A HIGH percentage of people lose their natural teeth during their lifetimes due to accidents, tooth decay, gum and bone disease, or other causes. But never has the reason been that they “have grown old.” And although there are numerous solutions for replacing several teeth, dental implants are an excellent alternative, despite their relatively high cost. With missing teeth, even if the person is not aware of it, there is a collapse of facial form, accompanied by an appearance of being older than they really are.
Although not as severe as the potential facial changes caused by loss of all teeth, losing a few teeth also produces a sunken facial look, and the appearance of a smile with a few missing teeth is considered unacceptable by most people. In fact, in most societies, people who present an appearance with missing teeth are considered uneducated and poor.
When a few teeth are removed, there is bone shrinkage, in which the supporting bone diminishes from then on, leaving a defect in contour in that area. This results in reduced eating efficiency, which is directly related to the number of teeth lost. After the removal of many teeth, chewing efficiency is significantly reduced, but the removal of one or a few teeth does not appear to cause a major loss of chewing effectiveness. The smile’s appearance is a negative characteristic caused by the removal of a few teeth.
However, if for whatever reason you have had numerous teeth removed or otherwise lost, you have other alternatives, which include a 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 for cleaning at will. It is called a removable denture and is the cheapest and therefore most common means of replacing lost teeth. A more advanced variation of this type of prosthesis uses mini-implants, which are the ultimate solution for loose dentures.
Then there is a more sophisticated and expensive partial denture. These involve implants, which are basically removable partial dentures that rest on and are retained by implants and the remaining natural teeth. You can remove this prosthesis for cleaning at will. These dentures stay in the mouth more firmly, appear more natural (there are no wire clasps) and are usually removed less often than the regular removable dentures. Finally, there are fixed partial dentures that 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 can occur after the removal of a tooth. An unsightly appearance is created when a front tooth is removed. When a back tooth is removed, the cosmetic appearance is not apparent, and patients may not be motivated to have the affected area examined until certain changes have occurred. First, the movement of the surrounding teeth and the collapse of the bite occur rapidly. Often, within weeks, the surrounding and opposing teeth begin to collapse toward the space 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:
- 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.
- Removable Partial Denture. A removable partial denture fills the space left by missing teeth and improves appearance and nearly normal function. There are also total dentures (whereby the person has no natural teeth on the jaw). This can be stabilised with mini-implants, with the dentures being removable or not.
- 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.
Repetition check: No line-by-line repetition, though some concepts are repeated for emphasis, especially around removable prostheses and implants.
