Single Missing Teeth & Small Gaps
Implants are most commonly used to replace single teeth or to fill a small gap where several adjacent teeth are missing.
People wishing to replace teeth in these situations usually have several options; a denture, a tooth-supported bridge, or an implant-supported crown or bridgework.
No solution is ever quite as good as a natural healthy tooth, but it is fair to say that in the majority of cases the option of supporting single or multiple teeth with dental implants is advantageous over the alternatives for several reasons, and is the closest that dentistry can offer to the real thing.
What are the alternatives to implants?
Not every tooth has to be replaced, and sometimes not interfering can be the very best approach.
However, if a tooth has been lost there can often be consequences to the teeth and tissues around it. The teeth in front, behind, and opposing the gap may all slowly “drift” into the space, and any unwanted movement of teeth is ideally avoided. If a tooth moves from its normal position it will contact the opposing teeth differently, and possibly in a way that places more pressure on both teeth leaving them more prone to fracturing. Unwanted tooth movement can also make cleaning the teeth more difficult leading to gum problems or cavities, and will often make any future treatment to replace the missing tooth more complex.
Conventional Dentures (partial or full)
Dentures can be used to replace anything from a single tooth or several teeth (a partial denture) to all the teeth (complete dentures). They are relatively quick to make, cost-effective, require little or no surgery, and cosmetically can often be as good as any of the other options. They are also quite easy to repair or replace, and can be taken out for cleaning.
The disadvantages however are numerous, and many people we treat approach us as they are finding wearing a denture difficult. Even in the best dentists hands they can be ill-fitting causing problems with speech, comfort, and function. Many people find they cannot eat a varied diet (mainly excluding more fibrous foods such as fruit and vegetables) and as a result general health can also suffer.
For many there is also a psychological side to the problem – they may not feel whole or complete when wearing plastic teeth that so easily come out. We often hear that this can impact on confidence and self-esteem, and even have serious consequences on people’s general enjoyment of life.
Another problem with dentures is that because they rub against the gums causing friction, the bone underneath will usually shrink away more quickly than if a denture was not being worn. This means that they quickly become loose and require either relining or replacing, and that future treatment with dental implants may be more difficult due to there being less bone available.
Types of Bridge
These are often referred to as “Maryland” bridges, and involve replacement of a tooth with metal wings which are glued to the backs of the adjacent tooth or teeth. Compared to conventional bridges (see below) they require little or no preparation of adjacent supporting teeth and can be aesthetically very pleasing.
The main problem people report is that the glue occasionally fails (especially if biting on something hard) and a trip to the dentist is required for it to be re-fixed. As such, they are sometimes used as temporary replacements for teeth but less often as a permanent solution.
Tooth-supported fixed bridge
This solution uses the teeth adjacent to the missing tooth or teeth for support. They do not require any surgery and are considered strong and stable long-term restorations which can have a very good cosmetic appearance. They need strong adjacent teeth for support.
The main problem with this treatment is the preparation required for the adjacent teeth (also known as the “abutment” teeth) which support the bridge. Drilling into a healthy tooth simply for the purpose of supporting a bridge is something we are moving away from where possible in dentistry because of the common problems that come with it. Teeth prepared in this way are at risk of requiring root canal treatment in the future. Furthermore, failure of any part of the bridge or supporting teeth is likely to result in failure of the whole bridge, and repair or renewal (if possible) can be expensive.
In addition, whilst a dental implant may seem more expensive than a bridge it is usually the case that as a long-term solution they work out more cost-effective than a bridge as they are less likely to cause problems which require further dental treatment (such as root canal treatment or replacement of the bridge).
Conventional bridge (note the reduction in size of the supporting teeth)
Contact us at Cottage Dental to either arrange a consultation with James or a free discussion with our treatment co-ordinator Jackie to find out more.