Missing teeth
In this week’s blog we will look at the options for replacing missing teeth and discuss the benefit of looking at orthodontic space closure as alternative or preparing the space properly before replacing the teeth that are missing to get the optimal result.
Bridges
A bridge is an easy affordable way to replace a missing tooth provided there is enough space to accommodate it. It replaces the gap with a porcelain tooth that it attached to one or two teeth next to it to provide strength and stability
What are the advantages:
It’s easily prepared and fitted within a few weeks so can fill the gap well, unlike a brace that could take up to 2 years to close a space
What are the disadvantages:
May involve some preparation of the adjacent teeth, sometimes extensively so potentially not reversible
If replacing a front tooth it may show a dark shadow on the tooth the bridge is attached to or a gap under the edge of the “false” tooth
Can lead to mobility of the teeth that it is attached to especially if heavy bite
Colour of the crown remains the same where other teeth will get darker with age so may need whitening to maintain this
Can be prone to coming off leaving you with a gap!
If the space is too narrow then any false tooth you put in there may look strange so only an option for back teeth, where it doesn’t show. If more space is needed to fit the right sized tooth in – you may have to have orthodontic treatment as well. Having a bridge doesn’t necessarily mean you avoid orthodontics
Implants
Replacing missing teeth with implants is a good option for patients, especially if they are concerned about the idea of having a bridge that could keep coming out. As the implant is screwed into the jaw bone under the gum the subsequent crown placed on top looks more like a natural tooth emerging from the gum
What are the advantages of having an implant
Looks more like a natural tooth than a bridge
Less chance of the false tooth coming off as it is usually screwed to the implant itself
Quicker than having a brace to close the space
What are the disadvantages of having an implant
They are not like natural teeth – they are fixed to the bone so will feel different to the other teeth to bite upon
Implants, like teeth, are still susceptible to gum disease so you have to maintain a very high level of hygiene around them
Implants can fail which means you can end up with no tooth
The crown part of the implant may need replacing more than once over your lifetime
It involves surgery, which may include grafting bone at the site the implant is to be placed
You may have to wait 3-6 months for the implant to integrate before a crown can be placed
The teeth next to it will change colour with age – your crown won’t so you may need to whiten the teeth to maintain them to the same shade
Bone around implants does recede with time and if the implant is placed at the front of your mouth you may notice the gum going greyer with time as the metal of the implant starts to be uncovered
What are the benefits or using braces to close or open gaps
The main benefit is that you are moving the teeth into the right position which makes the dental work much less complex. You are much more likely to get a good result with the bridge or implant if the space is the right size and the bite is better. For implants, it’s really important that the teeth either side of the gap are well out of the way, otherwise there may not been enough room under the gum to fit the implant in. Braces are and ideal way to help prepare the site of the implant. Also you need good foundations for any dental work
If a space can be closed with a brace then you avoid the need for false teeth to be placed altogether. Over the following years this may save you a considerable amount money.
Ultimately there is no “right” or “wrong” way to approach this. It has to be your decision, but in order to make that choice you need to know all the options and what is good about them. So although having dental work done to disguise crooked or missing teeth may be a faster, easier option for you it’s important to not just to look at the “right now”. Consider the long term consequences of your choices – that way you won’t have regrets later