permanent teeth from being extracted nowadays, unlike in the past when extraction was often considered the first line of treatment. However, situations do arise where it is no longer possible to treat a tooth and it has to be removed.
Replacing a missing tooth can be expensive, particularly if the patient opts for an implant or a high-quality fixed prosthesis. However, the perils of having a tooth extracted and leaving a gap in the mouth are well documented.
What Happens When A Tooth Is Extracted
An uncomplicated extraction usually takes around a week to heal, after which the extraction site is covered with gingiva. Changes to the bony socket in which the tooth was lodged continue to take place for close to three months after the procedure, changes that will not cause any physical discomfort.
One of the most commonly extracted teeth is the first molar, since it erupts early into the oral cavity and is not aesthetically visible from outside. People will almost never opt for an extraction if it is one of the front teeth or at least never leave them unreplaced even if they do have to get it removed.
Taking the first molar as an example, here are the classical steps that occur because of an unreplaced tooth.
Movement Of The Surrounding Teeth
Every tooth in the oral cavity tries to find its counterpart through eruption. This means that the tooth opposite to an empty space will attempt to find its counterpart through continued eruption. This is actually referred to as supra-eruption and is very harmful to the tooth.
As a result of this supra-eruption, the roots become exposed to the oral cavity. Enamel, which is the hardest substance found in our body, does not cover the roots. It only extends up to the part visible in the mouth, that is, the crown.
Since the covering of the root is not designed to be subjected to the environment present in the oral cavity, it quickly gets destroyed and the tooth starts to become acutely sensitive as a result. This supra-erupted tooth also becomes weaker due to the fact that less and less of its roots are embedded in bone. It is extremely common for such teeth to become so weak and mobile that they are of no use in the oral cavity and have to be extracted as well.
Another problem that patients frequently face due to the presence of a supra-erupted tooth is chronic trauma to the gums on the opposite side of the arch. The tooth erupts so much that it actually reaches the other jaw and then cause ulcer formation, pain, swelling and bleeding to occur.
Once a tooth moves from its normal position in the jaw, the tight contact with adjacent teeth preventing food lodgment is lost, and so some amount of food will almost always get stuck in these areas. Expectedly, these areas are highly prone to the development of tooth decay.