Replacing Lost Teeth

Does the tooth need to be replaced?

If the lost tooth is at the front of the mouth, then 99% of the time patients will want the tooth replaced for cosmetic reasons. A lost tooth does not always need to be replaced. Wisdom teeth are removed all the time and we very rarely look at replacing these. Teeth are frequently taken out for orthodontic purposes to make space to move the teeth, and eventually the gap that was present following the extraction will be closed. Sometimes in an 11yr old child if the first molars are very badly decayed and have a poor future it is better to remove these teeth at this stage. In time the teeth behind the first molars will drift forward into the gap left by removing the tooth, but only if the extraction is carried out at the right time.

Nearer the back of the mouth we enter a grey area about answering this question. There are millions of people walking around with missing teeth with no apparent consequences. There is even a concept called the shortened dental arch which suggests that if we have all our front teeth and premolar teeth this is enough to allow us to function in a stable way. However, depending on the orientation and positioning of the teeth, they can tilt and drift. This can alter over time the way one bites together potentially leading to jaw joint problems.

The same tilting and drifting can also make teeth more prone to gum disease and tooth decay. In addition, if the remaining teeth are put under more pressure because there are less teeth to bite on this can lead to the other teeth breaking or increasing in mobility.

Please talk to us if you have a missing tooth and we can provide you with tailored advice and recommendations. 

If I do decide on replacement, what should I replace my lost teeth with?

The options you will have for replacing missing teeth are dental implants, dental bridges or dentures.

Dental implants are usually the preferred option because they do not involve the destructive preparation of the teeth on either side. Bridgework is done less commonly these days, especially at the back of the mouth. This is due to the destructive nature of preparation needed for a bridge, and because the cost of an implant is quite close to the cost of a bridge anyway. At the front of the mouth a resin bonded bridge (which involves removal of very little tooth structure) is an option, and they are relatively inexpensive. However because of the way they hold onto the tooth, they can debond (come away) from the supporting teeth.

Where more than one tooth is missing, a denture becomes more of an option. The cost of dentures replacing multiple teeth is relatively inexpensive compared to a multiple implant case. The compromise is that the finished result will not be as secure. Dentures are not fixed in place and need to be taken in and out of the mouth. For many patients, dentures are not well retained in their mouths and implants give them that added security.

Sometimes placement of implants is combined with a final restoration of either a bridge or a denture. The form the final restoration takes on top of an implant, whether it be a crown, bridge or denture, will be discussed in detail prior to starting dental implant treatment.