How to Replace a Missing Tooth

“Yikes, I just broke my tooth and my dentist says it can’t be repaired. What do I do?”

It’s always an emotional experience to lose a tooth.   As a patient, it can be a difficult and confusing time to try to understand what to do next.  When considering how to replace a missing tooth, there are basically three options.

A partial denture: This removable appliance is the least sophisticated of the three options.  A partial denture is supported by the residual natural dentition and is clipped in and out of the mouth.  It should be removed before going to bed, placed in a hydrating solution overnight and then cleaned in the morning before placing it back into the mouth.  Most people find this to be inconvenient and a lot of hardware for replacing one or two teeth. There is also a stigma associated with wearing a removable partial denture.

 

 

A fixed bridge: A fixed bridge is permanently cemented to the adjacent teeth. This is an improvement over the partial denture since it does not have to be removed from the mouth at night. However, the adjacent teeth have to be cut down in size so that the supporting crowns for the replacement tooth can be of the same proportion. The replacement tooth (called a pontic) is soldered to the adjacent crowns and rests on top of the gum tissue, filling the empty space. These solder joints present a hygiene problem since you cannot floss these areas.  Special aids have to be used for proper hygiene around the pontic of the bridge.  Additionally, this restoration creates a situation where the two adjacent teeth are now supporting the chewing power of three teeth.

 

 

A dental implant:  A dental implant which is a titanium anchor surgically placed in the jaw where the tooth is missing. Once healed and integrated into the surrounding bone, a crown can be attached to complete the restoration.  The surgery, which can be performed in the oral surgeon’s office with either local or general anesthesia, is surprisingly simple and causes only mild post-operative symptoms. This is the preferred restorative method for the following reasons:

 

 

• Dental implants are permanent and do not have to be removed.
• Adjacent teeth do not have to be altered in size or manipulated in any way.
• Each tooth carries its own load, eliminating stress to adjacent teeth.
• Dental implants essentially replace the root of a missing tooth, which prevents bone resorption that is normally associated with tooth loss.
• Dental implants look, feel and function like natural teeth.
• Caring for dental implants is just like caring for natural teeth; you may brush and floss as normal.
• Because of improved hygiene and bio-mechanical loading an implant should outlast a bridge.

Therefore, if you are missing one or several teeth, a dental implant is the superior restorative choice.  However, not everyone is a candidate for dental implants.  You should consult with your general dentist or oral surgeon to see what option is best for you.