Missing Teeth? Now What?
B L O G | S U N R I S E D E N T I S T R Y
https://sunrise-dentistry.com/
Many years ago there were not many
options to replace missing teeth.
George Washington was plagued
with dental issues most of his life.
If you Google ‘George Washington
wooden teeth’ you will see all kinds of
stories and even pictures of the
dentures that George Washington
wore (you can actually view the only
known set of Washington’s dentures
at a museum in Mount Vernon
Washington).
Contrary to popular belief that his
teeth were made of wood, his
dentures were made up of human
teeth, several different metal alloys,
Ivory (suspected to be from
elephants) and maybe even teeth
from cows and horses.
Fortunately for us, in this day and
age, there are really safe and long-
lasting and attractive materials that
can make up for ailing and missing
teeth.
The information here is designed to
help you decide what option is best
for you and will hopefully explain in
laymen’s terms the differences
between each option and the pros
and cons of each.
Dr. Strietzel will help guide you
through the process of deciding what
the best option is for your situation.
It is important to discuss the options
with your dentist as your dentist
brings a wealth of wisdom and
understanding and knows what
kinds of prosthetics will best suit the
conditions of your teeth, bone, and
gums.
When you have teeth extracted it
creates changes in your mouth.
While in some cases these changes
have minimal effects, in most cases
areas of missing teeth can create
complications to the teeth that were
near the extracted tooth as well as
the bone around it. Following are a
few of the complications:
Bone Loss:
When a tooth is lost, the bone tissue
that is under it begins to weaken.
This can lead to a misaligned jaw and
functional issues with the jaw.
Teeth shifting:
When teeth shift it changes the bite.
It changes the way your top teeth
meet your bottom teeth, which could
potentially create a harder contact
where the surfaces come together.
The problem with this is if teeth are
hitting too hard it causes repetitive
trauma to the teeth involved and may
result in an abscess forming, which
could lead to a root canal or another
extraction in order to mitigate the
infection.
Repeated trauma to a tooth is never a
good thing. Missing teeth that are not
replaced can eventually change the
bone structure of the face.
Aesthetics:
Depending on where the missing
tooth is located, we may be inclined
to not smile (or even laugh) or we
might talk with our hand in front of
our face because, let’s face it, for most,
it is embarrassing for people to see us
missing teeth. We wonder what other
people think instead of flashing our
awesome smile at them.
Replacing missing teeth
Implants:
Replace the missing tooth with an
implant. There is significant expense
with this option and it is a fairly
drawn-out process. In the end, you
will have a new “tooth” that looks and
functions just like a real tooth.
If you want to choose this option, Dr.
Strietzel will want to get an x-ray of
your jaw to ensure that your bone
tissue is healthy and strong enough to
tolerate an implant.
A dental implant can fail if the bone
tissue is not strong enough. If it is
acceptable, the assistant will then
make an impression of the jaw to aid
in determining placement. Our office
refers to the actual implant placement
to an oral surgeon or a prosthodontist.
Once the implant is placed, you will
need to allow it to heal for several
months until the surgeon reports that
the area has healed well and you are
ready for the restorative phase, the
placement of a crown and an
abutment which secures the crown to
the implant, that we will do in our
office.
This phase usually takes about 3
weeks between taking the impression
and getting the restorations back
from the lab. Implants can also be
placed to support a bridge to replace
multiple missing teeth in a row.
We used to expect implants to last
forever, but today we know they, like
most anything else, do have a life
expectancy.
There are many factors involved in
how long they last and a range of 8-20
years is often used. Talk with your
dentist about your specific situation
and what a reasonable implant life
expectancy for you is. Many would be
in the 12-15 year range.
Fixed Bridge (also called a fixed
partial denture):
If implants are not an option for you,
a fixed bridge might be your next
choice. A fixed bridge is when two
existing teeth serve as an anchor for
one or more teeth that are missing in
between the two existing teeth.
A mold is taken of the area to have
crowns made for each of the two
existing teeth on either side of the
missing tooth or teeth. The
replacement teeth are placed between
the two crowns, creating a bridge.
The bridge is then cemented into
place. Bridges have a life expectancy
that is similar to an implant if the
teeth used for support are strong.
The disadvantage to this option
compared to an implant are:
1) You need to remove significant
tooth structure (mostly enamel)
from both adjacent teeth.
2) All three or more are attached
together and it is a little more
involved to floss that area.
3) In the future, if you develop decay
or other problems you need to
address, you will have to replace all
three or more attached teeth.
Flipper:
A flipper is meant to serve as a
temporary replacement for one or
more anterior (front) teeth. It either
sits in the upper palate or the lower
jaw depending on the location of the
missing teeth. Many people choose
to use this temporary partial as a
permanent partial.
We don’t recommend this, as
temporary’s break easily as they are
not meant to last. Consider the long
term financial implications of
replacing or repairing a broken
flipper over and over.
Removable Partial:
A removable partial denture may be
an option if implants and bridges are
not an option. If you don’t have
enough quantity or quality of bone for
an implant or if the remaining anchor
teeth in the mouth are not strong
enough to support a bridge, then the
removable partial is likely the best
option.
Impressions are taken and sent to a
lab for the part to be made. The dental
assistant will make adjustments as
needed and for the comfort of the
patient.
The disadvantages to this option are:
1) It is removable and therefore can
move during function, which causes
rubbing and soreness.
2) It must be removed and cleaned
regularly.
3) They do not tend to last as long as a
bridge or implant.
4) Most people strongly prefer
something fixed.
The main advantage to this option is
they do cost less, especially when you
are missing multiple teeth in one arch
(upper jaw or lower jaw).
Fixed or Removable Dentures:
If you are missing all your upper
and/or lower teeth, then a full denture
may be your option.
In the fixed option, several implants
are placed in the jawbone (which
helps to keep the bone tissue strong as
well as provide a base for the denture).
Impressions are made after the gums
have healed and a bridge is made and
then permanently affixed to the
implants.
In a removable denture, two or more
implants are fitted with small locator
devices that line up with the
implants so the denture can snap in
and out of the mouth.
If a patient is unable to have
implants due to cost or condition of
the bone tissue, impressions are
made for dentures that are meant to
fit snuggly along the gumline.
For additional gripping, denture
adhesives, such as poligrip, can be
used to help prevent food from
getting under the denture and
increase the stability of the hold.
As mentioned above, implants help
maintain the jawbone in addition to
resisting movement left to right,
front to back and up and down.
dale@durangolive.net
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