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Except for wisdom teeth, all missing teeth with tooth-sized spaces in the mouth should be replaced. Adjacent teeth can shift, opposing teeth can overgrow into the space, bone loss and plaque accumulation can occur, as well as changes in the bite, TMJ, and compromised chewing and nutritional issues. There are three ways to replace missing teeth. Removable Dentures, Fixed Bridges, and Implant-supported restorations. These are the Pros and Cons of each method, but remember, everyone’s mouth is different and your options may be limited.
Removable Dentures can be taken out of the mouth. They are the least expensive alternative and can restore the full arch (upper or lower) of missing teeth. They should be replaced every 8-10 years because of gradual bone loss. They can be very esthetic, however, they are bulky and attract plaque and may move a bit when chewing. Full dentures can be less efficient for chewing food and present some short-term speech issues. They require daily cleaning.
Fixed Bridges cannot be removed by the patient. They are a group of crowns that are in one piece that is cemented to the surrounding teeth, after those teeth are shaped. They are more expensive, very esthetic (if there is enough gum tissue around them), and much less bulky. They are meant to last at least 10 years, but it depends upon individual circumstances. Daily brushing and flossing underneath the bridge is necessary to preserve the restoration.
Implants are the closest restoration to natural teeth and also the most expensive. They cannot decay and usually do not have gum disease related issues if daily good hygiene is practiced. Implants can fail, but the long- term success rates are said to be greater than 90% for 10 years. Some patients are not good candidates due to health or smoking-related issues. Implants are the only restoration that preserves the bone around them. Implants are the supporting structures and can be used to retain removable dentures as well as fixed restorations. Single crown implant supported restorations can be brushed and flossed the same as natural teeth and do not require support from adjacent teeth as with fixed bridges.
If you google these terms and press “Images” you can see examples.
By Michael Acquista, DDS
October 1, 2021
