Sometimes it is not possible to save a tooth with treatment because of clinical or financial reasons. In these circumstances the tooth is extracted or removed and the question arises as to what to do about the missing tooth.
There are six options for replacing missing teeth.
1. Leave it alone
2. A removable partial denture and flexi partial denture
3. A conventional fixed dental bridge (fixed denture)
4. An adhesive resin retained maryland bridge
5. A dental implant
6. An orthodontic treatment combined with any of the above.
Leave it alone
It is not always necessary to replace a missing tooth. The decision to replace it is based on a number of factors, including appearance, loss of function, health of surrounding teeth and bone and opposing teeth, whether there are other missing teeth and financial considerations. You would be surprised how often the best course of action is to leave it alone.
Removable partial denture and flexi-partial denture
The least costly and most common option for replacing a missing tooth is to have a removable partial denture, usually made from a combination of a metal called chrome cobalt and acrylic. Flexi partial dentures, made from flexible nylon resin, are gaining in popularity with dentists and patients because of greater comfort and aesthetics than chrome cobalt partial dentures. Both chrome cobalt and flexi partial dentures are fairly easy for the patient, requiring very little preparation and several teeth can be replaced if required. Appearance is good but patients can take a while to adjust to having a metal or plastic object in their mouth.
Conventional fixed dental bridge
The third option for replacing a missing tooth is a conventional fixed dental bridge (sometimes referred to as a fixed denture). The procedure is more expensive and takes a number of visits to complete. A disadvantage is that the healthy teeth on either side of the missing tooth require extensive removal of tooth tissue with a dental drill to enable a mold to be taken. The mold is taken to a dental laboratory and a dental bridge is constructed of porcelain and gold. To replace one tooth the bridge will consist of three units, two crowns to fit over the existing teeth and a third to fit into the missing space all joined together by a precious metal framework. More than one missing tooth can be replaced. The result is usually very good with the appearance and fit very life-like. You can expect a lifespan of at least five to ten years. There is a moderate risk of root treatment being required on the crowned teeth.
Adhesive resin retained maryland bridge
An adhesive resin retained dental bridge, sometimes referred to as a maryland bridge, is less expensive and less treatment invasive than a conventional fixed dental bridge. There is less removal of tooth tissue so there is less damage to surrounding teeth. It is useful when replacing a single tooth. It is more successful when placed in the upper jaw (over 80% success after 10 years) and less successful in the lower jaw because of a tendency for slight natural tooth movements. This type of bridge consists of a porcelain crown (pontic) fused to a metal framework, which is specially treated so that it can be glued with an adhesive resin to the back of the teeth on either side of the missing tooth. A de-bonding (loosening) of the bridge, if it happens, can be quickly corrected by cleaning the metal framework and reapplying an adhesive resin.
Another option for replacing a missing tooth which is gaining momentum with dentists and the public, is a dental implant. A dental implant is made from a precious metal, called titanium, in the shape of a root. This is screwed into the bone, where it integrates into it like a root. Implants have a number of uses. They can be used to support a crown, a bridge or a denture. They can also be used in orthodontic treatment. They are ideal for use in a situation where a tooth replacement is necessary but a bridge cannot be used. They feel very natural and surrounding teeth do not need any preparation. The disadvantages are high cost, the required surgery and the fact that many dental visits are required over a number of months.
Combined orthodontic treatment (braces)
Orthodontic treatment on its own or combined with other treatments can be used to help close the gap caused by the loss of one or several teeth.
If you have a missing tooth or teeth why not call Reva Dental on 056 776 3786 and our dentists will give you a thorough appraisal of your options including cost, longevity, appearance and all other relevant considerations. You may be eligible for a free check-up. See www.revadental.ie