When all of the teeth are present in both jaws, there is stability. Teeth are not actually rigid in the mouth, but stay in place due to a complex series of pressure contacts and eruption forces. This series is broken when a tooth or teeth are lost or missing, and one of the possible effects is overeruption of the opposing teeth. An unopposed tooth, one with nothing to bite against, slowly moves out of its socket toward the empty space. Let’s take a look at how this occurs, why it matters, and how overeruption of teeth is prevented and treated.
What Is An Over Erupted Tooth?
Teeth have a natural eruptive potential that lasts throughout life. This continuous eruption is a normal physiological movement of a tooth: it keeps each tooth in contact with its partner in the opposite jaw and makes up for gradual tooth wear from chewing (dental attrition). The opposing tooth provides the stopping force.
Overeruption occurs when a tooth loses that opposing force. When a tooth is lost and not replaced, the tooth above or below the gap keeps erupting because nothing stops it. The same problem goes by several names, including supraeruption, supereruption, hypereruption, super eruption and extrusion. It is most common in posterior teeth, particularly molars, and an upper molar that has lost its lower partner is a typical example.
It is also very common. In a study of unopposed posterior teeth published in the British Dental Journal, 83 percent of the sites examined showed overeruption, with movement ranging from under half a millimeter to more than 5 millimeters, and about half of the unopposed teeth were involved in occlusal interferences with the bite.
How Overeruption Develops After Tooth Loss
Individual With All Teeth Present
Side view of upper and lower jaw teeth.
All Teeth Are Present
The presence of all teeth creates stability in the jaw. Each upper tooth meets a lower tooth, and those contacts hold both in position.
Two Teeth Missing
Two lower molars missing in the jaw, disrupting the series of contacts and pressures of the teeth. The upper molars above the gap are now unopposed.
Over Eruption
Without the counter forces of the bottom teeth, the top teeth may overerupt. As the tooth moves, the alveolar bone and gum around it can move with it, or the root can become exposed. The adjacent teeth may also tip into the space, a problem we cover on our page about tooth drifting.
Signs Of Overeruption
Overeruption is usually painless and happens gradually, so many patients only notice it once it is well advanced. Common signs include:
- A tooth that looks longer, higher or lower than the neighboring teeth.
- An uneven bite, or a tooth that hits first or catches when you slide your jaw from side to side.
- Food packing around the tooth and the teeth beside it.
- Sensitivity to cold from an exposed root surface.
- In advanced cases, the tooth touching or pressing into the gum of the opposite jaw.
Problems Overeruption Can Cause
An over erupted tooth can lead to several dental complications:
- Bite problems. The tooth disrupts normal occlusion and can create occlusal interferences that affect chewing and put strain on the jaw.
- Gum and bone problems. Uneven gum levels and exposed roots make the area harder to clean, raising the risk of dental caries and periodontal disease.
- Soft tissue damage. A severely over erupted tooth can bite into and traumatize the gum on the other side.
- Less room for tooth replacement. This is often the biggest issue. The overerupted tooth can take up much of the vertical space where the missing tooth used to be, leaving too little room for an implant crown, bridge or denture without first correcting the opposing tooth.
How Overeruption Of Teeth Is Treated
Treatment planning depends on how far the tooth has moved and what we plan for the missing tooth. Options include:
- Reshaping. Mild overeruption can often be corrected by carefully adjusting the biting surface so the bite is level again.
- A crown. Where more height needs to be removed, the tooth may be shortened and covered with a crown. If the reduction is significant, root canal treatment may be needed first.
- Orthodontic intrusion. Using orthodontic techniques, often with small temporary anchorage devices, an orthodontist can move the over erupted tooth back up into the bone.
- Crown lengthening. When gum and bone levels have followed the tooth, our periodontists can perform crown lengthening to restore an even gumline before a new crown is made.
- Extraction. If a tooth has overerupted severely or has lost too much support, removing it and replacing both teeth may be the most predictable option.
Once the opposing tooth is corrected, the missing tooth should be replaced so the problem does not return. A single dental implant restores the opposing force without relying on the neighboring teeth, and an implant-supported bridge can replace several missing teeth. Where bone has been lost at the site, bone grafting may be needed before implant placement.
How To Prevent Overeruption
The best way to prevent overeruption is to replace a missing tooth before the opposing tooth has time to move. If you need a back tooth removed, plan the replacement at the time of extraction and ask about socket and bone preservation. If you are waiting for an implant, your dentist can check the opposing tooth at regular visits and, if needed, place a temporary replacement or a retainer-type appliance to hold it in position.
Frequently Asked Questions
How Long Does Overeruption Take?
It varies. Some movement can be seen within months of losing the opposing tooth, and it often continues slowly over years. Not every unopposed tooth moves, and the amount differs from person to person.
Can A Super Erupted Tooth Be Saved?
In many cases, yes. Mild to moderate overeruption is usually managed with reshaping, a crown or orthodontic intrusion. Extraction is reserved for severe cases or teeth with poor support.
Will An Over Erupted Tooth Move Back On Its Own?
No. Replacing the missing tooth stops further movement, but moving an over erupted tooth back into position requires orthodontic treatment.
Does Overeruption Hurt?
Usually not. Discomfort, when it happens, tends to come from sensitivity on an exposed root, food trapping, or a bite that no longer fits together comfortably.
Book A Consultation
If you have lost one or more teeth, dental implants might help you restore the function and beauty of your mouth and prevent overeruption of the teeth that remain. To learn whether you are a dental implant candidate, schedule a personal appointment with one of our board-certified periodontists. All of our doctors are periodontists who can also provide a complete evaluation of your gum health and perform any necessary gum treatments. Call (347) 493-2439 or request a free consultation.
