What happens if I don't replace the missing tooth?

• Nothing noticeable, for a while, especially for a tooth far in the back.
• Teeth shift. The teeth beside the gap can tip into it. The tooth above or below can drift, too: if a lower tooth is missing, the upper tooth above it has nothing to bite against and can slowly move down into the space (and the same in reverse). Shifting can open spaces where food gets trapped, change your bite, and make replacing the tooth later harder.
• Bone shrinks where the tooth was, which may mean a graft if you want an implant later. See Do I really need a bone graft?
• Chewing changes. You may chew more on the other side, and other teeth take more of the load.
• Appearance, for gaps that show when you smile.

These changes are usually slow, often over years, and they vary a lot from person to person. Missing several teeth tends to affect chewing and the bite more than missing one.

Many people do fine with a gap, especially a back tooth where the teeth around it are stable, like a last molar. Even then, the tooth that used to bite against it can drift into the space over time, so ask whether that tooth needs watching. It's also reasonable if cost, health, or timing make replacement hard right now. Ask your dentist whether the teeth near the gap are likely to move.

That's your choice. Ask your dentist to check the gap and neighboring teeth at each visit. If you might want an implant later, ask whether a socket graft now would keep that option open.

If the gap shows, or you're worried about teeth shifting while you decide, a temporary partial denture (often called a flipper) can fill the space for now. See Other options.

One insurance note: if you switch dental plans later, some plans won't pay to replace a tooth that was missing before your coverage started. See The missing tooth clause.