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Once a tooth is removed, the gums may close and the area can appear fully healed. Underneath, however, the bone that once surrounded the tooth root is changing shape. These changes can affect how the missing tooth is replaced later.
What Causes Bone Loss After an Extraction
The alveolar bone is the part of the jaw that forms the tooth sockets and supports the roots. After a tooth is extracted, the body no longer needs to maintain the socket in its original shape, so it begins a natural process called bone remodeling.
The periodontal ligament also plays a role. This thin layer of tissue connects the tooth root to the surrounding bone and helps transfer pressure from chewing. Removing the tooth eliminates this connection and changes the blood supply and mechanical signals in the area.
During healing, the body removes damaged bone and forms new bone inside the empty socket. At the same time, the outer walls of the socket gradually shrink. This means the socket can fill with bone while the overall ridge still becomes narrower and somewhat shorter.
How Quickly Does the Bone Shrink?
Bone remodeling begins soon after the tooth is removed. The fastest changes generally occur during the first three to six months, although the ridge can continue to change more slowly afterward.
Width usually decreases more than height. The bone on the cheek side of the socket often changes the most because it tends to be thinner than the bone on the tongue or palate side.
The amount of bone loss after an extraction depends partly on the condition of the bone and socket at the time the tooth is removed:
- The thickness of the bone surrounding the tooth
- How much bone is present before the extraction
- Existing bone loss from gum disease
- Damage to the socket from infection or other dental problems
How Bone Loss Affects the Jaw and Surrounding Teeth
As the bone at an extraction site shrinks, the shape of the jaw ridge and the gum tissue covering it can gradually change. The effects depend on where the tooth was removed, how much bone is lost, and how long the space remains without a tooth.
Bone loss can affect the area in several ways:
- Changes in the gum and jaw contour: The ridge may become narrower or develop an indentation where the tooth was removed, which can be particularly noticeable in the front of the mouth.
- Movement of nearby teeth: Teeth next to an open space may gradually shift or tilt, while the opposing tooth can move toward the empty space.
- Changes in your bite: Tooth movement can alter how the upper and lower teeth come together.
- Less support for tooth replacement: Significant ridge loss can make future implant placement more complex and can affect the fit and appearance of other restorations.
If you are considering a dental implant, the amount of remaining bone is an important part of treatment planning. Our guide to the tooth extraction and implant timeline explains how extraction, graft healing, and implant placement may fit together.
Reducing Bone Loss After an Extraction
When we remove a tooth, we consider the condition of the surrounding bone and whether the area will need to support a future tooth replacement. If preserving the ridge is important, we may recommend socket preservation at the time of extraction.
Socket preservation involves placing bone grafting material into the empty socket to help maintain the height and width of the ridge as it heals. It is not necessary after every extraction, and we recommend it based on the condition of the site and the plans for replacing the missing tooth.
Discuss Your Tooth Replacement Options
If you have had a tooth extracted and would like to discuss your replacement options, our board-certified oral surgeons can evaluate the area and help you determine the next step.
To schedule an appointment at one of our 5 locations, call or text (480) 830-5866 or visit us at our Mesa, North Mesa, Queen Creek, Tempe, or Show Low locations.
FAQs
Does the jawbone always shrink after a tooth extraction?
Yes. Some bone loss is expected after a tooth is removed because the jaw no longer needs to support the tooth root. How much the bone shrinks varies depending on the anatomy and condition of the extraction site.
Can bone grow back after an extraction?
New bone normally forms inside the socket as it heals. However, this process does not restore all the width and height lost from the outside of the ridge.
Is a bone graft necessary after every extraction?
A graft may not be needed if the tooth will not be replaced or if the remaining bone and treatment plan do not require it. We can assess the site and explain whether socket preservation offers a meaningful benefit.
Can I still get an implant years after losing a tooth?
Often, yes. Imaging can show whether enough bone remains for implant placement. If the ridge has become too narrow or short, grafting may help rebuild the necessary support.
