How do I replace my missing tooth?
Bridges, Implants, and Partials
In the U.S., approximately 70% of the population is missing at least one tooth. This leaves the majority of the country to have to make an important decision. "How do I fill in that missing space?" There are three options for almost every patient: the fixed partial denture (bridge), removable partial denture, and an implant. Let's look at the advantages of all three.
Bridge (Fixed partial denture)
The bridge is a very popular restoration, which is widely used by most dentists. Bridges are fixed appliances (not removable); they use adjacent teeth that are prepped to support the bridge, to hold the bridge and maintain the space. They are quick an easy to fabricate. A patient can have a permanent bridge cemented in place within a few weeks assuming the surrounding teeth and gums are healthy. Patients often choose a bridge for two reasons: the short amount of time it takes to restore to completion and it cements in place (does not move). Bridges satisfy criteria to replace normal contour, comfort, function esthetics, speech, and health. However, there are certain disadvantages. The adjacent teeth, whether they have had previous fillings, root canals, etc., must be prepped for the bridge. This means that the dentist must remove all the enamel (healthy or not) to make room for the full coverage bridge. Bridges do not take into account the health and position of the bone in the area of the missing tooth. Without internal stimulation form certain biting forces in the bone when the tooth was removed that bone will resorb away at varying rates. The average lifespan of a bridge is 50% success at 10 years. Patient can still get decay under bridge and sometimes require toot canal therapy. While bridges have been widely accepted by patients and dentists alike, they do have their disadvantages.
Partials (Removable partial dentures)
Other patients wish to stay with an option that is a little more non-invasive. Certain people with single or multiple missing teeth can choose to fill in the spaces with a "partial." Benefits to the partial include: no numbing/surgery, usually less expensive (in the short term), can fill multiple spaces throughout the arch with one appliance. Assuming all the teeth and gums are in proper health, the patients have impression taken by their dentist. The impressions are used to make models of the teeth and a removable appliance is made that uses the existing teeth to hold it in place. Every morning the patient puts in the appliance, and every night he or she takes it out. Removable partial dentures often put more stress on the abutment teeth that hold it in place, and the patient, in turn, could lose more teeth. The portion of the partial that rests on the gums actually causes the bone to resorb away faster that if the appliance was never there. Patients can have this partial relined to fill in spaces after bone resorption, but once the bone is gone, it's gone.
There is only one option that allows patients to be restored to proper health and function in all aspects. Implants help support the surrounding dentition, gum tissues, and BONE! An implant to replace a single missing tooth does not require any damage to be done to the adjacent teeth. It has no organic material so there is no risk of getting a cavity on an implant. It is the next best thing to a natural tooth that we have. It does require surgery to place the implant; but this surgery is often much less invasive than taking a tooth out. Success rates of implants have been found greater than 97%. Bone requires a 4%internal strain to maintain itself. Implants can satisfy the need. One disadvantage of an implant is time. A final permanently restored implant can take up to one year to complete. However, there is a temporary appliance the patient can wear while the implant is healing. As long as the patient will brush and floss well around the implant and visit their local dentist for regularly scheduled hygiene visits there is no reason why a healthy implant couldn't outlast any other appliance.
Patients have many options when it comes to replacing single missing teeth. Patients should educate themselves on the best methods to restore their mouths to oral health. Ask your local dentist about all risks, options, and complications. Of the three we have resented here, the single dental implant is the best appliance, in most cases, to restore the patient to proper health, function, comfort, esthetics, speech, and contour with respect to teeth, gums, and surrounding bone.
About the Author
Dr Cody Cowen is a Dentist in Shreveport LA. Dr. Cowen specializes in Cosmetic Dentistry in Shreveport LA. He is a partner in Shrevport Bossier Family Dental Care and practices in each of their two offices.