Tooth Replacement Options

If you’re missing one or more teeth, you may be all too aware of their importance to your looks and dental health. Your teeth are designed to work together to help you chew, speak, and smile. When teeth are missing, it is difficult to do these things. Even the loss of a back tooth may cause your mouth to shift and your face to look older. Fortunately, missing teeth can be replaced.The following are three tooth replacement options your dentist may suggest, depending on your needs. Replacement teeth should last for years at a time, so it is important to choose a treatment that’s right for you.

• Implants
• Fixed Bridges
• Removable Partial Dentures

Position of teeth immediately after a tooth is lost

If the tooth is not replaced, other teeth can drift out of position and change the bite. Shifting teeth can possibly lead to tooth decay and gum disease.

1. Implants

Many patients choose implants for a single tooth replacement, several teeth, or to support a full set of dentures. Implants are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth. They are made of titanium (a strong, lightweight metal) and other materials that are accepted by the human body.

Most patients find that an implant is secure and stable—a good replacement for their own tooth. However, implants are not an option for everyone. Because tooth replacement implants require surgery, patients should be in good health overall. Patients either must have adequate bone to support the implant, or be able to have surgery to build up the area needing the implant. Patients also should be ready to commit to a daily oral care routine and to regular dental visits.Chronic illnesses, such as diabetes or leukemia, may slow healing after surgery. Patients with these issues may not be good candidates for tooth replacement implants. Using tobacco can also slow healing. Your dentist can help you decide whether implant treatment is a good option for you.

What’s Involved?

There are many different kinds of implants. Treatment can take only one day, or it can take several months, or somewhere in between. Your dentist can outline a treatment plan that is most likely to be successful for you.

There are three general phases of implant treatment:

1. Placement of the implant: The dentist surgically places the implant into the jawbone. There may be some swelling and/or tenderness after the surgery, so pain medication is usually prescribed to ease the discomfort. Your dentist may recommend a diet of soft foods during the healing process.
2. The healing process: What makes an implant so strong is that the bone actually grows around it and holds it in place. This process takes time. Some patients might need to wait until the implant is completely healed, up to several months, before replacement teeth can be attached to the implant. Other patients can have the implants and replacement teeth placed all in one visit.
3. Replacing your missing tooth or teeth (prosthesis): The dentist or a lab will custom-make a crown, bridge or dentures to fit your mouth and your implants. Once completed, the man-made teeth are attached to the implant posts.

The prosthesis usually takes some time to make. In the meantime, your dentist may give you a temporary crown, bridge or denture. This can help you eat and speak normally until the permanent replacement is ready.

Implant-Supported Bridge

Missing teeth

A bridge is placed on implants

After the Bridge is placed

Advantages of implants:

• An implant is most similar to a natural tooth.
• Nearby teeth do not have to be involved in the placement procedure.
• Implants may last for many years, even decades.
• Some types of implants and artificial teeth or dentures can be placed in just one or two visits.
• Implants may help prevent shrinkage of the jawbone from tooth loss.

Disadvantages of implants:

• Implants are not right for everyone, since they require surgery.
• Implant placement may take longer and may require more dental visits than other options.
• Implants may cost more than other treatments.

2. Fixed Bridges

Another tooth replacement option is a fixed bridge. This is a restoration that fills the space where one or more teeth have been lost. A fixed bridge is bonded or cemented into place — only a dentist can remove it.

How is a bridge placed?

Placing a bridge usually takes more than one dental visit. On your first visit, your dentist prepares the teeth on either side of the gap. The bridge will later be attached to these teeth.

Your dentist then takes an impression of your teeth and the space and sends the impression to a dental laboratory. Technicians at the lab make the bridge out of metal, ceramics, glass-ceramics or a combination. Your dentist will place a temporary bridge to protect your exposed teeth while you are waiting for the permanent one.

When talking about bridges, your dentist may use these terms:

• Pontic: the replacement for your missing tooth
• Crown: a “cap” that covers the attachment tooth

During one or more follow-up visits, the bridge is fitted, adjusted and cemented in place.

Bridge Placement

Before the bridge, teeth are shown with the space where a tooth has been lost.

Teeth next to the gap are prepared for placement of the bridge.

The custom-made bridge is placed over the prepared teeth.

The bridge is cemented into place.

Advantages of fixed bridges:

• look, feel and function like natural teeth
• don’t require removal for cleaning
• cost less than implants

Disadvantages of fixed bridges:

• likely to be more expensive than removable bridges
• affect the teeth next to the bridge
• may require extra effort to clean under the pontic

3. Removable Partial Denture

As its name describes, a removable partial denture can easily be taken out of the mouth for cleaning. Partial dentures usually have replacement teeth fixed to a plastic base that matches the color of your gums. The plastic base may cover a metal framework. Partial dentures often have some form of clasp that attaches to your natural teeth.

Your dentist may also recommend crowns, or “caps,” on your natural teeth. Crowns may improve the way a removable partial denture fits your mouth.

Getting used to a removable partial denture

It takes practice to put in and take out a removable partial denture. It may feel odd or tight for the first few weeks. But in time, you should get used to it. Never force it into place by biting down. This could bend or break the clasps.

Removable partial dentures should not be worn 24 hours a day. Your dentist may tell you to take out the partial denture at bedtime and put it back in when you wake up. Usually your dentist will make follow-up appointments to look for pressure points or sore spots. He or she will adjust your denture so it fits comfortably.

Once your missing teeth are replaced, eating should be a much more pleasant experience. Since missing teeth can make it difficult to speak clearly, wearing a removable partial denture can help with that, too.

Over time, as you age and your mouth changes, your removable partial denture may no longer fit well. It also could break, crack or chip, or one of the teeth could loosen. Sometimes dentists can make the repairs, often on the same day. Complex repairs may take longer.

Removable Partial Denture

Partial denture being placed

Partial denture in the mouth (showing clasps)

Advantages of removable partial dentures:

• usually less expensive than fixed bridges or implants
• usually easier to repair than fixed bridges

Disadvantages of removable partial dentures:

• can be less stable than other choices
• they can break or be lost
• can be uncomfortable
• some people are embarrassed to take out their teeth at night and for cleaning
• may need more frequent replacement than other options

Explore All Your Options

Your best for tooth replacement is an important decision. Your dentist may refer you to a dental specialist for additional care. Here are some of the dental specialists who may be called upon:

• Prosthodontist — restoration and tooth replacement
• Oral and maxillofacial surgeon — dental surgery and treatment of the entire oral cavity, including neck and face
• Periodontist — treats periodontal (gum) diseases

Talk to your dentist. He or she can answer your questions and help you decide which option will work best for you: implants, a fixed bridge or removable partial denture.