People wonder and speculate what happens on the gaps left when a tooth has been extracted. Is this space maintained or do the surrounding teeth fill in on these gaps?

If you look at how teeth are usually aligned in the mouth, it might lead you to believe that they all maintain their position even though some teeth can be lost. Sadly, our teeth break their line and move into the spaces made available by missing or lost teeth.

Believe it or not, our teeth – especially those in the back – have a tendency to move towards the front/the midline. This is due to the combination of forces our teeth are subjected to and comes from contact between our upper and lower teeth as well as the action of soft tissues like the cheeks and the tongue. Although this might seem like a problem it does serve the purpose of compensating for the natural wear that occurs on the sides of our teeth.

Once a tooth is extracted, the tooth behind it can slowly and progressively drift to the empty space as nothing is preventing it from moving. This phenomenon is clinically called ‘mesial drifting’ (mesial – towards the midline of the arch).

Aside from drifting, our teeth can also rotate around its axis due to absence of a neighbouring tooth. The presence of other teeth on either side stops the tooth from moving and changing its normal position.

If the space problem is not addressed, the tooth that used to contact it on the opposite side can also move. For example, an extraction of a molar in the lower jaw can cause the molar that used to contact it on the upper jaw to move down to the space. In advanced forms, the tooth on the opposite jaw can move as far as a few millimetres towards the space. As the movement increases, the height of this crown will considerably be higher than the normal plane of its neighbours.

Somehow, the space will seem like a magnet that attracts the teeth that used to be in contact with the extracted one. If this is not addressed immediately, it could result to more extensive treatment solutions like orthodontics (the use of dental braces) or even the extraction of the opposite tooth if it becomes too far out of its natural position.

Certain measures can be used to maintain the space a tooth used to occupy. Space maintainers such as the use of dental bridges, removable dentures, and dental implants will prevent the movement of the other teeth and maintain the harmony of tooth contacts.