Let’s start with why we have to replace missing teeth at all. Is it important to do so? What will happen if you don’t get a replacement?
The human dentition is designed to function with twenty-eight interacting teeth. Each tooth connects with two other teeth in the opposing arch.
When we lose a tooth it’s like knocking a brick out of a wall! At first nothing happens, but soon gravity and external forces take over and the wall starts to collapse. It’s the same with teeth: gravity and other forces win. The teeth either side of the gap begin to collapse inwards and the opposing teeth start to move. This results in malocclusion.
The longer you wait to replace missing teeth, the more complicated replacement gets and the more costly. You may even sacrifice replacement options – for example, the bone at the gap resorbs over time and so an implant may not be feasible.
There are various ways to replace missing teeth and all have different cost implications and different benefits. It’s much like getting from A to B: you can, for example, walk, cycle, scooter, or drive a small, medium-sized or extravagant car. Each will get you there, but differently.
The available tooth replacement options are, acrylic partial dentures, metal-based chrome cobalt dentures, Maryland bridges, cantilever bridges, and implant crowns and bridges. You will have to rely on the expertise of your prosthodontist to ascertain which is the best option for you.
Meanwhile let’s have a look at the two most popular long-term replacement options: bridges and implants.
The decision whether to have a dental bridge or a dental implant depends on your unique situation. Every individual circumstance is different. Just as you are unique, so is the decision.
The primary consideration as to whether implant or bridge is the best option is the condition of the teeth adjacent to the gap. If the bounding teeth are in good condition, then an implant is probably the way to go. However, if the adjacent teeth are in poor condition, heavily filled, with poor cosmetics (such as big black metal fillings), then they would probably need crowning anyway. In this case it is a no- brainer to opt for the dental bridge. Another consideration is how long the tooth has been missing – whether you’ve had a recent extraction or the gap has been there for a while.
Is there a tooth still present that needs to be extracted? That might mean the need for a temporary tooth if the gap is visible when you smile. In the case of an implant, you would likely need a temporary denture for three months, which is not as comfortable as a temporary bridge. Why a temporary denture or temporary bridge? The answer is for healing. The recent extraction site needs to heal for several weeks before an implant or bridge can be placed, so that gum shrinkage doesn’t affect the cosmetics of the end result.
Another consideration in general is the position of the gap. Is it in the front or back of the mouth?
These considerations all affect the decision as to whether to have a dental bridge or dental implant. Generally there is little cost difference between a dental bridge and a dental implant. That said, a dental implant requires adequate bone and if there is insufficient bone for a dental implant then bone grafting may be required. This can push up the cost by several hundred dollars and possibly extend treatment time from four months to seven months.
If you feel confused as to which tooth replacement option is best for you, don’t feel alone. As you can see, there are several factors that come into play in the decision-making process. Your dentist or prosthodontist will happily assist you to make an informed decision.