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Bridges, Implants and Dentures
Missing teeth -- a common dilemma for many people who have had teeth removed because of extensive cavities, gum disease, injuries, and those who may never have developed some of their teeth due to a heredity trait. Missing teeth can often be a source of embarrassment as it can also affect a person’s quality of life.

Some of the problems associated with lost teeth include difficulty eating or chewing (hard foods can get painfully jammed into the gum), speech problems, and also cause the adjacent teeth to shift. When these teeth shift, they can create further cosmetic problems and also become more susceptible to cavities, bite problems and gum disease. With all of these potential problems, it’s good to know the pros and cons of some of the most common solutions that your dentist can offer for replacing missing teeth.
The three most common ways for a dentist to replace one or more missing teeth are a bridge, implant(s), or partial denture. A bridge is one of the most common ways that missing teeth are replaced. The procedure involves the dentist trimming down the teeth surrounding the missing one, taking a mold (impression), and then having the laboratory construct the bridge out of porcelain and gold. The procedure takes about three visits (4 weeks), and about two hours of total in-office time. The bridge is fitted over the surrounding teeth, and cemented into place, replacing the missing one(s).

The results are generally excellent. The teeth look very natural, and the comfort level is high (for most people, it feels like their own teeth). The downside of the procedure is the relatively high cost and the possibility that the teeth prepared for the bridge may require root canal in the future. In some cases, a bridge may not be used, as in instances where there are no teeth on one side of the missing one (several teeth are missing in a row), or the surrounding teeth have had extensive bone loss due to gum disease.

An implant is an option that has recently gained increasing acceptance for tooth replacement. The procedure involves placing a one-to-one and a half centimeter titanium rod into the jawbone to replace a tooth. The implant serves the same function as a tooth root. After the implant heals within the jawbone, teeth can be attached to the implant, replacing those that are missing.

Implants are ideal in situations where a bridge cannot be used, but permanent tooth replacements are desired. Implants feel very natural, and also have the advantage of preserving the surrounding teeth. On the downside, implants are a somewhat invasive procedure, requiring minor oral surgery for placement, are time consuming (most cases take between 6 to 9 months to complete), and can be quite expensive. If multiple teeth are missing, the cost will usually far exceed all other tooth replacement options.

The final main option for tooth replacement is the partial denture. A partial denture is a removable device (prosthesis) used to replace missing teeth. The main advantages of the partial denture are the relative ease of the procedure for the patient (very little, if any, teeth preparation is needed), and the comparatively low cost. The main disadvantages of the partial are the unnatural feel (it takes time to adjust to them) and some people have difficulty chewing and speaking with them. Partial dentures can have a natural appearance, but in some cases, an unflattering metal clasp is visible when talking or smiling.

Whether you choose a bridge, implant(s) or partial denture it will depend on many factors. You and your dentist should discuss the benefits as well as the limitations of each of these options before deciding how to replace any missing teeth.

Written by Dr. Jerry Gordon

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