ALTHOUGH not as severe as the potential facial changes caused by the loss of all teeth, losing a few teeth also produces a sunken facial look and a smile with a few missing teeth is then considered unacceptable by most people. In fact, in most societies, people who present an appearance with missing teeth are considered uneducated and poor.

A high percentage of people lose their natural teeth during their lifetime because of accidents, tooth decay, gum, and bone disease, or other reasons. Although there are numerous solutions for replacing several teeth, dental implants are an excellent alternative although they are relatively expensive. With missing teeth, even if the person is not aware of it, facial form collapses.

When a few teeth are removed, there is bone shrinkage in which the supporting bone diminishes, leaving a defect in contour in that area. This results in reduced eating efficiency and is directly related to the number of teeth lost. After the removal of many teeth, chewing efficiency is reduced significantly, but the removal of one or a few teeth does not seem to cause a major loss of chewing effectiveness. The smile’s appearance is a negative characteristic caused by removing a few teeth.

However, suppose, for whatever reason, you have had numerous teeth removed or otherwise lost. In that case, you have other alternatives, including Traditional Fixed Partial Denture (Bridge), which essentially attaches to the contiguous teeth remaining in the mouth. You cannot remove this type of prosthesis. Then there is the traditional removable partial denture which rests on, but does not attach to, the remaining teeth in the mouth. You can remove this prosthesis at will for cleaning. It is simply called a removable denture and is the cheapest and, therefore, most common means of replacing lost teeth. A more advanced variation to this type of prosthesis involves mini implants, the ultimate solution for loose dentures.

Then there is a more sophisticated and expensive partial denture. These involve implants, 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. These dentures stay in the mouth more firmly, appear more natural (there are no wire clasps), and are usually removed less often than regular removable dentures. Finally, fixed partial dentures are attached to implants alone or to the remaining teeth. You cannot remove this prosthesis. They are referred to as bridges.

If you elect to do nothing to correct the problem of losing one or more teeth, 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. When a back tooth is removed, the cosmetic appearance is not observed, and patients may not be motivated to examine the affected area until certain changes have occurred. First, the movement of surrounding teeth and collapse of the 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.
Consequently, if you have one or more missing teeth, you have the following alternatives:

1. Traditional Fixed Bridge. A traditional fixed bridge attaches to the teeth adjacent to the space or you can place it on mini-implants. You cannot remove this prosthesis.

2. Removable Partial Denture. A removable partial denture fills the missing teeth space and allows an improved appearance and nearly normal function. There are also total dentures (whereby the person has no natural teeth on the jaw). This can be stabilized with mini-implants, with the dentures being removable or not.

3. Mini – Implant followed by Crown (cap). After you place an implant, a crown is cemented over the implant head a few days later, thereby creating near-optimal function and appearance.