If you have missing teeth, you may choose to do nothing and leave the space empty. Alternatively, you may want to replace them. Treatment options include the following.
- Bridges – false teeth that are fixed onto adjacent natural teeth.
- Dental implants – metal ‘pegs’ are placed in your jawbone, and dentures, crowns or bridges are clipped or screwed on top of them.
- Dentures (false teeth) – removable plastic or metal frameworks that carry false teeth.
The most appropriate treatment for you will depend on the number of teeth you have missing. It will also depend on where teeth are missing in your mouth and the condition of any remaining teeth. Your dentist will help you decide which option is best for you.
A dental implant is essentially a substitute for a natural root and commonly it is screw or cylinder shaped. Each implant is placed into a socket carefully drilled at the precise location of the intended tooth. If an implant has a screw-thread on its outer surface it can be screwed into position and if it does not, it is usually tapped into place. The main aim during installation of any implant is to achieve immediate close contact with the surrounding bone. This creates an initial stability, which over time is steadily enhanced by further growth of bone into microscopic roughness on the implant surface.
In order to support replacement teeth, dental implants normally have some form of internal screw thread or post space that allows a variety of components to be fitted. Once fitted, these components provide the foundation for long-term support of crowns, bridges or dentures.
You may be a candidate for any one or all of them, depending on the circumstances. Implants are becoming the treatment of choice for a number of reasons. Most significant among these is the expected longevity, strength and stability offered by current implant treatment, as well as the predictability of implant treatment with current technologies. Listed below are common treatment options for missing teeth.
Fixed bridge / Resin bonded bridge
Teeth can also be replaced with a fixed bridge if there are teeth in the area that are adequate in number and sufficiently healthy and strong to support the artificial teeth. In order to fabricate a bridge, the adjacent teeth are prepared by reducing their size (or cut down) to remove all the enamel, making room for the prosthetic tooth restoration. A prosthetic tooth (or teeth) can be suspended between adjacent teeth in this way to provide a functional and cosmetic replacement for the missing tooth.
The limitation of this form of treatment has to do with the irreversible preparation of the adjacent (abutment) teeth for support. This exposes them to the risk of trauma to their nerves, raising the risk of requiring root canal treatment. Long-term, fixed bridges between natural teeth have an average life expectancy of 10-12 years before requiring replacement. Replacement of fixed bridges often entails further treatment as the abutment or supporting teeth have been further compromised over time by advancing dental disease (such as cavities or periodontal bone loss).
In certain cases it is possible to use a resin bonded bridge which either have minimal preparation of the adjacent teeth or in some cases no preparation. The application of this treatment option is limited however if used with the correct planning this option of treatment can be very successful.
Dentures are removable false teeth made of acrylic (plastic), nylon or metal. They fit snugly over the gums to replace missing teeth and eliminate potential problems caused by gaps.
Gaps left by missing teeth can cause problems with eating and speech, and teeth either side of the gap may grow into the space at an angle. Sometimes, all the teeth need to be removed and replaced.
You may therefore need either:
- complete dentures (a full set) – which replace all your upper or lower teeth, or
- partial dentures – which replace just one tooth or a few missing teeth
Dentures can help to prevent problems with eating and speech and, if you need complete dentures, they can also improve the appearance of your smile and give you confidence.