Missing Teeth
Why replace Missing
Teeth? There are several reasons that you want to replace a missing tooth
or teeth. A tooth has many functions some being to chew, to speak, to keep
the facial muscles and tissue in a proper position, to smile, and to keep
the other teeth from shifting. Once a tooth is lost this whole balance is
disrupted and it leads to many various problems.
Once a tooth is
lost the teeth start to shift, this make take some time to notice but it
happens fairly rapidly. After a few years the size of the opening has
closed dramatically. What used to be a fantastic smile is a gapped hole
smirk. Some just prefer not to smile big anymore because they are
self-conscious of their looks. The cheeks or the lips can appear sunken
in. You may speak differently and sound differently. What once was a
stable bite is now changing. What once was a self cleansing tooth
arrangement is now a plaque trapping nightmare. Chewing can be more
difficult and tooth decay becomes more prevalent. These are just some of
the effects of losing a tooth. This situation can cause TMJ problems and
can cause headaches and other discomfort. To minimize the possibility of
problems the missing tooth should be replaced promptly. There are a many
ways to replace that missing tooth or teeth. The most popular are listed
below.
Conventional Fixed Bridge
Implants
Removable Partial
or Full Denture
Conventional Fixed Bridge
The conventional fixed
bridge is a tooth replacement that is attached with cement to the adjacent
natural teeth. If you have one or two missing teeth on a single side this
can be the best method of replacement. If the two teeth adjacent to the
space are healthy and the supporting structure (bone and gum tissue) are
adequate a fixed bridge can be placed. The only drawback is that the teeth
have to be prepared for a conventional bridge to be placed. The
preparation requires 1.5 to 2 mm of tooth structure to be taken off the
outside of the tooth. If the teeth have no restorations in them it is hard
to decide whether to prepare perfectly good teeth. If this is the case
perhaps an implant is better suited in that area.
The procedure
takes usually two to three visits and is outlined below.
The first
visit is just like that of a crown, at the first appointment your dentist
will numb the area and prepare the teeth by removing 1-2 millimeters of
the natural crown away until the weakened portion of the tooth is removed
(if any) and solid tooth structure remains making sure there is sufficient
space for a porcelain or gold bridge to fit over the tooth and that the
two teeth draw together. This procedure requires a great deal of skill and
precision to ensure a successful result. The bridge must fit perfectly to
prevent further decay and gum disease. This bridge will also restore the
patients bite, prevent shifting of the teeth and must look good. After the
preparation is completed, an impression of the area is taken to be sent to
the laboratory. At the laboratory the lab technician will fabricate a
bridge to the dentist's specifications. The dentist will then place a
'temporary bridge' on the teeth to protect the preparations, allow you to
function on the teeth, keep the adjacent and opposing teeth from moving
and allow you to smile while your bridge is being fabricated.
At
the second appointment, the bridge is bonded or cemented to your natural
tooth. Your new bridge should look natural and feel comfortable in your
mouth. It is vital that you take care of the bridge and associated teeth.
The margins are areas that are susceptible to decay and must be kept
clean. You must use bridge threaders and clean under the bridged area. If
you take care of your bridge it can last 5 to 15 years or even longer.
The cost of a bridge is usually equivilent to the cost of the
number of teeth being replaced times a cost of a single crown. This
procedure should only be used in replacing one or two teeth on a single
side. If a larger span bridge is desired the procedure is different and
can cost more. Please contact us to see what would be right for you. Back to Top
Implants
Implants are used to replace a
single tooth, many teeth on one side, or used to support an entire fixed
or removable bridge replacing all the upper or lower teeth. The most
common implant used today is the osseointegrated implant. This implant is
placed in a hole which is drilled into the patient's lower or upper jaw.
Depending on the number of teeth being replaced, one or more implants are
placed in the bone. If neccessary a substrucure is fabricated and then a
crown, bridge or denture is securely fastened to the substructure or
implant.
Implants are useful for patients that have tried but
can't wear conventional dentures. Patients that lost a tooth, have two
teeth with no or small fillings adjacent to the hole and don't want to cut
the teeth down to make a bridge, would also make good candidates. In
either case the patient has to commit to good oral hygiene. Implants are
usually placed in outpatient settings and have a healing phase of 3 to 9
months.
There is a significant investment involved to place the
implants as well as restore them. They can be placed by periodontists,
oral surgeons, or trained general dentists. So make sure to keep the
implanted areas healthy, by brushing and flossing daily. More information
click here. Back to Top
Removable Partial or Full Denture
A partial or
full removable denture is a set of artificial teeth that are not fixed
permanently to one own natural teeth. This set consitsts of usually
plastic teeth set in an artifical plastic or plasic and metal framework
that rests on the gum tissue. A partial denture is used for people who
have multiple spaces on one or both sides or whose teeth are not strong
enough to support a fixed bridge. If the back tooth is lost on a fixed
bridge the only way to replace that tooth would be to place a partial
denture or an implant supported denture or bridge. A partial denture
usually has clasps or arms that fit around the existing natural teeth and
use them for retention. The plastic base just sits on top of the gum
tissue.
A complete denture is just that, it replaces all the teeth
on either the top or bottom jaw. The full denture can be the most
difficult restoration to get accustomed to. The lower jaw offers little
resistence to displacement. Therefore the lower denture tends to move
around quite a bit. This movement only causes further atrophy of the
jawbone itself, making the denture less and less retentive.
The
upper denture can create a seal using the soft palate (roof) of your
mouth. This seal can be adequate to keep this denture in place. You can
and do get resorption of the bone but it is significantly less that the
lower.
To fabricate a denture it usually takes approximate 5-7
visits over a period of at least a month. Preliminary and final
impressions are taken, teeth are selected, the denture is tried in, and
then after proper teeth placement is established the denture is processed.
After the denture is delivered there probably will be a few, to many,
adjustments needed to make minor adjustments.
Partial and full
dentures can last many years. They periodically need to be relined to
compensate for lost bone.
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