Dr. Tanner Townsend and Dr. Josh Muir discuss the consequences of delaying tooth replacement. Dr. Muir emphasizes the significant bone loss that occurs when teeth are missing, which complicates and increases the cost of future treatments like implants. He explains that teeth stimulate bone growth, and without this stimulation, bone density decreases, leading to esthetic and functional issues. Dr. Townsend adds that missing teeth can affect confidence and speech. They also note that bone loss can cause a sunken facial appearance, necessitating additional bone grafting. Both agree that prompt tooth replacement is crucial to maintain oral health and aesthetics.

Dr. Tanner Townsend 0:05 Welcome back to the Smile Reconstruction Podcast. I’m your host Dr. Tanner Townsend, and I am here with my co host, Dr. Josh Muir, and today we’re going to be talking a little bit about what happens when you delay replacing missing teeth. So the question I have for you, Dr .Muir, is waiting to replace a missing tooth worth the cost of bone loss and more expensive treatment later on down the road.

Dr. Josh Muir 0:33 Great question. I think the important thing is for people to know there is a cost to doing nothing, and so in many cases, I don’t think it’s worth it.

Dr. Tanner Townsend 0:45 100% agree with you. Well, let’s kind of jump into why you don’t think it’s worth it, and what are some of the things that patients really might not be considering initially, and that they are good things for them to know in making this decision. If they have a tooth that’s either going to be needing to coming out or they recently had removed and so on. So what? What are some of the consequences that you have found with delaying treatment, of some of the common things that happen?

Dr. Josh Muir 1:16 Yeah, I think a really good example is a patient today that was that came in for a consult, someone that is trying to do the minimal amount of dentistry now, but still wants to go with implants as soon as she can in the future. And so her thought was, I’m going to have my teeth taken out. I’ll just go to a denture in a year or so, maybe two years I’ll switch to implants, and so we had to have the talk about what is the cost of doing nothing with it. So the biggest thing is bone loss. So when we take a tooth out, there’s a couple of things that happen. One is it leaves that hollow space with thin walls of bone around it, and some of that bone fills in, but some of it collapses so it gets narrower and it gets shorter. And so the problem with that is, when we try to do implants later, there’s just not as much bone to work with. And so oftentimes that means we have to do additional bone grafting, bone grafting, exactly. And so the other thing that happens, though, is you have to think of our teeth as something that stimulates our bone to be strong. So just like if we use our muscles, we are stimulating our muscles. They pull on the bone, and we maintain good bone health. When someone gets older and they stop being active, they can have some osteoporosis. They stop using their muscles, it stops pulling on the bone, and their bone starts to become more porous. It’s just not as strong. They’re more prone to fracture and all of that. So our teeth as we chew on them, and implants would be included in that. Implants as we chew on them, it puts forces in the bone, and so the bone reinforces itself around those, and we end up keeping our bone longer. So those are some of the things.

Dr. Tanner Townsend 3:13 One of the other things I think people don’t really take into account as well with like consequences that happen when you delay getting teeth placed or or whatnot, is like, how it can affect your confidence? How can it affect your speech? How can it affect, like, just the way you feel about yourself? It’s amazing to me. We I’ve even had patients that have lost a second molar, and I’ve even advise some patients, very back of the mouth, very back of the mouth, you do 10% of your chewing on that tooth. So it’s not, it’s not a critical tooth. You can live without it. But we have patients sometimes that are like, I can’t live without a tooth. And it’s, it’s a confidence thing for them, and so we replace it. And that is totally fine to do, but it’s just amazing, like how it affects even though it has such a great significant portion in the health aspect of maintaining bone and making sure other teeth don’t shift, but it has a huge factor on the mental side as well, and the way we talk, if It’s like a front tooth. So just all those factors have a big role and can affect the way that person is viewed and have consequences in the greater health down the road.

Dr. Josh Muir 4:32 Yeah, and it, you know, with losing that bone as well, if implants are delayed, or bone grafting is delayed, there are some esthetic difficulties that happen as well. So anytime in the front anything that’s visible at all, we lose bone and that nice, even gum line between the different teeth will diminish, and it’s very difficult to get that back.

Dr. Tanner Townsend 4:57 Now, another thing that I’ve noticed is like a patient, let’s say a patient that is missing a lot of teeth or has been wearing a denture for years, they have they lose a lot of bone, just like you had mentioned that, if you’re not using that bone or nothing stimulating that bone, we lose it. And one of the things that patients often complain about is their face looks sunken in, and they don’t like that, and that’s one of the consequences of delaying treatment. Even if we do implants and stuff like that, we have to do additional bone grafting to try to get that sunken in look gone. And so those are extra things that need to be done that otherwise don’t need to be done if we aren’t putting things off and off down the road.

Dr. Josh Muir 5:42 Yeah, and we were both involved in that case recently, where to replace some of the teeth in the front, yeah, there had to be bone grafting to bulk that out, not to put the implants in, but just to make it look natural, just to make it look nice. A smile, for people that show their gum tissue, a smile is more than just teeth that that gum tissue, our eyes can pick that out if it doesn’t look quite right. So, yeah, all important.

Dr. Tanner Townsend 6:11 So what are some solutions that you have found to helping fix missing teeth, but also being proactive with managing these problems that pop up in people’s mouths.

Dr. Josh Muir 6:26 I think the biggest thing with that is, you know, if you find yourself in the position where you’re about to be missing teeth, or over the years, you’ve missed one here, missed one there, it’s just involving a trusted dental partner. So for example, you could come into our office and we just talk. It’s just a consult appointment. We’re giving you options and ideas. It doesn’t mean you have to move forward with it right now, but if you have a plan in mind, you can even say, Well, I’m still doing fine now, and I’m someone that who delays as long as I can, but you can make a plan. And if you make a plan, you can decide, hey, option one. Well, I know I want it to be as natural as it can be, so let’s do All-on-X. Let’s have a fixed set of teeth. We’ll do multiple implants, and we’ll replace all of the teeth with that at the appropriate time. Or you say, No, I don’t want implants, period. I just want a regular denture and but I know I’m going to want that at the time my teeth come out, yeah, because I don’t want to go without teeth. Or you’ll say, hey, I want to start in a denture. And then if I’m not doing great with that, let’s add some teeth, or some implants to snap it into. Or let’s do the All-on-X so that it’ll stay in there and be more natural. So those are, those are, realistically the options for all of the teeth. But you know, we’re also talking today about options for replacing one tooth. And so before you have your tooth taken out, come in and see us, and let’s make a plan. And oftentimes, especially in the front, we can put an implant and a temporary crown on the same day, and most people won’t even notice a difference between the before and after on the same day. So it’s, you know, just involve a trusted dental partner in this and have a plan in mind. Would you say that’s correct?

Dr. Tanner Townsend 8:23 Yeah, I agree. I think a lot of people delay for varying reasons, of because of cost, because of fear at the dentist, because of they just don’t want to take the time to do it out of work. But I think involving that trusted dental professional to give you just a plan, know what your options are and what the consequences are of having a missing tooth and leaving it that way, because there is a cost for that, whether it’s monetary or options later on down the road or quality of life. And so I think, I think you hit it right on the head of you need to involve that trusted dental professional, and that’s why we we recommend that you go in as soon as you know something’s kind of awry, that way you can get it fixed and get a game plan of what you need to do.

Dr. Josh Muir 9:14 Yeah, so for people that might be listening to or watching this, you know they’re going to a dentist regularly, regularly. And the dentist says, Yeah, you got to have this tooth out. If they don’t mention bone grafting or implants or any of that as an option, what do you tell them? What would you what would you advise them to do?

Dr. Tanner Townsend 9:36 I would advise the patient to to probe the dentist. Of what are my options? How can I replace this tooth? Sometimes the dentist might just need to be reminded of, oh, there are options. And there are several options that we need to review. And whether it’s a bridge, whether it’s an implant, whether it’s a partial, I think they just. Need to be reminded sometimes and prompted to review those options. Is there any that I kind of left off, that you’re still thinking?

Dr. Josh Muir 10:06 I think that makes sense. I mean, first, if you’re going to a dentist, if that’s your dental home and you trust that person, yeah, just ask him. Just ask him, Hey, I’ve heard about bone grafting. I’ve heard about implants for when teeth come out. Do I need to be thinking about that? And most of the time, if you ask the question, they’ll they’ll say, Well, yeah, that would be really good to think about. I didn’t realize you were interested in that. It’s always good to have that conversation. Now, if you find yourself in a situation where it doesn’t seem like they’re up to date with some of those techniques, then find someone else. I mean, come in for a consult. You know, we, we don’t have a hygienist. We’re not doing a lot of fillings and that kind of stuff. So use your your dentist for that. But if you have questions, come in for a consult. I mean, we can take care of you from start to finish on these processes.

Dr. Tanner Townsend 11:05 Yeah.

Dr. Josh Muir 11:05 So

Dr. Tanner Townsend 11:06 I think just remembering, like you had mentioned that one, go to your trusted dental provider. First ask what the options are, what is able or what is, are the options that you have for you? And then if they feel like something’s outside their comfort zone, ask them who they trust in their dental sphere of who they work with, who would be best to send you to to get that care? Yeah. And so that’s what we recommend. Make sure that you talk with your dental professional about what’s going to be best for you if you are about to lose a tooth or have been missing teeth for a while, and then move forward with your dentist, or find someone that’s going to be able to help you to get taking care of the problem of the missing teeth.

Dr. Josh Muir 11:53 Yeah, and we’ve both had patients that have waited, and something that would have been, what I’m going to say easy a year ago is now involving sinus grafting and these bigger procedures to restore the bone and so, yeah, thanks for sharing that don’t be don’t become one of those patients that has to take a longer road filled with more expensive procedures and a longer treatment time, you know, involve us in the process, and we can help you avoid some of those. So, yeah, closing remarks, you know, there are solutions for everyone, and even if that solution is just having a plan set up for the future, that’s a great solution for now, and just understanding that waiting can make dental problems worse, and implants are no exception. So

Dr. Tanner Townsend 12:51 Yep, couldn’t have said it better myself. Well, that is it for today’s episode of the Smile Reconstruction Podcast. We thank you for joining us, and we hope that kind of answers some questions on why we don’t recommend waiting to replace some missing teeth. And thank you so much, and we will catch you next time.

Dr. Josh Muir 13:10 Thank you.