You will lack a certain amount of zooplankton that settle and live and reproduce in the sand. And you will lack the biofilter that develop in the sand.
I was on the edge about removing the sand in my nano but before I put the sand my little blue legged hermit crab were always stuck upside down because they had no grip to move around on the glass, so I did put sand just so that they can move easily and the look is MUCH better too.
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More fish die from human stupidity than any other disease...
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