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What are some tooth replacement options?

Dental Implants

A dental implant is much like a natural tooth which has a rod in your jawbone, topped by a crown that you can see. When you need an dental implant, your dentist inserts a metal post beneath your gum and into the bone. It fuses to the bone in your jaw and acts like the root of a tooth, then your dentist makes a replacement crown on the metal post, designed to blend in with the way your own teeth look and feel. Dental implants also can be used to anchor dentures. Most patients find that an implant is secure and stable - a good replacement for their own tooth.

Dental Implants, however are not an option for everyone. Because implants require surgery, patients should be in good health overall and have healthy gums. Further, patients either must have adequate bone to support the dental implant, or be good candidates for surgery to build up the area needing the implant. Patients also should be committed to very thorough oral hygiene every day, and regular dental visits. If you are considering dental implants, a full evaluation by your dentist will help determine if you would be a good candidate.

What is involved in placing dental implants?

First, surgery is performed to place the dental implant. Up to six months may be required for the bone to grow around the dental implant to firmly hold it in place. In certain cases, dentists can use techniques that may allow immediate use of the dental implant. Some dental implants require a second surgery in which a post is attached to connect the replacement teeth. With other dental implants, the dental implant and post are one unit placed in the mouth during the initial surgery. After healing, the next step is begun. The replacement tooth is made and fitted to the post portion of the implant. Because several fittings may be required, this step can take one month or longer to complete. Dental Implant surgery can be done either in a dental office as an outpatient procedure or in a hospital, depending upon a number of factors. A local or general anesthetic may be used. Usually, pain medications and when necessary antibiotics are prescribed. Your dentist will give you instructions on diet and oral hygiene. Dental implants can provide replacement teeth that look natural and feel secure, and also can be used to support complete or partial dentures. It is possible to stabilize dentures and eliminate the need to remove them each day.

Advantages of dental implants:

• An dental implant is most similar to a natural tooth

• Adjacent teeth do not have to be involved in the placement procedure

• Dental implants may decrease or help prevent shrinkage of the jawbone from tooth loss

Disadvantages of dental implants:

• Dental implants are not intended for everyone

• Dental implant placement takes longer and may require more dental visits than alternative procedures. General dentists usually determine if an implant is appropriate for you, but sometimes they may refer you to a dental specialist for additional care. Following are some of the dental specialists who may be called upon, and brief descriptions are their areas of expertise:

  • Prosthodontist - restoration and replacement of teeth

  • Oral and maxillofacial surgeon - dental surgery

  • Periodontist - periodontal (gum) disease

Fixed Bridges

Another alternative is a fixed bridge (sometimes called a fixed partial denture). This is a restoration that replaces or spans the space where one or more teeth have been lost. A fixed bridge is bonded or cemented into place - only a dentist can remove it. Your appearance, dental health and the proper functioning of your mouth all are important reasons for wearing a fixed bridge. It helps maintain the natural shape of your face and may help support your lips and cheeks. If you need an extensive fixed bridge procedure, your dentist may refer you to a prosthodontist.

How is a fixed bridge attached?

A fixed bridge is commonly cemented or bonded to the natural teeth next to the space left by the missing teeth. An artificial tooth (called a pontic) replaces the lost natural tooth, and restores its function. A pontic is attached to a crown (restoration that covers a tooth). Crowns, which are cemented on adjacent prepared teeth, serve as retainers that support the fixed bridge.

Are there different types of bridges?

A fixed bridge can be attached to your natural teeth. Different types of artificial teeth may be used in fixed bridges. These include gold, porcelain fused to metal, and all porcelain. In some instances, a resin-bonded fixed bridge (sometimes called a "Maryland Bridge") can be used to replace one or more missing teeth. Because it is attached by a special procedure called bonding, it doesn't require the use of crowns or extensive tooth preparation. Your dentist can determine whether this treatment method is appropriate for you.

Advantages of fixed bridges:

• Look, feel and function like natural teeth

• No need to remove form mouth for cleaning

Disadvantages:

• Likely to be more expensive than removable bridges

• Affects the adjoining teeth

Removable Bridges

As the name describes, a removable bridge (sometimes called a removable partial denture) can be taken out of the mouth for cleaning. Although removable bridges generally are less expensive than fixed bridges, when indicated, may feel more stable and comfortable. Depending on your situation, a removable bridge may be for you. Removable bridges usually have replacement teeth attached to gum-colored plastic bases connected to metal framework. They may attach to your natural teeth with metal clasps or devices called precision attachments. A claspless removable bridge, may provide better support and aesthetics. Crowns on your natural teeth may improve the way a removable bridge fits your mouth. Ask your dentist which type is right for you.

Will I grow accustomed to a removable bridge?

Inserting and removing the new removable bridge takes some practice. It may feel awkward for the first few weeks. However, your mouth eventually should become accustomed to it. The bridge should fit into place with relative ease. Your dentist can explain how long the removable bridge should be warn and when it should be removed. At the start, you may be asked t o wear it for the first 24 hours. While this may temporarily cause discomfort, it is the quickest way to identify any parts requiring adjustment. If the bridge puts too much pressure on one area, that spot will become sore. Your dentist can adjust the bridge to fit more comfortably. Once adjusted, your dentist may recommend that you remove the bridge before going to sleep and replace it when you awaken. Once your missing teeth are replaced, eating should be a much more pleasant experience. Since missing teeth can make it difficult to speak clearly, wearing a removable bridge can help with that, too. Over time, as you age and your mouth changes, your removable bridge may no longer fit well. It also could break, crack or chip, or one of the teeth could loosen. In many instances, dentists can make the necessary adjustment or repairs, often on the same day. But complicated repairs may take longer. If you need extensive dental reconstruction, including a removable bridge, your dentist will provide the treatment or refer you to a prosthodontist.

Advantages of removable bridge over fixed bridge:

• Usually easier to repair

• Usually less expensive

Disadvantages:

• Removable bridges can be less stable than alternative choices

• They can break or be lost

• Some people find removable bridges uncomfortable

• Some people are embarrassed to talk out their teeth at night and for cleaning