This question sometimes surfaces after a tooth has been extracted, and the patient is then presented with making the choice of having the tooth replaced. In this instance, we are referring to teeth that have been lost because they are no longer viable and not teeth that have been extracted as part of braces treatment.
This question stems from the thinking that if the space can be closed, the tooth need not be replaced with a prosthetic one. Let us review some of the considerations.
Considerations
Is crowding present? If crowding exists (meaning teeth are bunched up because there is insufficient space for them to be arranged in an orderly manner), and the extracted tooth contributes to the crowding, then its absence can be utilised to alleviate the crowding.
Will the bite be affected? Our teeth function as a set of two arches. Upper teeth and lower teeth need to meet correctly to break down food. Closing a space can result in one arch being reduced in dimension. This will result in two arches that do not complement each other and will not meet or bite correctly.
Will there be asymmetry? Apart from existing as two arches, our teeth also exist in pairs. Every tooth on one side will have its mirror-image counterpart on the other side. Closing a space without replacing a tooth often results in asymmetry or an uneven, lopsided appearance.
In the odd event that the above conditions fall into place to result in a possibly harmonious arrangement, then the answer is “yes”. However, the reality is that these situations are rare unless already planned as a part of braces treatment, often together with the extraction of some other teeth.
More often than not, attempting to close an extraction space by shifting teeth will result in asymmetry and a poor bite. The very opposite is often carried out: Using Invisalign or braces to widen a space so that an appropriately sized tooth replacement can be placed. This is sometimes necessary when teeth next to the extraction site tip or shift into the available space over time. A few weeks with Invisalign aligners can be enough to move these teeth to a more favourable position.
