The appearance of a smile with a few missing teeth
– is considered unacceptable by most people
EVERY intelligent person would surmise that many people loose their natural teeth during their lifetime because of accidents, tooth decay, gum and bone disease, or other reasons. There are numerous solutions for replacing several teeth. The choice depends mainly on availability, affordability and need among others. Obviously there are negative consequences for failing to replace functional and aesthetic teeth within the appropriate period.
• Collapse of Facial Form: Although not as severe as the facial changes caused by loss of all teeth, losing a few teeth also produces a sunken facial appearance. The appearance of a smile with a few missing teeth is considered unacceptable by most people.
• Bone Shrinkage: When a few teeth are removed, the supporting bone shrinks from then on, leaving a defect in contour in that area.
• Reduced Eating Efficiency: Reducing eating efficiency is directly related to the number of teeth lost. After removal of many teeth, chewing efficiency is reduced significantly, but removal of one or a few teeth does not seem to cause a major loss of chewing effectiveness. The appearance of the smile is the negative characteristics caused by removal of a few teeth.
If you have had numerous teeth removed, you have the following alternatives:
• Traditional Fixed Partial Denture (Bridge). A traditional fixed partial denture attaches to the attaching teeth remaining in the mouth. You cannot remove this prosthesis.
• Traditional Removable Partial Denture. A traditional removable partial denture rests on, but does not attach to, the remaining teeth in the mouth. You can remove this prosthesis at will for cleaning.
• Place Implants and Construct a Removable Partial Denture. Place implants, allow healing, and construct a removable partial denture that rests on, and is retained by, implants and the remaining natural teeth. You can remove this prosthesis at will for cleaning.
• Place Implants and Construct a Fixed Partial Denture. Place implants, allow healing, and construct a fixed partial denture that is attached to implants alone or to implants and the remaining teeth. You cannot remove this prosthesis.
• Do Nothing. If you elect to do nothing, your remaining natural teeth will continue to move, and your bite will usually collapse and degenerate further. This is not a good alternative in most cases for more than a short time.
Two situations exist after the removal of one tooth:
An unsightly appearance is created when a front tooth is removed. This condition is unacceptable in most societies, and it usually influences people to seek treatment. When a back tooth is removed, the cosmetic appearance is not observed, and patients may not be motivated to have an examination of the affected area until the following changes have occurred:
The movement of surrounding teeth and collapse of bite occur rapidly. Often within weeks the surrounding and opposing teeth start to collapse toward the space that was created by the tooth removal, making an acceptable replacement difficult. The contacting areas of teeth near the space may open, and food may become impacted between the teeth.
If you have one missing tooth, you have the following alternatives:

1. Traditional Fixed Bridge. A traditional fixed bridge attaches to the teeth adjacent to the space. You cannot remove this prosthesis.
2. Removable Partial Denture. A removable partial denture fills the missing tooth space and allows an improved appearance and nearly normal function.
3. Implant followed by Crown (cap). Place an implant, allow healing, and place a crown over the implant head, thereby creating near optimal function and appearance. You cannot remove this crown.