How can I prevent teeth shifting after extraction?

Question

Hello doctor,

This question is about teeth shifting and its connection to TMJ or facial asymmetry. When I was 15 or 16 years old (not sure), I got my tooth out, specifically in the bottom molar on the right side. Now years later I am 18 years now. I noticed that the tooth that was extracted was replaced by the old tooth (shifting).

I also noticed my jaw was pretty asymmetrical. The other one has a very nice jaw structure, while the other was very smooth (the one where my tooth was extracted years ago). And I noticed that part was very slim while the other was very full.

I just got my tooth extracted last week (the same molar, but on the other side, bottom). I did extensive research on this, and most people I talked to, including student dentists, say there was no connection. While others said there were.

I know my tooth will shift since it will find ways to always replace it, and I'm expecting it to shift and somehow change its facial structure. Will my face or jaw shift or change shape as well?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Generally when a permanent tooth is extracted,

1. Bone loss happens in the jaw. The bone underlying the tooth is like soil. If there are no tree roots to hold the soil, soil erosion happens. Likewise, without a tooth, bone thickness in the extracted area will gradually reduce and become slim.

2. We will shift to a unilateral chewing pattern (we tend to chew more on the other side and will avoid using our extracted side). This may lead to an asymmetrical face, especially in the period of jaw growth (14 to 21 years of age). Also, our facial chewing muscles will lose support from the tooth and will start to sink in. This can also lead to loss of facial symmetry.

3. The nearby tooth starts drifting and slanting due to loss of support from the extracted tooth and bone. This is called mesial migration. This can lead to TMJ, bite, and jaw issues in the future. Ideally, replacement of the extracted tooth is done to prevent mesial migration (shifting), bone loss in the extracted space, and to resume a bilateral chewing pattern. Hence, balance in our bite and facial structure will be maintained.

I hope this helps.

Take care.