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The Options to Restore Missing Teeth
It happens to most of us at some stage in our lives; the day when a dentist tells you that a tooth or worse still, several teeth are beyond saving and need to be extracted. After the initial shock, this will usually lead to the realization that you are in fact getting old! To make matters worse missing teeth can cause many problems. Some are obvious, such as:
* your appearance when you smile,
* lisping when saying certain sounds,
* reduced chewing efficiency leading to poor digestion,
* loss of support for your facial muscles making you look older than you are.
There are other, more subtle changes that can occur when teeth are missing:
* increased pressure on the remaining teeth when chewing making them more prone to fracturing,
* tilting of teeth around the missing teeth,
* over-eruption of teeth opposing the missing teeth,
* a change in the bite resulting in problems with the jaw joint (TMJ.)
To ensure these problems do not occur, dentists always advise replacing missing teeth. This can be carried out in three ways; dentures, bridges or dental implants.
Dentures
This treatment option is the most basic and the least invasive of the three. It is also usually the cheapest option. The biggest drawback is that the denture is not fixed and consequently, there will be some movement especially when eating. It will also need to be removed to be cleaned. The base of the denture can be made in either acrylic or metal (usually a cobalt-chromium alloy). The metal denture is much stronger and can be supported by remaining natural teeth (if present) so that it is better fitting and more secure. The teeth can be made from acrylic or porcelain. It usually takes several appointments as the denture is made in stages to ensure it is the best possible fit. The end result can look great but wearing dentures will not make you feel young again.
Bridges
This treatment option involves preparing teeth adjacent to the missing tooth/teeth so that a false tooth/teeth can be cemented or bonded to them. The bridge is made from porcelain and may have a metal sub-structure. There are different types of bridges a dentist can use but a conventional bridge will involve preparing the adjacent teeth in a similar fashion to crowns. A temporary bridge is then cemented into place will the final restoration is constructed in a dental laboratory. The finished bridge is then cemented or bonded (depending on the type of porcelain used) into place permanently. The drawback to this option is the amount of tooth that has to be sacrificed on the adjacent teeth. This is made worse if the adjacent teeth are healthy and have no fillings. By preparing these adjacent teeth, their long term prognosis is reduced and they may end up needing further work in the future. In certain circumstances and providing only one tooth is missing, a different type of bridge can be used to try to minimize the preparation needed on adjacent teeth. This still uses porcelain to replace the missing tooth but has metal wings that stick to only the backs of the adjacent teeth. This means that only the backs of the adjacent teeth need to be prepared rather than the complete tooth.
Implant-retained restorations
A dental implant is artificial root, usually conical or cylindrical in shape, made from medical-grade titanium. It is placed in the jawbone with which it integrates with over time resulting in a very strong and secure base. Attachments, known as abutments, can then be connected to the implant on top of which crowns and bridges can be placed to give a fixed restoration (dentures can also be connect to implant abutments to help them become more stable but the denture is still removable ). Adjacent teeth do not need to be drilled and compared to the other treatment options for missing teeth, this is the strongest and longest lasting. The only drawback is that it does take longer to get to the final result. Each case needs to be evaluated by an implant surgeon but it may take between two and six months after a tooth is removed before the final restoration is fitted. However, once fitted the restoration will feel as close to a natural tooth as possible. In fact, many patients cannot feel any difference between an implant-retained crown and their natural tooth. It is because of this, and the fact that implant treatment has such a high success rate, that it has become the preferred treatment option for replacing missing teeth.
Hopefully this has helped in giving information to why missing teeth need be replaced and how this can be achieved. More information on dental implants is available at our Dental Implant Centre.
About the Author
Dr. Sanjay Narda is the Clinical Director of the Bank House Dental Centre and the Implant Specialist at several dental centres within the UK. The Bank House specializes in Implant and Cosmetic Dentistry.
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