When patients come to us with missing teeth, says Dr David Kerr, they often complain about 2 things:
1. Trouble eating
Missing teeth affects your ability to chew and limits the foods you can eat easily. As you get older, nutrition can become an issue.
2. Self-conscious about appearance
If you lose lots of teeth, it can change the way your face looks and how you age.
Why replacing a missing tooth is important
“People who are missing one or two teeth often don’t see their dentist because they’re embarrassed and leave it until they’ve lost several,” says Dr Kerr. “Then there are others who think, Oh well, no teeth, no problems. No! That’s not the case.”
1. You can lose even more teeth
When a tooth is gone, your jawbone loses the functional anchor that keeps the bone stimulated. The body thinks it doesn’t need the bone there anymore, so it absorbs the old bone tissue (resorption). Less healthy jawbone means there’s more chance of losing the teeth you still have.
“In patients who’ve lost many teeth, 40% to 50% of the available bone volume disappears within six months,” cautions Dr Kerr. (This is less evident in patients who have only lost a tooth or two.)
2. It can cause problems with your bite
When you lose teeth, your remaining teeth drift and bacteria increases, then comes a cascade of bite-related problems until your bite collapses.
“When you lose significant numbers of teeth, eventually the profile of your face can change,” says Dr Kerr.
“As horizontal bone width is lost, the lower half of your face can start disappearing. In cases of severe bone resorption, some people’s nose can touch their chin.”
3. Gum disease can develop
This can result from teeth that have become difficult to maintain, the added pressure on the jaw joints, and poor nutrition as a consequence of not being able to eat the foods you need.
So what can I do for a lost tooth?
Come in and see your dentist. We’ll have a good look at your teeth and talk with you about missing tooth replacement options.
Here are some things to think about:
- Do I want new teeth that are removable or fixed?
- How much can I afford to spend?
- How soon do I want this sorted out?
3 missing tooth replacement options
- Partial dentures – for one or a couple of missing teeth
- Complete dentures – replace all or multiple missing teeth
- An impression is taken of your teeth, then the dental lab makes an acrylic plate with prosthetic teeth
- The plate fits into your mouth and gums
- Economical – but low cost is really their only advantage
- Issues with fit and comfort – if there’s a large area of missing teeth there’ll be more bone loss, causing gaps to appear under the dentures and problems with the way they fit
- Can be irritating and move around in your mouth – “While some people wear dentures successfully, we find many patients tolerate wearing them rather than love them,” says Dr Kerr
- Need to be removed at night
- Not a long-lasting solution – as teeth shift in your mouth, dentures need to be replaced every few years
A prosthetic tooth (ceramic crown) is bonded to the tops of the prepared teeth, holding the new tooth in place.
- Fixed solution, unlike dentures – while bridges are old school, they work well
- Replace one missing tooth, or several (joining multiple ceramic teeth together is called a long-span bridge)
- Invasive – the re-contouring procedure removes natural, healthy teeth structure
- Hygiene maintenance can be a problem – food can get caught underneath the bridge and it’s more difficult to clean
- Possible problems with long-span bridges – the longer a bridge gets, they can flex and put pressure on other teeth
3. DENTAL IMPLANTS
Of all the missing tooth replacement options, a dental implant most closely mimics the natural anatomy of your teeth. “They’re the closest thing we can give you to having your tooth back,” says Dr Kerr.
- A titanium fixture (abutment) is surgically implanted in the jawbone and acts like the ‘root’ of the tooth (titanium is used in orthopedic surgery to put hips, knees and broken bones back together)
- The implant is like a screw and forms a functional, structural connection to the jawbone
- It integrates with the jawbone and heals (osseo-integration), which can take months
- A prosthetic tooth (ceramic crown) is attached to the implant, securing the tooth in position
- Highly successful one-tooth solution, particularly around other healthy teeth
- Suitable for replacing multiple missing teeth – a long-span bridge (with two or three teeth) can be attached to one implant
- Permanently fixed
- Prevents bone resorption – the jawbone is stimulated again, preventing the bone from disappearing and re-establishing function
- Not subject to tooth decay
- Prosthetic tooth is very strong – prevents other teeth from shifting and restores chewing function
- Highest-cost option
- Procedure takes the longest time to complete
- Not suitable for all patients
- Healthy jawbone is key – how well the implant integrates with the bone determines its success
Feeling lost with a lost tooth?
“You need to be thoroughly assessed to see if you’re a good candidate for any of these missing tooth replacement options,” says Dr Kerr. “Then you and your dentist can work out which is best for you.”