I have missing teeth, what are my options?
It can be challenging to decide what to do, after losing a tooth. Your teeth support your health and well-being. Missing teeth may affect the comfort and function of your mouth, your ability to eat a variety of nutritious foods as well as your speech. Gaps in the mouth can also cause esthetic changes as teeth shift to fill in the missing space. Fortunately, in the event that you lose a tooth or need to have a tooth extracted there are several options available to you. You can do nothing, have a partial denture, a bridge or a dental implant.
The first decision, and easiest, is to leave an empty space where the tooth was removed. While this may be the least expensive option, it can result in unsightly gaps and spaces between teeth, and can also make chewing more difficult. In addition, adjacent or opposing teeth may sometimes drift into the empty space, causing bite or gum problems.
If, like most people, you decide to replace the missing tooth, the following options may be available to you.
Partial or Complete Dentures
Dentures are false removable teeth that are relatively quick and easy to make. They can be partial, where only one or a few teeth are replaced, or complete, where all the teeth are missing in the jaw and are replaced.
A partial denture holds false teeth on a plastic or metal framework. The framework is removable, and is designed to fit around the adjacent teeth. It may cover part of the gum tissue or roof of the mouth. There may also be hooks and rests to help hold the framework in; these can sometimes be visible when smiling. Dentures should be removed nightly for cleaning, and to allow the gum tissue to “breathe” and to minimize stress on the anchor teeth.
A bridge uses natural teeth adjacent to the empty space, to support a false tooth/teeth between them. The natural teeth need to be shaved or contoured, so that a crown (cap) can be placed over top. These are called the abutment teeth. The crowns on each tooth support the false tooth in between, known as the pontic tooth. Bridges are excellent solutions if the adjacent teeth already require crowns for unrelated reasons (e.g. large fillings that are at risk of fracture).
A dental implant is a cylindrical and/or tapered post, usually made of titanium that serves as a substitute for the tooth root. Dental implants are often the best treatment for missing teeth. When a damaged or decayed tooth is removed, both the visible part of the tooth, called the crown, and the root are lost. A dental implant is placed in the jawbone so that it can fuse with your natural bone and become a strong and sturdy foundation for a replacement tooth/teeth. Implants can be used to replace an individual tooth or for an implant-supported bridge or denture containing multiple teeth. Dental implants are the closest you can get to healthy, natural teeth. They will allow you to confidently eat, smile, laugh, talk, play and enjoy all of your regular activities of everyday life without worrying about your teeth.
When a tooth is lost, the jawbone in the area shrinks. Dental implants help to support the maintenance of the bone.
Advantages of Dental Implants
When looking at the advantages of dental implants, it is helpful to compare them against the other above options to replace missing teeth.
Compared with Partial Dentures
Many patients prefer implants over partial dentures as implants are fixed in place and are not removed nightly. Implants can also be more esthetic, as they do not have hooks or clasps that can be visible when smiling.
Compared with Conventional Bridges
In situations where the natural teeth (abutments) are completely healthy, shaving or reducing them to prepare for a bridge “damages” them unnecessarily. Furthermore, should any of the natural teeth/abutments be lost for any reason (e.g. decay or gum disease), the entire bridge is usually lost as well. In contrast, implants do not affect the adjacent abutments; they are placed only in the positions where teeth are missing, and do not rely upon the adjacent teeth.
In addition, bridges can generally only be placed where there are natural teeth/abutments on either side of a space (except for limited-use “cantilever bridges”). In contrast, an implant can still be placed even in situations where an abutment is missing.
Which Option to Choose?
Ultimately, the option that is chosen to replace missing teeth depends on many factors including your concerns, finances, and goals for treatment. A discussion between yourself and us will help to determine which treatment is the right one for you.