REPLACING MISSING TEETH
A person may have a missing tooth/teeth for several reasons. The most likely reasons, as an adult, is a result of either severe gum disease or, dental decay, or trauma. Your dentist may have suggested a few options to replace the extracted tooth. This page will hopefully help you make your decision.
Need more help in making your decision? Download our Missing Teeth Treatment Options PDF here for more information, or call us on 07 3188 9477.
1. NO TREATMENT
Although most dentists agree that this option is not a viable one, it is helpful to know what the risks and benefits are for leaving a space in the mouth. The only positive thing about leaving a space is that there is time to decide on how to replace the tooth or teeth so you do not have to rush into a treatment.
The analogy to think about is like driving a car with 3 wheels. The car will still be able to move, but over time, the car will start to breakdown slowly in different places because it is compensating for that missing wheel.
It is the same with a missing tooth. You may not feel it initially, but over time, it can affect the gums, teeth, muscles and the jaw joint.
The picture above gives a common transition of the teeth when the gap between the teeth is not replaced.
- the surrounding teeth start to tilt/drift into the gap, causing other spaces between teeth to open up. This in turn allows further risk of decay and gum disease to affect the adjacent teeth
- the opposing tooth starts to fall into the space. This causes the top tooth to become more sensitive and looser
- due to the gap, the chewing efficiency is less on that side. So now, there is a tendency to favour the other side, usually leading to jaw joint pains, clicking and muscle aches, and ultimately affecting the teeth on the opposite side as well.
So below are some options to consider to replace the missing tooth.
2. A FIXED BRIDGE
A bridge, as the name implies, fills the gap left by the missing tooth. The approximate longevity for a bridge is 7-15 years, although some can last upwards to 20 years.
Fixed Bridge – two crowns are made for the teeth on each side of the gap, and a false tooth is anchored between them. This is a non-removable option.
There are some drawbacks though. The healthy teeth adjacent to the missing tooth need to be ground down and capped or crowned. The capped teeth are weakened in the process, and often fail over time, creating more problems, such as, further decay, the need for root canal treatment or further tooth loss. Also, the bridge does not address the problem of bone loss. The bone in the area where the teeth are missing can continue to deteriorate, and eventually cause other problems.
Cleaning under the bridge is also an issue, and the use of special flosses are required to clean this area effectively.
3. A REMOVABLE PARTIAL DENTURE
Most spaces can be filled with a removable denture. The primary advantage of this option is the reduced cost compared to that of bridgework or implants. The procedure is also less invasive (no surgery involved, and little or no adjustment to the existing teeth) and is reversible. These appliances typically last about 10 years.
A removable partial denture – made of plastic and metal that clip to adjacent healthy teeth in order to fill the gaps created by missing teeth
The difficulties that come with dentures tend to be many. Many people who wear partial dentures say they are reluctant to smile or laugh in public because they are afraid their denture may slip, or that the wires may show. They can impact the ability to eat, since it can fall out. Removable partial dentures can increase the build-up of plaque around the supporting teeth, which can lead to tooth decay or gum disease. Pressure or movement of the partial can result in trauma to the surrounding teeth or gums.
Just like bridges, dentures do nothing to prevent loss of bone in the jaw. In fact, if the dentures are not supported well, it can lead to further damage to the surrounding bone and gums, causing the existing teeth to become sensitive and loose.
4. A DENTAL IMPLANT
Rather than resting on the gum line like removable dentures, or using adjacent teeth as anchors like fixed bridges, dental implants are a long-term replacement for missing teeth. They look, feel and function most like a natural tooth, mostly because they are fixed in place. Dental implants, if properly maintained, can last a lifetime.
Dental implants are metal anchors that are surgically placed into the jawbone. Small posts are attached to the implant and provide stable anchors for the replacement crown.
In the case of dental implants, the positive tend to outweigh the negative. No healthy teeth are damaged as part of implant treatment. Not only is the gap left by the missing tooth filled, so is the root. The implant integrates with the jawbone and the implant and crown perfectly mimic the function of a natural tooth. One disadvantage is the length of the treatment. Often, the implant is placed and there is a waiting period of 1-3 months before applying the crown, so that the implant can fuse with the bone. Another drawback cited is cost. However, a dental implant is a one time cost and it preserves the other healthy teeth, gum and bone in your mouth. The other options may need to be replaced once or twice in a lifetime and can cause further damage. In the end, the other options may wind up to be costlier.
Overall, your options are many, including a bridge, partial denture, dental implant or leave the space. However, patients must understand all their options prior to making decision and they should know the risks and benefits of each procedure and the likely outcome.
At Aperture Dental we are happy to explain each procedure until you thoroughly understand the basic nature of it.