We understand how missing a natural tooth not only affects your smile and personality but can also seriously affect your ability to eat and speak. Therefore, you must replace your missing teeth as soon as they are lost. Maintaining good oral health is essential for overall well-being.
This article offers various options that can be utilised by your dentist when it comes to permanent replacing your missing teeth. But, before we discuss tooth replacement options, we must understand why replacing missing teeth is important.
Why should I replace my missing teeth?
Here are the problems which can arise if you do not get your lost natural teeth replaced in time.
Aesthetics
A missing tooth can hurt your smile and facial aesthetics, especially if it becomes visible whenever you smile or speak. Issues such as advanced gum disease can damage the supporting structures of teeth and potentially result in the tooth falling out. Regular dental check-ups are crucial for preventing tooth decay, so scheduling routine check-ups and cleanings with your dentist is important.
Chewing Efficiency
Speech Efficiency
Tooth Misalignment
When a tooth is lost, the neighbouring teeth gradually start to creep into the gap. As a result, spaces start to appear between the teeth, causing cosmetic as well as functional dental problems, such as food becoming stuck and causing gum issues. The neighbouring teeth will also collapse inwards into space, and become crooked. To replace a tooth in the gap, the collapsed teeth will need to be uprighted beforehand. Accidents or injuries to the mouth can cause teeth to be knocked out or damaged beyond repair.
Bone Resorption
So, what are my options?
Now, we come to the options available for replacing missing natural teeth.
1) Dentures
Removable partial dentures are a good option for replacing a missing tooth. Dentures are removable appliances that derive their support from the underlying oral soft tissues and neighbouring teeth with the help of metallic extensions called clasps. They are made from acrylic resins or metal alloys and they can be used for replacing one, multiple or all missing teeth in the jaw.
Pros of Removable Dentures
- Cost – Removable dentures are one of the most cost-effective options for replacing missing teeth, especially multiple missing teeth.
- Repairability – Dentures, if accidentally cracked or fractured, can be repaired in many cases at the dental laboratory.
Cons of Removable Dentures
- Unsightly when removed - Dentures need to be removed every night before sleep, which will expose the gaps in the teeth. If dentures are broken or lost, it will not be able to be worn, affecting the appearance. Also, teeth support the lips and when dentures are taken out, it usually collapses the lips, leading to a wrinkled collapsed in appearance.
- Stigma of having missing teeth – As the dentures are not fixed inside the mouth permanently, you will always be aware that the teeth are missing. ‘False teeth’ are associated with old age and loss of youth, which is undesirable.
- Can drop out or float away – Dentures have been known to fall out when laughing too hard or sneezing. In the water, they can also come loose and float away.
- Short Life Span – Removable dentures are prone to loosening, cracking and fracturing. Therefore, they frequently require repair or permanent teeth replacement.
- Insufficient Chewing and Speech Efficiency – As the denture is a floating piece on the gum, many denture wearers often complain of difficulty in their ability to chew food or speak, even when they are using dentures for replacing their missing teeth.
- Cannot eat certain foods – Sticky, crunchy, hard, chewy foods are unable to be eaten easily and meat and vegetables often need to be cut apart before eating.
- Staining – Despite good care, removable dentures tend to get stained very quickly and lose their aesthetic appearance.
- Bone resorption – Since dentures rest on the oral soft tissues and the jawbone, they tend to increase the rate of resorption of the underlying bony tissue. Loss of bone will cause more loosening of dentures and
2) Bridges
Bridges, are fixed prosthetic devices. As fixed prosthetic devices, dental bridges rely on the surrounding teeth for support to "bridge" the gap created by missing teeth. Dental bridges consist of crowns which rest on the supporting natural teeth present on both sides of the missing tooth gap. The gap is then hidden with a crown which is used for replacing the lost teeth.
Pros of Dental Bridges
- Feels natural – Because it is fixed permanently to the teeth, removing it is unnecessary. It becomes a part of you and will be comfortable when eating, and speaking.
- Superior Functionality – Unlike the removable denture, a bridge remains attached to the teeth. As a result, it offers superior functionality in terms of chewing and speech efficiency. All types of food can be eaten as per usual.
- Superior Clinical Life – Compared with removable dentures, dental bridges tend to last longer, sometimes even more than 10 years.
- Aesthetics – Aesthetically pleasing crowns can be used with bridges, restoring your natural facial aesthetics and smile without looking fake or out of place.
Cons of Dental Bridges
- Need for Natural Tooth Preparation – In the case of bridges, the enamel layer of the supporting natural teeth needs to be removed slightly, to create room for the attachment of the bridge.
- Difficulty in Oral Hygiene Maintenance – Need to use a special floss or interdental brush to clean under the bridge, to clean out any trapped food or bacteria.
- Longevity- May need to be replaced after several years.
3) Dental Implants
A dental implant is a screw-shaped fixture made from titanium alloys, which is directly embedded within the jawbone to serve as the root component of an artificial tooth. Once an implant becomes firmly embedded inside the bone, a suitable prosthesis like a crown, denture or a fixed complete bridge is attached over it to complete the artificial tooth structure. Dental implants offer a permanent solution for maintaining oral health, owing to their excellent durability and strength.
Pros of Dental Implants
- Superior Functionality – Implants fuse with the bone around them. This phenomenon, known as osseointegration, ensures that the implant remains firmly anchored within the bone. As a result, you can enjoy your favourite foods without having to worry about the slipping or dislocation of your artificial teeth. Not only this, but dental implants also allow you to speak clearly and without any difficulty.
- Does not affect the neighbouring teeth – Implants can be placed in a gap to replace a tooth, and does not need the neighbouring teeth to be cut in order to do so.
- Can replace more than one tooth – Two or more implants can be used to replace multiple teeth in the same space. For example, in a case where all the teeth are missing from the upper jaw, four implants can be placed to replace all twelve teeth of the top jaw.
- Durability – Dental implants are made from high-quality titanium alloys, which make them very strong and durable. They do not decay, and are stronger than natural teeth. In fact, with proper care, you can expect your implant-supported teeth to last for a lifetime.
- Excellent Clinical Success Rates – Dental implants have an overall success rate of more than 98% and can last for more than 10 years.
- Safety – Dental implants are made from titanium alloys, which are known to be biocompatible and safe for use inside the human body.
Cons of Dental Implants
- Cost – Due to the surgical procedures involved and the multiple visits required for preparation, dental implants tend to be more expensive than other dental restorations.
- Need healthy bone and gums – As dental implants are supported by the bone and gums, these need to be kept in a healthy condition for the implants to last. This can be maintained by good brushing and flossing, as well as regular scaling and polishing at the dentist.
- Time – As the implant is placed in the bone, it takes time to heal, which may be a few months.
- May need a second surgery for bone grafting – If the tooth has been lost for a long time, the bone in that area will slowly be removed away by the body. In some cases, the bone may need to be built up by a bone grafting surgery beforehand, which will take more time and cost.
Conclusion
Choosing the right method for replacing a missing tooth depends on individual needs and preferences, your dentist is the best person to advise you regarding the best option for you.
However, dental implants have nowadays become the most preferred option for tooth replacement, both among patients and dentists. If you also want to get your smile and confidence back by replacing your lost teeth, then dental implants should be your first choice.
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References
- Boretti G, Bickel M, Geering AH. A review of masticatory ability and efficiency. J Prosthet Dent. 1995 Oct;74(4):400-3. doi: 10.1016/s0022-3913(05)80381-6. PMID: 8531159.
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Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database of Systematic Reviews 2014, Issue 5. Art. No.: CD008397. DOI: 10.1002/14651858.CD008397.pub2. Accessed 15 May 2024.