With all the teeth present, 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. Each tooth is held in its socket by the periodontal ligament, and the teeth beside it and opposite it keep it where it belongs. However, teeth do tend to shift over time. This occurrence is known as tooth drifting, dental drifting or mesial drift, the natural tendency of teeth to migrate forward toward the front of the mouth. When teeth are missing, the remaining teeth drift from their normal position much faster, and they tilt into the gap left behind.
What Is Tooth Drifting?
When you lose a tooth, the remaining teeth no longer have the support that the bone and missing tooth once provided. Because there is no longer support, the adjacent teeth begin to shift or move out of their anatomical position and into the open area. The tooth behind the gap usually tips forward, the tooth in front can lean back, and the opposing tooth in the other jaw can grow into the space. This causes those shifting teeth to weaken and makes them more susceptible to further tooth loss.
Tooth drifting is a common phenomenon after losing a tooth, especially a back molar that you cannot see in the mirror. Because the gap is out of sight, many patients do not notice the teeth have shifted until their bite feels different or food starts to catch between teeth.
What Causes Teeth To Drift?
Missing teeth are the most common reason we see, but they are not the only one:
- Tooth loss. An extraction or a lost tooth removes the contact that held the neighboring teeth in place, so they move into the space.
- Gum disease. Periodontal disease destroys the bone and ligament that anchor teeth. As support is lost, teeth can fan out, open spaces (diastema) or become loose, a problem known as pathologic tooth migration. As periodontists, this is one of the most frequent causes of shifting teeth we treat.
- Bruxism. Clenching or grinding your teeth at night places heavy forces on the teeth that can push them out of position over time.
- Age. Some mesial drift is normal throughout life, which is why lower front teeth often become more crowded as we get older.
- Stopping retainer wear after orthodontic treatment. Teeth that were moved with braces or Invisalign tend to relapse if they are not held in place.
Why Tooth Drifting Matters
A single missing tooth can set off movement in several teeth. Once teeth drift, the way the upper teeth and lower teeth meet changes, which can lead to malocclusion (a misaligned bite), uneven wear on the enamel, and in some patients jaw pain. Tilted teeth also create areas that are hard to clean, so plaque collects and the risk of tooth decay, gingivitis and periodontitis rises. At the same time, the jawbone at the extraction site shrinks without a tooth root to stimulate it. You can read more about that bone loss on our page on the consequences of single tooth loss.
Drifting also makes replacing the tooth harder. If the neighboring teeth tip into the space, there may no longer be enough room for a replacement tooth of the right size, and some patients need orthodontics to reposition the teeth before an implant or bridge can be placed.
Stages Of Tooth Drifting After A Missing Tooth
Full Mouth Of Healthy Teeth
Side view of full mouth of teeth where the teeth are stable.
Missing Lower Molar
One molar is lost due to trauma or decay.
Missing Tooth Disrupts Bite Pressure And Contacts
Adjacent teeth can be pushed toward the empty space.
Continued Pressure And Forces On The Tooth
Continued pressure and forces on the tooth keep pushing the teeth out of line. The neighboring teeth keep tipping, and the opposing tooth can grow down or up into the gap, a problem we explain on our page about over-eruption from missing teeth.
How To Prevent Teeth From Shifting
The most reliable way to prevent teeth from shifting after losing a tooth is to replace it before the surrounding teeth have time to move. Movement can start within months of an extraction, although the pace varies from person to person. Other steps that help:
- Plan the replacement at the time of extraction, and ask about socket and bone preservation so the site is ready for an implant.
- If you have had orthodontic treatment, keep wearing your retainer as directed.
- If you grind your teeth at night, ask about a night guard.
- Keep up good dental hygiene and regular periodontal checkups, since gum disease is a major driver of tooth migration.
A retainer helps hold straightened teeth in place, but it will not treat drifting that is caused by a missing tooth.
Tooth Drifting Treatment Options
Replacing missing teeth with a single dental implant or a single tooth bridge are common treatment options for teeth drifting. Our periodontists generally recommend dental implants, because an implant fills the space without relying on the neighboring teeth and provides a natural looking and functional replacement tooth.
Dental implants are posts, usually titanium or zirconia, that are surgically placed into the jaw bone beneath the gums. Since the implant is fixed into the jaw bone, it provides support for the artificial tooth, does not become loose, and helps maintain the bone around it. We offer several dental implant options depending on the number of missing teeth. If you are considering dental implants, you need healthy gum tissue and sufficient jaw bone density to properly place the implant. If the bone is too thin or soft, bone grafting may be required.
Where teeth have already shifted significantly, an orthodontist can help reposition them with traditional braces or clear aligners before the missing tooth is replaced. If several teeth are missing, see our treatment options for replacing several missing teeth.
Frequently Asked Questions
Does Tooth Drifting Hurt?
Drifting itself is usually painless, which is why it often goes unnoticed. Discomfort tends to come later, from a changed bite, food trapping between tilted teeth, or strain on the jaw.
Can Dental Drift Be Fixed?
Yes. Mild drifting is often managed by replacing the missing tooth. Larger movements may need orthodontic treatment first to move the teeth back into position.
How Soon Do Teeth Shift After An Extraction?
Some movement can begin within months, and it continues gradually for years if the gap is left open. How much and how fast depends on which tooth was lost and on your bite.
Why Are My Teeth Drifting If I Have Not Lost A Tooth?
Gum disease, teeth grinding, natural mesial drift with age, and stopping retainer wear are the usual causes. A periodontal exam can show whether bone loss is involved.
Book A Consultation
If you have noticed shifting teeth or have a gap that has not been replaced, our board-certified periodontists can check your bite, gums and bone and explain your options. Call (347) 493-2439 or schedule your free consultation.
