Do you have a missing tooth (or teeth) that need to be replaced? Throughout our lives, teeth can be lost for a variety reasons. They can be lost from tooth decay, periodontal disease, nutritional neglect, and accidents. Missing teeth can compromise your eating habits, speech, health, and appearance. The loss of a front tooth can negatively affect the appearance of your smile, your speech, and your self confidence. Losing a tooth in the back of your mouth can lead to a number of issues affecting your ability to chew, your ability to properly clean your teeth, jaw collapse, teeth shifting, and the health of your remaining teeth. Replacing a lost tooth will prevent further destruction and help save your remaining teeth. Replacing lost teeth can save you time, money, keep you healthier,and prevent many other oral difficulties in the future.
The loss of a single tooth can start a devastating chain reaction of events. After a back molar tooth is lost, a series of destructive events occurs including the displacement and tilting of other teeth around it including a supra eruption (when a tooth continues to grow into the mouth because it is not being kept in place by it’s opposing tooth) of the tooth above it, decay, drifting and formation of periodontal pockets. Eventually, bone loss and periodontal disease, to the teeth surrounding the lost tooth, tend to cause further destruction. If you fail to replace a lost back tooth, you may cause the loss of other teeth.
What Can Happen If Lost Teeth Are Not Replaced?
-Shifting of Teeth - When a tooth is lost, for whatever reason, the surrounding teeth will begin to drift into the open space. This includes both adjacent teeth as well as teeth in the other arch. A once straight smile can quickly turn into a crooked one. Replacing a lost tooth sooner, rather than later, can prevent this from happening As the number of lost teeth increases, the further the damage to the overall eveness of the bite and, making it harder to replace later on. The altered position of teeth causes the forces to be applied incorrectly while chewing, making fractures and bone loss much more likely. The incorrect forces also cause wear which can result in loss of tooth height and subsequent facial changes.
-Temperomandibular Joint Issues (TMJ Disorder) - As your teeth shift out of their normal alignment, bite issues usually develop. When the upper and lower teeth do not meet properly, it can strain and eventually damge the TMJ. This can lead to head, jaw, and ear pain, headaches, dislocations, clicking and popping, as well as permanent damage to the joint.
-Periodontal Disease - When teeth begin to shift, it makes it that much harder to keep your teeth clean. It will be harder to brush and floss certain areas which have, essentially, created a trap for plaque and food debris to build up. When plaque and bacteria are not removed and allowed to build up the result can be tooth decay and periodontal disease. When teeth shift and drift, they oftentimes create a root exposure problem, and allow forces to move them in unnatural ways. This can loosen teeth, and make them very sensitive. Periodontal disease can lead to further tooth loss.
Patients have multiple options when teeth are lost. They can include fixed ( permanent and not removable) or removable options. These procedures can include:
-Removable Dentures - This option has been the longstanding traditional option when multiple teeth are missing. Removable dentures are often the fastest and least expensive alternative in the short term. There are some disadvantages to removable dentures. Removable dentures work by attaching to exisiting teeth. This often leads to these “anchor” teeth becoming loose, worn, decayed, or broken. There can also be bone loss under the denture, which over time will make the denture more and more mobile and uncomfortable. Removable dentures can also be inconvenient to clean after eating especially if out at a restaurant. Lastly, removable dentures have about 1/3 the chewing power and efficiency of natural teeth. This can lead to poor chewing and lack of good nutrition in one’s diet.
-Fixed Bridge - This entails cutting down surrounding teeth, and fitting them with fused crowns to replace any missing teeth. The most popular type of fixed bridge is called a 3 unit bridge. This means that the two natural teeth adjacent to the missing tooth serve as anchors. This is a very stable option but does also have disadvantages. Disadvantages include:
-Removal of good tooth structure from adjacent teeth.
-Difficulty maintaining good dental hygiene under bridges as normal flossing is not possible
-Long term prognosis of most dental bridges in between 8-10 years before it needs replacing. This is an average. Some bridges can and will last longer.
-Dental Implants – Dental implants are the largest initial investment, but most cost effective long term solution for replacement of missing teeth available today. The main disadvantage to dental implants is the time it takes to be completed. Following placement of the dental implant a 4-6 month healing time is generally needed before the tooth can be restored. Dental implants are the ideal solution for many tooth replacements in dentistry today.
-All on Four Dentures - When many or all teeth are lost, or if you are rapidly progressing to full mouth breakdown, This dental implant/denture option is an excellent choice. The best thing about this procedure is that you have your entire procedure done and walk out with teeth the same day. There are usually 4 dental implants placed and a titanium bar supported denture placed. It is screwed down, but can be removed if needed. The biggest negatives here are price, and post operative possibility of bruising and discomfort while healing.
Tooth Replacement Conclusion
Tooth loss can happen at any time to anyone. Losing a tooth due to a trauma, disease, habits, etc. can be a big problem for a variety of reasons. If not replaced, they can cause issues for you including bone loss, periodontal disease, and more tooth loss. Replacing lost teeth as soon as possible will save you discomfort and greater expense in the future. Knowing your options, and being informed can help you and your dentist come up with the best treatment options for you. Remember, sooner is better than later, but know that whenever you are ready to move forward with tooth replacements there will always be options!