Aesthetic: gaps in teeth tend to prevent people from talking and smiling freely. Missing teeth and resulting bone loss result in sunken cheeks, loss of facial support, and a shorter nose to chin distance, causing an aged appearance.
Function: Speech and chewing are quite obviously affected. Many people are unaware that gaps in your teeth actually make it harder to clean the remaining teeth effectively, putting your oral hygiene at risk.
Shifting of teeth: When you lose a tooth, the tooth behind it tilts forward into the open space and the tooth opposite it moves up or down into the open space. These misaligned teeth are at higher risk for periodontal disease.
Bone loss: Bone in your jaw is stimulated by the slight movements in the teeth that are present. When a tooth is gone, the stimulation stops and you can expect loss of about 25% of bone width in the first year and 4 millimeters of height loss over the next few years. This leads to some particularly serious aesthetic and functional problems
There are so many treatment options for patients missing all, several, or just one tooth. Here we explain three tooth replacement options with some of their pros and cons. There are other options and combinations of treatments that can be devised for your particular needs.
Implant: In the surgical phase, an implant is placed into the bone where the tooth is missing. During the healing process of several months, the implant integrates into the bone. In the restorative phase, the dentist makes a crown to place on the implant via an abutment.
- Looks and feels much like a natural tooth.
- Easy to care for – similar to natural teeth.
- Good longevity. Costs over your lifetime can be less than fixed bridges.
- Very few contraindications for treatment.
- Very comfortable and easy procedure with minimal post op discomfort
- Help prevent loss of bone in jaw due to missing teeth.
- May require separate procedure for bone grafting or sinus lift if bone loss is significant.
- Total time to finish treatment can take months.
- Up front cost can be more than for a fixed bridge.
- Some factors such as smoking and uncontrolled diabetes can slow healing and lower prognosis.
Bridge (Fixed partial denture): The dentist prepares the teeth on either side of the gap so the bridge can be attached. The bridge is fabricated in a dental lab from an impression. The bridge, made up of a pontic (the replacement for the missing tooth) connected to a crown on each side (the caps that cover the attachment teeth), is cemented into place.
- Lower up front cost and more insurance carries cover it.
- Time to finish treatment significantly less.
- More difficult to clean.
- Difficulty cleaning abutment teeth, leads to likelihood of recurrent decay, resulting in bridge replacement. This adds to lifetime cost of a bridge.
- Anatomical irregularities may create annoying food traps as bone recedes over time.
- Requires cutting of healthy neighboring teeth.
Removable Dentures and Partial Dentures: As the name implies, these are removable for cleaning the appliance and around any remaining teeth. The procedure for partial dentures may require some dental work on your remaining teeth. They are fabricated in a dental lab from impressions and measurements taken by the dentist. They generally require several adjustments once the appliance is delivered to achieve maximum comfort. The process can take several weeks.
- When replacing several or all teeth, the cost is lower.
- No surgical phase and minimal or no cutting of healthy teeth to support it.
- Most repairs and maintenance are easy
- Do not function as or feel like natural teeth.
- More areas for food to catch.
- Takes some time and effort to get used to.
- Over time, continued bone loss can cause denture to no longer fit. May need replacement more often than other options.
- They can break if you drop them or clench down hard.
- Can have some occasional discomfort