I Have One Back Tooth That is Loose. I Suspect Bone Disease. If I Have It Removed, Will my Other Teeth Space Out? If So How Soon

Several years ago I was told I had minor bone loss in my lower back jaw. The pain went away with increased dental regimen. However, recently I have noticed the tooth becoming looser. I am guessing the dentist will suggest that I remove the tooth. Will this cause my other teeth to space out and will the missing tooth affect my overall bite? It is the very last tooth next to the wisdom tooth I had removed as a teen. Do I HAVE to visit a periodontist?

Doctor Answers 6

Depends on the amount of movement that's going on

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If your tooth is loose then it might be a goner.  Honestly, it's going to move through just normal eating, thus even with periodontal therapy it might not be able to 'tighten up'.    That being said, IMO , it's only a matter of time until tooth needs to be extracted.  Especially if you're noticing increasing spacing. 

Will losing a back tooth cause tooth shifting?

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I would definitely recommend seeing a periodontist first in order to determine whether there was anything that could be done to resolve your situation short of tooth removal.  If tooth removal is suggested, the fact that this tooth is not in the middle of your jaw means that there are no teeth posterior that would shift forward without a suitable tooth replacement.  However, the opposing tooth would  grow taller without a replacement tooth.  If tooth extraction cannot be avoided, I would consider, a bone graft and implant supported crown to stabilize your bite.

Daniel Melnick, DDS
Laurel Dentist

I Have One Back Tooth That is Loose. I Suspect Bone Disease. If I Have It Removed, Will my Other Teeth Space Out? If So How Soon

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Yes, I would recommend you see a periodontist to see if there is still something that can be done to keep your loose tooth.
If your tooth is loose because of gum (and bone) disease, then at some point your dentist will usually recommend it be removed.  It is better to remove it earlier than later, as the longer it goes, the more the bone will be lost as well.
And yes, after removing a tooth it should be replaced by either a fixed dental bridge, a dental implant or a removable partial denture.  If not, the tooth that opposed the missing tooth will start to migrate into that space, and the teeth on either side of the missing tooth will drift into that space.  Thus, throwing off your entire bite.
This whole scenario takes a while, usually a few years to become noticeable, so better to make the corrections within the first year of losing the tooth.

Norman Huefner, DDS
Laguna Niguel Dentist

Do I have to see a periodontist?

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Generally I tell my patients in this situation that if they want to do everything they can to keep their teeth they should see a specialist.  It is impossible to diagnose your situation without seeing you.  Having said that,  I sounds like you will be loosing the second molar and possibly more teeth.  Your first priority is getting the disease under control and focus on the teeth you can save while getting rid of those you can't. Once this is done a thorough evaluation of your bite and what it will take to stabilize it is needed.  When we loose posterior teeth is can cause opposing teeth to supra erupt, adjacent teeth to drift, and/or a posterior collapse of the bite.  This collapse places inordinate amounts of force and strain on the anterior teeth resulting in excessive wear, crowding, splaying of upper anteriors, fracturing etc etc... .  One thing to remember,  just because you don't have pain does not mean you can't have active periodontal disease.


Will Removing A Molar Tooth Cause Spacing

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If you have incresing mobility with this molar there is a good chance that it will need to be extrated, but it should not cause any spacing of the other teeth.  I would see your general dentist first, allow them to examine the tooth, then see a periodontist if they feel that is necessary.  A 3D CT scan of that area will determine quanity of bone, whether an extraction is nessecary, and whether or not it could be replaced with a dental implant.  Hope this helps.

Loose Back Tooth

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If your back teeth are beginning to loosen, you should definitely visit a periodontist to obtain an opinion on course of treatment. There might be surgery to help prolong the life of your teeth. Or, if there is a localized infection, perhaps the extraction of a single tooth will preserve the bone around the adjacent teeth.

Jay Neuhaus, DDS
New York Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.