Can a Single Molars Support Chewing After Tooth Extraction?

Orthodontics - Is it feasible to have occlusion with only one lower left molar remaining?

Hello, I recently consulted about orthodontics and received a treatment plan that includes the extraction of the following teeth: the upper left and right first premolars, the lower right second molar, and the lower left first molar (which has previously undergone root canal treatment but only has a remaining root).
Additionally, all four wisdom teeth will be extracted during the orthodontic treatment period (the upper wisdom teeth have erupted, the lower left wisdom tooth is tilted and currently only a small portion is visible, and the lower right wisdom tooth is horizontal).

Bone screws will be placed: one on the upper left, one on the upper right, and one on the lower left.
Initially, the doctor assessed that extracting the lower left first molar would allow the wisdom tooth behind it to be moved forward as a replacement.
However, the final plan was changed to still extract the lower left wisdom tooth and place a bone screw to pull the second molar forward to close any potential gaps.
If the plan involves moving the wisdom tooth forward, an additional lower left premolar would need to be extracted, which would create a larger gap.
My main concern now is that according to the doctor’s final orthodontic plan, there will only be one molar remaining in the lower left area.
Will this affect my occlusion and chewing function in the future?

CHIN, 20~29 year old female. Ask Date: 2016/08/22

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Chin,
Hello! Regarding the extraction of that tooth, the orthodontist will make a professional assessment, and it is advisable to trust their judgment.
If you are still not satisfied with their explanation, you may seek a second opinion.
Since there is only one molar left, it is important to consider the number of opposing teeth.
Please communicate more with your dentist! Thank you! Wishing you safety!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2016/08/22

More Info

After tooth extraction, particularly of molars, the ability of the remaining teeth to support chewing can be significantly affected. In your case, the extraction of multiple teeth, including the first molars and wisdom teeth, raises valid concerns about the long-term implications for your chewing function and overall oral health.

When a molar is extracted, the immediate concern is the loss of a major player in the chewing process. Molars are designed to withstand significant forces during chewing due to their broad, flat surfaces and multiple roots that anchor them securely in the jawbone. If only one molar remains, it may struggle to handle the increased load, leading to potential issues such as tooth wear, sensitivity, or even further tooth loss over time.

In your specific situation, if the orthodontic plan involves extracting several teeth and relying on a single molar for chewing, it is essential to consider a few factors:
1. Load Distribution: The remaining molar will bear a greater share of the chewing forces. This can lead to excessive wear or stress fractures, especially if you have a history of bruxism (teeth grinding) or if your bite is misaligned. If the remaining molar is not adequately positioned or if the occlusion (bite) is not properly adjusted, it may lead to discomfort or further dental issues.

2. Compensatory Mechanisms: The body often adapts to changes in the dental arch. If one molar is left, the adjacent teeth may shift to compensate for the missing ones. This can lead to misalignment and further complications, such as temporomandibular joint (TMJ) disorders, which can cause pain and dysfunction in the jaw.

3. Future Dental Work: If the remaining molar becomes compromised, you may need additional dental interventions, such as crowns or even implants, to restore function. It’s crucial to have a plan in place for maintaining the health of the remaining teeth and addressing any issues that may arise.

4. Orthodontic Considerations: The orthodontist's plan to use bone screws to reposition teeth is a common practice to close gaps and realign the dental arch. However, it is vital to ensure that this plan does not compromise the function of the remaining molar. Regular follow-ups with your orthodontist will be essential to monitor the changes and make adjustments as necessary.

5. Dietary Adjustments: After extractions, you may need to modify your diet temporarily to accommodate changes in chewing ability. Soft foods may be easier to manage until you adjust to the new dental arrangement.

In conclusion, while a single molar can support chewing after the extraction of other teeth, it is crucial to monitor its health and function closely. Regular dental check-ups, maintaining good oral hygiene, and following your orthodontist's recommendations will be key to ensuring that your chewing function remains intact. If you have concerns about the adequacy of your chewing ability or the health of your remaining teeth, discussing these with your orthodontist or a restorative dentist can provide you with tailored advice and potential solutions.

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