Tooth Replacement
Are you missing one or several teeth? Are you considering having teeth removed and debating the replacement options available? Dr. Martha Dever understands that these decisions can be tough to make and can help you choose which treatment is right for you.
The primary options for replacing missing teeth are: dental bridges, dental implants and dentures. Each type of treatment has its own advantages and deliberations.
Dental Bridges
A bridge is a unit that allows for a link from one end of a space that is missing teeth to another, thus it "bridges the gap" for a missing tooth/teeth. The teeth at either end of an empty space are prepared for crowns, and then a crown is made for both of these teeth with the false teeth fused in the middle.
A bridge is best suited when there are only one or two missing teeth in an area that have a tooth in the front and back of the space involving the missing teeth.
Requirements for a solid bridge are that the remaining teeth are sufficiently strong to support the weight of chewing for the teeth that are missing. This decision should be made at the discretion of your dentist. For optimal success, a bridge requires careful cleaning with special floss beneath the false teeth, so that the gums and remaining teeth stay healthy and provide a long life for your bridge.
Dental Implants
A dental implant is the most lifelike replacement for a missing tooth available in dentistry today. An implant is a replacement for a tooth that involves replacing the original tooth root that has been removed with a false tooth root made of titanium metal.
Implants are placed under anesthesia in a procedure that generally takes about 45 minutes to 1 hour. Implants heal and fuse with the bone in your mouth for about 4-6 months, depending on the area that the implant is placed and an individual patient's needs. A crown or bridge is placed on the top of the implant(s) to replace the tooth/teeth that are missing.
An implant or multiple implants are best suited when there are teeth missing in an area that does not have teeth surrounding both the front and back of the empty area. Hence, a link is not possible between teeth to make a bridge. People congenitally missing teeth or that have randomly fractured just one tooth, may also decide an implant is very logical.
Finally implants can be considered the foundation for replacement of all of your teeth using a cosmetic denture on top of implants placed for anchorage. This is commonly referred to as an “All on Four” procedure where as few as four implants can be placed as the support for these cosmetic teeth replacements.
Dentures
A complete denture is used to replace teeth for either the upper or lower jaw or for both jaws, when all teeth in these areas are missing or need to be removed. Dentures are made as "false teeth" set into a pink acrylic material that serves as a base which covers the gums and bone where teeth are no longer present. Dentures can be made for the upper or lower jaws and can even be made as an immediate replacement for teeth the day they are removed.
A partial denture is used to replace multiple missing teeth in one or both jaws, as needed. They can be made as a temporary fix for a missing tooth while healing from the placement of an implant or can be made for permanent replacement of missing teeth. A permanent partial tends to have a metal base for solid support with pink acrylic and teeth on top. The denture is held in by “arms” attached to the other remaining teeth and can be made of either metal or clear acrylic. Temporary partials can be made as well as a holding place for a missing tooth or teeth while healing from the placement of an implant(s) or while waiting to decide on a final tooth replacement option. These are made of pink acrylic base with or without metal arms. Many people refer to this temporary partial as a “flipper”.
Some additional considerations:
Over the time a denture is worn, the pressure of the false teeth on the jaw bones causes the bone to resorb, or shrink away. When this occurs, a reline of your dentures is necessary to ensure proper function and prevent sores on the gums. Partial dentures may also require adjustments to the clasps or arms that surround the adjacent teeth to reestablish a tight fit, after a denture has been taken in and out of the mouth many times and the clasps have loosened.
Partial dentures are highly recommended over complete dentures for the lower jaw due to the issues of fit and stability. If there is any way to save some of the teeth for the lower jaw to allow for a partial rather than a full denture, it would be wise to consider this option. Otherwise it would be smart to consider using implants to support a lower denture.