How common is tooth loss, and what causes it?
According to the World Health Organization (WHO), almost 7 percent of people aged 20 or older worldwide have lost all their teeth, and among those aged 60 or older the figure is around 23 percent. The American Dental Association (ADA) writes that the average adult between 20 and 64 has three or more decayed or missing teeth.
The WHO describes tooth loss as generally the end point of a lifelong history of oral disease, above all advanced decay and severe gum disease; accidents also cost teeth. The FDI World Dental Federation adds teeth that never developed and extractions for surgical reasons. The cause matters for planning: before a gap is closed, any decay or gum disease that threatens the remaining teeth has to be treated. How gum disease is treated is explained in our guide to gum disease treatment.
This guide is about missing teeth in adults. The early loss of baby teeth in children is assessed separately.
What happens to the neighbouring teeth and the opposing tooth?
Teeth are held in balance by contact with their neighbours and with the teeth they bite against. When a tooth is lost, that balance can shift. The FDI describes two possible changes in its patient information:
- Tipping and drifting: the teeth either side of the gap can move and tilt into the space.
- Over-eruption: if the tooth in the opposite jaw has lost its partner, it can keep growing out of the gum into the gap.
The American College of Prosthodontists (ACP) adds rotation of the tooth around its own axis in its position statement on replacing a single back tooth. The same statement notes, however, that current evidence shows these changes to be less frequent and less extensive than was historically believed.
Studies support this balanced picture. Carlsson and Kiliaridis report in the British Dental Journal (2005) on a Swedish study: of molars that had been without an opposing tooth for more than ten years, 18 percent showed no over-eruption and 24 percent over-erupted by 2 mm or more; about three quarters stayed below 2 mm. In another study with a mean observation period of 6.9 years, over-eruption stayed below 1 mm in 99 percent of unopposed teeth.
In short: the teeth around a gap can move, but not to the same degree in everyone. Whether anything is changing is shown by regular check-ups, which you can have with your own dentist at home.
How does the jawbone change?
After an extraction, the bone that surrounded the root shrinks. The ADA also points to possible bone loss around a missing tooth. A systematic review in Clinical Oral Implants Research (Tan and colleagues, 2012) found that six months after extraction the bone width had decreased by 29 to 63 percent and the bone height by 11 to 22 percent; the greatest changes occurred in the first three to six months.
This matters to you mainly if an implant is an option, because an implant needs enough bone. How the bone is assessed and, if necessary, rebuilt is explained in our guides to bone grafting before implants and socket preservation after tooth extraction.
When most or all teeth in a jaw are missing, the bone loss can also show in the face: Cleveland Clinic describes sunken cheeks as a possible consequence.
How do missing teeth affect chewing, speech and appearance?
According to the FDI, untreated tooth loss can affect quality of life. Among other things, the federation lists:
- less chewing power and therefore a narrower choice of foods
- difficulty speaking clearly
- weakening of the jawbone
- with visible gaps, effects on self-confidence and social life
The ADA adds that a large gap can affect speech and eating, and that even a missing molar that nobody can see changes the way you chew. The WHO describes tooth loss as psychologically traumatic, socially damaging and functionally limiting. How noticeable these effects are depends on how many teeth are missing and which ones.
Does waiting make later treatment harder?
In some cases, yes. The FDI points out that accepting a gap can later affect appearance, function and quality of life, and that replacement becomes harder if more teeth are lost. If the teeth shift significantly or more are lost, the space may need to be restored after all.
The bone plays a part too: according to the review by Tan and colleagues, it changes most in the first months, and the thinner it becomes, the more likely additional procedures such as a bone graft are before an implant. For patients travelling for treatment, that means: even if you postpone the replacement, it is worth discussing the options and time windows early, so that one trip does not turn into two.
Does every missing tooth need to be replaced?
No. According to the ACP position statement, replacing a single back tooth can be beneficial, but the decision is individual: the informed preference of the patient, the available evidence and the long-term maintenance needs are weighed together. The ACP explicitly counts no treatment among the options and recommends recording the starting point in that case.
According to the FDI, a gap can remain untreated if it does not limit speaking or chewing and you do not want it replaced. This avoids cutting the neighbouring teeth and makes cleaning easier. The FDI also describes the concept of the shortened dental arch: not all missing teeth are replaced if a smaller number of teeth still gives enough chewing power and comfort. Carlsson and Kiliaridis refer to the same concept.
These routes depend on the remaining teeth staying healthy: brush twice a day with fluoride toothpaste, clean between the teeth, limit sugar and attend check-ups at the interval your dentist suggests (according to the FDI, every 3 to 12 months depending on your risk).
What are the options for closing a gap?
If the gap is to be treated, the main options are:
- Implant: an artificial root in the jawbone carries a crown, a bridge or a denture. The procedure and the trips involved are described on our dental implants page.
- Bridge: a fixed replacement supported by the neighbouring teeth. The Oral Health Foundation notes that a bridge also stops nearby teeth from drifting into the gap. The comparison for a single gap is in our guide dental implant or bridge.
- Removable denture: replaces several missing teeth and is taken out for cleaning; the differences from fixed replacements are explained in our guide removable or fixed dental prosthesis.
- Dentures or fixed teeth on implants: when many teeth are missing, our guide dentures or implants compares the options.
Which solution fits depends on the number and position of the missing teeth, the condition of the neighbouring teeth and gums, the bone and your expectations.
What does this mean for treatment in Türkiye?
A gap in itself is not an emergency; you have time to plan well. For a preliminary assessment you can send us photos of the gap and any existing X-rays from home on WhatsApp at +90 532 363 49 54. These often show whether a bridge, a denture or implants are likely, and whether one or two trips are probable: crowns and bridges can usually be completed within one stay, while implants usually need two trips several months apart.
The plan becomes binding only after the examination at our clinic in Serdivan, if necessary with a cone-beam CT (CBCT) scan that shows the bone in three dimensions. Before treatment starts you receive a written treatment and cost plan; when you leave, you receive a summary of your treatment and copies of your X-rays for your dentist at home. We answer questions after your return on WhatsApp in English and German. How the transfer from Istanbul and the accommodation in Sapanca are organised is described on dental treatment in Türkiye; how we look after you once you are home, on aftercare and follow-up.