Dr Shail Jaggi: Missing Teeth-Replacing them a must?

I belong to the band of Conservative or Restorative Dentists and having trained in a specialisation that focuses on restoring rather than removal I rarely extract teeth. I have a huge emotional guilt when it comes to extracting teeth.

That said I still have those really badly damaged teeth that absolutely must go. In these cases tooth extraction is inevitable, and absolutely necessary. But these are pulled out only with a promise of replacement at the earliest.

Unfortunately, tooth extractions can come with a multitude of problems at a later stage after the extraction and I’m not referring to pain or discomfort here.

Pain or discomfort are a small side effect that will go away quickly. I’m talking about the long term effects of tooth extraction. Often dental implants are the best option for patients.

I have so may people ask me “whats the big deal doc? I got 32 teeth am sure pulling one out is not going to be so bad. I can live with 31!”

So absolutely true, but unfortunately nature has more in mind and living with 31 does not work. Let’s discuss this.


All the teeth are designed to be in contact with each other and these contacts are really tight. And there’s a science to this placement. I’m really not going in to science now. But briefly, when we have one extraction done the other tooth which is designed to be in contact starts to look for a contact and if you haven’t had immediate dental implants to re-fill the space, not finding one it starts to tilt. The upright tooth is now at a funny angle.

This tilt destroys the balance of the upper and lower teeth which were in contact with each other and suddenly the upper tooth is trying to find a new contact and shifts, as each tooth starts to shift suddenly there’s a whole new imbalance that’s created only because a single tooth was extracted.


This whole new malalignment changes the way the teeth contact with each other. Suddenly you may find a lot of food lodgement between your teeth. And you wonder why. The simple reason being because the teeth have started moving around there are more spaces between your teeth which results in food getting stuck. This leads to sudden new cavities between teeth. And once perfectly healthy teeth now have decay, thanks to that one extraction.


Our specch can sometimes be affected with a simple extraction. The open space of the extraction tends to create areas through which air escapes leading to lisping or whistling sounds while speaking. And it can be really odd or sometimes embarrassing.

Shifting of the Jaw:

Not having tooth balance on one side can lead to excessive chewing on one side and a gradual shift of the jaw to one side. Long term this can have implications on the health of the jaw. It can cause pain, discomfort, clicking sounds from the jaw and inflammation of the jaw joint which can be acutely painful. If extraction is necessary, however, you can have dental implants in order to prevent this from happening. You can find out more about the procedure from sites like https://teethnow.com/.

Compromised Nutrition:

Missing teeth can lead to inability to chew food effectively and this may lead to problems with digestion. The side effects of which I don’t need to enumerate.

Alteration of Facial Appearance:

The teeth help to maintain the shape of the face by supporting the lips and the cheeks and prevent the the face from ageing early. Very often loss of teeth can make a relatively young patient look much older.

Bone Loss:

After an extraction, the jaw bone at the site of the extraction will gradually shrink and undergo degeneration. Bone needs to be stimulated to stay healthy. It’s always a good idea to replace that missing tooth.

So if you’ve had an extraction sometime in the past it’s a good idea to get going and replace that missing tooth so you don’t have long lasting side effects on things other than your teeth.

Happy Navaratri and dance away the night with Garba starting soon. Till I see you again next week.

Dr Shail Jaggi

Dr Shail Jaggi

Dr Shail Jaggi is a passionate dentist with specialisation in cosmetic dentistry and endodontics. She manages an Advanced Microscope Enhanced Practice – Dentalwiz dealing with all aspects of dentistry. Dr Jaggi is recipient of ‘Outstanding Dentist Of The Year -2015’. Dr Jaggi writes every Wednesday on Pune365.
Dr Shail Jaggi