The Consequences of a Missing Tooth

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Babies typically get their first teeth around six months of age and all 20 of their primary teeth by the age of three. Adults have 32 teeth,  or just 28 if they, as many do, have had their wisdom teeth removed.

Yet in the U.S. adults between the ages of 20 and 64 have an average of just 24.92 remaining teeth. The top causes of tooth loss? Decay and gum disease.

The loss of a single tooth can affect your overall health, facial aesthetic, and mouth function. And it can set off a domino effect of oral health complications. The loss of a tooth is truly the trigger to a series of unfortunate events. Here’s how.


To stay strong and healthy, our bones need stimulation. This is why exercise is so important to maintain bone health, especially for those at risk of developing osteoporosis. In response to the force placed on them through day-to-day activities and exercise, our bones develop more cells to increase their density and, in turn, become stronger.

For the alveolar bone in your jaw which supports your teeth, this stimulation comes from the very teeth it supports. The act of chewing, talking, and other activities put small stresses on the teeth. This stimulates the bone which then creates more cells to strengthen itself and continue supporting the teeth. When a tooth is lost, the alveolar bone is no longer being stimulated in this way. The creation of cells to continue to build and repair that section of bone has now stopped. As new cells are no longer being created to replace old ones, there is about a 25%  decrease in the width of the bone within just the first year of tooth loss. Without stimulation, the bone continues to increasingly lose width and height over time. As this happens, the gum tissue surrounding your teeth begins to recede as well.


Once the alveolar bone is lost, the basal bone below begins to deteriorate. And with it, the distance between your nose and chin. As the space decreases, the face eventually partially collapses forcing the chin to rotate upwards. At this stage, your jaw becomes increasingly susceptible to fracturing.

Aesthetically, the face appears to sag—the mouth droops down, your cheekbones become more prominent as the area appears to be sucked down and inward without the support of your teeth, and your skin develops more wrinkles as a result.


As your jaw bone shrinks, your gums are forced to pull back and recede. Gum recession puts them at risk of developing infections as well as increasing the risk of tooth decay as the root becomes exposed.

When gums recede, they pull away from the tooth which forms a pocket between the gum and tooth. This space easily collects debris and plaque, the collection of which leads to irritation and infection.

As your body works to fight off the bad bacteria causing infection, it also breaks down the jawbone and connective tissue holding your teeth in place. A vicious cycle is created where the breakdown of bone and tissue causes the pockets to deepen. This, in turn, allows the infection to spread even further. Without the support of gum tissue or jawbone, teeth become loose and eventually fall out.


Malocclusion is the misalignment of your teeth. It means that when the mouth is closed, your teeth aren’t meeting together properly. In a healthy mouth with proper alignment, the grooves of your molars should fit within one another.

Lack of stimulation to the gums and bone structure from tooth loss and gum disease causes the support of surrounding teeth to become compromised. Teeth can begin to twist, migrate or collapse into the newly created gap.

Teeth that have rotated or shifted will no longer fit one another as they once did. This misalignment can cause discomfort and pain, and the malocclusion will make eating difficult. Those who have developed malocclusion may also find they have speech problems or develop a lisp. 

Proper alignment is also important for providing an even distribution of force over the teeth. Over time, the uneven pressure from malocclusion can lead to broken teeth and even tooth loss.


Perhaps the most noticeable consequence of a missing tooth is the impact it has on one’s self-esteem. Smiling can help to improve self-confidence, health, and mood. But those who feel self-conscious of their smile due to a few missing teeth may find themselves holding back from flashing a grin.

There are many things that can be done to protect your oral health from the damages of a lost tooth. Dental implants can replace a tooth while continuing to stimulate the jaw bone as the root of a tooth would. This helps to preserve the health of your jaw bone in addition to the alignment and health of surrounding teeth. Crowns can fix a collapsed bite caused by uneven wear caused by a tooth that has been missing for some time. And bridges can replace multiple teeth lost while preventing the shifting of the natural teeth from occurring.

Dr. Guerriero has completed a residency program at Stony Brook University Hospital that was heavily focused on complex prosthodontics and implant dentistry. He is dedicated to lifelong learning and plans on continuing education at the Misch Implant Institute to further specialize in the placement and restoration of implants.

Committed to offering the best dental care available, he takes the time to listen to each patient’s individual concerns. This enables Dr. Guerriero to deliver treatment that meets patient goals while maintaining optimum oral health.


The best prevention is regular dental cleanings coupled with a consistent at-home hygiene routine. Make your appointment today with Dr. Guerriero and the Bela Family Dentistry of Sandhills team.

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