We had a little argument with one of our patients recently, although it is not very common that we get into conflicts in the dental surgery. Steve arrived with a very swollen face caused by a heavily decayed and infected molar tooth. His main desire was to stop the pain as soon as possible so he thought the best would be to get the tooth taken out immediately. He said that back tooth is not very important for him and this was the main point of disagreement between him and the dentist.

After taking the x-rays we saw that the tooth can be saved with a root canal filling. After the root canal treatment the root would be able to support a crown with a post, which can last for decades. The first step would be to clear the tooth and together with the help of antibiotics the pain would also stop in 2-3 days. In the end we managed to persuade Steve, that he does need this tooth – and all his back teeth – with the following arguments:
When there is a gap the teeth will tend to occupy the empty space. They would either move sideways leaving bigger gaps between the remaining teeth or lean in and therefore they would not provide optimal chewing surface.

The opposing teeth (in case of a lower tooth they are the upper ones on the same side) will not get any counterforce, therefore they would slowly start to move downwards. Any missing tooth in the long term will weaken the opposing one as well and eventually these will also erode.

In case there are missing teeth on one side, chewing will not be balanced. If we chew only on one side for a longer period of time, the joint will be overloaded on this side and get weaker on the other. This imbalance can cause several irreversible processes in the temporomandibular joint: the joint will get painful, give a strange noise when chewing and get easily dislocated.

In case there are several missing molars only the front teeth are left for chewing. However as the shape of the front teeth shows, they were designed for biting and not for chewing. If we use the front teeth for chewing for a long period of time these teeth will be overloaded, which they will not be able to resist: they will get weaker, get broken or start to move.

Eventually Steve trusted us and undertook the root canal treatment; now he is happy with his new crown. In case of missing teeth we recommend to get them replaced with implant based crowns or bridges; we provide free consultations and give free treatment plans to make the process easier and help you to find the optimal solution.