Missing teeth is a cause of concern and distress for many people throughout their life. Not only do missing teeth have an impact on the appearance of one’s smile, they can also result in significant functional problems. Regardless of the way in which the tooth was lost, it can affect your speech, ability to chew, and even the spacing and position of surrounding teeth. Luckily, there are a number of options available to give you a confident smile and mitigate any issues you may be experiencing as a result of missing teeth.
Complications of missing teeth:
The complications of missing teeth vary from person to person and depend on factors such as:
- How many teeth are missing and where in the mouth they were positioned.
- Oral hygiene and gum health
- Condition of surrounding teeth
The most immediate impacts of a missing tooth are difficulties chewing and changes to the appearance of the smile. Over time, these can be further complicated by the movement of the surrounding teeth. Our teeth do move slightly over our lifetime, however are largely kept in place by adjacent teeth and the forces in the mouth created by the tongue and muscles of the jaw. Once a tooth is removed, the teeth surrounding the gap often begin to shift in order to fill the gap. If a tooth has no tooth opposing it, it can drift upwards or downwards in an attempt to meet the opposite jaw.
Treatment options for missing teeth:
Everyone’s mouth is a little different, so it will always be best to ask your dentist which is the most suitable option/s for you. Here are some of the more common ones they may go through:
1. Do nothing!
If you are not experiencing any difficulties resulting from the loss of a tooth and are unphased by the appearance of the gap, then there is always the option to leave it as it is. Your dentist can assess the condition of the space, jaw bone and adjacent teeth and alert you to any risks associated with leaving things as they are.
It is important to note that some of the following treatment options should be completed within a certain window of time after tooth extraction.
2. Dental Implant:
A dental implant is arguably the closest replacement for a real tooth. It is made up of two components – a metal screw which acts as the ‘root’ of the tooth, and a crown (the visible ‘tooth-like’ structure). The process of placing an implant is performed in stages. Firstly, your dentist will determine your suitability for an implant by assessing your overall oral health, the condition of the space and its relationship to surrounding teeth, and the health of the jawbone. If you are a good candidate for an implant, your dentist will refer you to a specialist, either an oral surgeon or periodontist, for further assessment and planning.
The next step is minor oral surgery – under local or general anaesthetic, the specialist will place the implant post into the jawbone. Following surgery, the area must be left to heal for a period of several months to a year, to allow the implant post to fuse to the jawbone. Once the specialist is happy with how the post has healed, they will send you back to your general dentist to fit the crown part of the implant.
Deciding on whether an implant is for you or not is a difficult decision, so Dr Shirley Kwok has kindly broken down the pros and cons of dental implants:
- Dental implants look aesthetically like your natural teeth.
- They are securely anchored in your jawbone which allows you to eat and drink normally.
- They prevent or slow down the bone shrinkage that typically occurs after tooth loss.
- As long as you look after the implant via good oral hygiene and regular dental visits, they can last up to a lifetime without the need for replacement.
- The procedure to place a dental implant is a lengthier process and cannot be completed in one appointment.
- As placing a dental implant involves a surgical procedure, there are risks associated with it, including sinus and nerve injuries.
- Sometimes additional procedures are required such as bone grafting if there is insufficient bone in your jaw.
- The initial cost of a dental implant is generally higher compared to alternative options to replace missing teeth e.g. dentures, crown and bridges.
- The success rate of dental implants is very high, however there is still a small chance of failure which can be caused by factors such as poor oral hygiene, gum disease, smoking, or certain medical conditions.
3. Dental Bridge:
There are several different types of dental bridges, however in essence they are all perform the same task – a fake tooth (or more) suspended between two existing teeth. The advantage of bridgework is that it restores original function of the missing teeth (chewing, speaking etc) at a price much more affordable than implants. It is also a less invasive and faster solution as the prosthetic teeth sit directly on the gums rather than being secured by surgically-placed posts.
The longevity of a bridge varies from several years to a decade and depends largely upon the health of the teeth on which it is placed and surrounding gums. To provide stability, the false tooth/teeth are secured to the existing two teeth on either side of the gap. This can be done a number of ways with the two most common methods being crowning the adjacent teeth or adhering the bridge to adjacent teeth via metal “wings” (a composite bridge). If the existing natural teeth are crowned, they will need to be ground down, which may compromise their longevity.
A denture is a removable oral appliance that resembles the appearance of natural teeth and gums. They can be created to replace a single tooth or an entire upper and lower arch. One advantage of dentures is that impressions and preparations can be made prior to a tooth extraction so that a replacement is ready instantaneously. The process for making a denture involves an initial appointment with your dentist to assess your suitability for the appliance and take impressions. The impressions are sent to a laboratory who create the denture and return it within 1-2 weeks. The denture is then fitted by your dentist who will ensure it sits correctly in your mouth and that you are happy with its appearance.
Dentures do require a certain amount of upkeep and will need relining and adjustment from time to time. Patients also report that it takes a bit of time to get used to the fit and feeling of a denture in the mouth. Cost-wise, the price of a denture depends on the type of denture and how many teeth are being replaced. It can vary from less expensive than a bridge, right up to the cost of an implant if full dentures are required.
It can be difficult to wade through the options and figure out which solution is best for your individual circumstances. If you have any questions, or need further guidance, please don’t hesitate to give us a call or book an appointment.
Happy brushing and flossing and we’ll see you at your next check-up!
About Our Authors:
Dr Shirley Kwok:
Dr Shirley Kwok has been with us at Highgate Hill Dental Centre for many years. She has extensive experience working in public dental clinics, and she now works in the private dental sector. Shirley has a special interest in surgical dentistry and in her spare time enjoys cooking and drawing!
Sophie began working at Highgate Hill Dental Centre in 2012 and has clocked up almost ten years experience in the dental industry working chairside with our dentists. After many years as a dental assistant, she moved into the role of Digital Content Creator for Highgate Hill Dental Centre whilst she completes medical school in Victoria.