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Many of us are missing one or more adult teeth. Because they can still chew their food, they may believe that there is no need to replace any missing teeth. Even those with only a few front teeth sometimes believe that they are fine. Let me fill in the information gap. Without the wisdom teeth, which are not needed for proper chewing function, we have 28 teeth. Of those, the six front teeth in each arch (upper, lower) are incisors and canines- they are designed to tear apart the food. The remaining eight back teeth (premolars and molars) are designed to masticate, or chew and break down the food enough to safely swallow it. These are the first steps in digestion, and they were intentionally designed for these purposes. When back teeth are missing, the efficiency of chewing is reduced. If one needs to chew more before swallowing, oftentimes, one will develop an aversion to chewy foods. These things alter the choice and assimilation of foods and negatively affect our health. I have seen people with no teeth eat food and insist that they don’t want or need teeth. I guarantee that their nutrition is compromised, and there will be consequences.
But what about those missing only one or two teeth? We refer to the upper or lower set of teeth as an ARCH. Think of a stone arch that is supported by two columns. If a stone is removed from the arch, the integrity of the arch is broken. The other stones can shift and the arch weakens. If more stones are removed, the arch can fall and lose its function altogether. The teeth are designed to work together, and when the arch is weakened, teeth can now start to shift and cause problems from bone loss to TMJ, extrusion and tipping of teeth, bite collapse, and the breakdown of the whole apparatus.
Now that we have established the need to maintain a full complement of teeth for proper function, why are implants the best solution, and how many should be used? Implants are the only restorations that preserve the bone around missing teeth. They do not need to use neighboring teeth for support. They do not decay, incur very little bone loss over time (if properly maintained), and they are highly successful for the long term.
Finally, how many implants are needed? One implant for every missing tooth is recommended. This is the way to restore the design and function to as close to 100%. This article is meant to help you understand why all missing teeth need to be replaced. Every implant you get is a step in the right direction, but the goal should be to replace ALL missing teeth.
By Michael Acquista, DDS
July 28, 2023
