Quite often patients make a decision to have a painful tooth extracted (rather than save it) as an emotional quick fix to relieve pain.  Sometimes those decisions are based on the affordability of the proposed treatment of saving the tooth and having the offending tooth extracted is cheaper.  However, in the long run, there can be significant ramifications of losing a tooth and not having it replaced in a timely manner.  Two recent cases where upper molars where extracted and not replaced quickly resulting in the adjacent teeth in the area shifting and migrating into the missing tooth’s space.  Both of these patients returned about 12-18 months later requesting tooth replacement.  But, the problem now is that the shifted teeth are in the way to replacing the missing tooth. Either a dental implant or fixed bridge cannot be done because of the shifted teeth.  Also, the teeth below the missing tooth have shifted as well, and the bite in that area is less than ideal.  Furthermore, the patient has been chewing on the opposite side of their mouth and quite often, more wear and tear on those teeth become more evident.  Losing a tooth can cause a cascade of events in your mouth that can be damaging to your overall oral health.  What may seem to be a cheaper and quick remedy in the short term may lead to more extensive issues in the long run.  Careful consideration should be given to any decision regarding tooth extraction and only you and your dentist can make that decision together.