After An Extraction: Why & When to Replace Missing Teeth
As dental professionals, we know how important it is to quickly replace missing teeth, whether it be from an injury, accident, or a necessary dental extraction. Though some patients are primarily focused on the appearance of missing teeth within their smile line, each of our teeth play an essential role towards our overall health.
Why is it Important to Replace Missing Teeth?
Chewing is the first step in the digestive process, allowing you to break down food particles both mechanically and chemically. Without healthy teeth (and the underlying gums and bone to support them), you cannot chew properly. Inadequate chewing reduces your body’s ability to absorb the appropriate amount of nutrients from food which can directly lead to malnutrition and indigestion.
Teeth also play an essential role in speaking. Missing teeth can lead to speech defects or impediments that can lead to difficulties communicating in your career and social life.
A missing tooth can affect the adjacent teeth, the gum tissues, and the jawbone itself. When a tooth is lost, the neighboring teeth can shift and move into the newly opened space. This shifting often leads to changes in the bite between the upper and lower jaws. Bite changes can lead to TMJ disorder, muscle pain and headaches.
A missing tooth also leads to gum recession on the neighboring teeth. As the gums recede, they expose the delicate roots of those teeth, making them susceptible to cavities and sensitivity.
The purpose of the jawbone is to hold teeth. When teeth are missing, the jawbone slowly shrinks over time in a process we call resorption. It becomes narrower and shorter, which also means it becomes weaker. Those who have lost all of her teeth are at greater risk for jawbone fractures.
What are the Dangers of Bone Loss?
As mentioned earlier, one of the most serious consequences of lost teeth is loss of the corresponding jawbone. Most bone loss occurs unnoticed by the patient until it is drastic. If you or someone you know has missing teeth, be aware of these common risks before encountering serious consequences:
An altered bite, due to the shifting of the neighboring teeth around the missing tooth
Loosening of other teeth in the mouth leading to further tooth loss
Increased lines in the face around the mouth or sunken cheeks and lips changing the appearance of the face
Changes in the fit or comfort of a denture or partial due to weakening of the jawbone
Why Do People Lose Teeth?
The most common causes of missing teeth are bacterial infections in the mouth, namely cavities and gum disease. Cavities are bacterial infections of the hard structures of the teeth, and gum disease is bacterial infection of the bone and gums surrounding the teeth. When a tooth has suffered severe decay, removal of the tooth may be recommended, however bacterial infections are usually preventable with good dental care and routine dental visits.
Smoking increases the risk for lost teeth because it increases the risk for both cavities and gum disease. Smoking dries out the mouth, making dental plaque more difficult to remove and lowering the pH inside the mouth to an acidic environment where bacteria thrive. It also reduces blood flow to the gum tissues, making treatment and recovery from gum disease less successful.
It is also possible to lose teeth as a result of trauma to the mouth. For example, car accidents or sports injuries can lead to broken or dislodged teeth that cannot be repaired.
What are My Options for Replacing a Missing Tooth?
There are many dental treatment options for replacement of a missing tooth or teeth. The options change based on how many teeth need replacement and where they are located. In cases of a single or couple of missing teeth, we can easily categorize the replacement options into three broad descriptions of dental treatment.
Removable Partial Denture (Partial)
Typically called a partial or “plate,” a removable partial denture replaces 2 or more consecutive teeth. Replacing the entire arch of missing teeth requires a removable full denture, which we often just call a “denture.”
As the name describes, this is a removable appliance, using clasps to attach to the other teeth in the arch. Partials are relatively inexpensive and replace a minimal amount of chewing force. They can also exert pressure on the supporting teeth, which reduces their overall lifespan.
Fixed Partial Denture (Bridge)
A bridge is also a partial denture in that it replaces a few missing teeth. The designation as “fixed” means that this is not removable by the patient. A bridge is permanently cemented onto the supporting teeth by your dentist.
The most popular type of bridge is the traditional bridge, which consists of two or more crowns that are supported by your own teeth on either side of a missing tooth. An artificial tooth (called a pontic) is attached to the anchor teeth creating a bridge. The pontic seats on your gum tissue to simulate a tooth coming from the gums.
Be advised that bridges require healthy teeth on both sides of the missing tooth space for the necessary attachment and support. A bridge also requires some necessary adjustments in oral hygiene and flossing routines to improve the longevity of your oral health.
Dental Implant Supported Crown
Dental implants have grown in popularity due to their long-term success in replacing a single missing tooth or the entire dental arch. A dental implant supporting a crown is the only tooth replacement option that replaces the entire missing tooth, including the root. The jawbone attaches to a dental implant, which provides support from within the bone instead of from other teeth in the mouth.
Though dental implants can be relatively expensive, the anchorage in the jawbone provides the best chewing function and the most natural cosmetic appearance when a tooth needs to be replaced. They also have the best long term prognosis and rarely have to be redone once placed in the mouth. This makes dental implants oftentimes the most economic cost option over a patient’s lifetime when considering other treatment options that will likely ultimately require replacement.
Am I a Good Candidate for Dental Implants?
Dental implants are a common treatment for patients who want the best prosthetic replacement for function and appearance, however, there are some requirements related to the health and quantity of the jawbone. Since the jawbone must surround and support the dental implant, a minimum height and width of bone is necessary. The bone must also be healthy and capable of attaching to the implant through osseointegration. This means that people with bone disorders, like osteoporosis, might not be good candidates for tooth replacement with dental implants.
If you are missing a single tooth and have lost bone in that area, you should see your dentist for imaging and measurements. If they show a lack of bone in the site where you want an implant, it is possible to augment the bone through grafting procedures. Your dentist may work with a specialist, like a periodontist or oral surgeon, to improve the quantity of bone in the future implant site.
Bone loss occurs gradually once a tooth is extracted, so it is important to replace the missing tooth with a dental implant as soon as possible.
How Can I Prevent Losing a Tooth?
As we mentioned previously, you can usually prevent tooth loss by preventing the dental diseases or trauma that most commonly cause it.
In order to prevent cavities and gum disease, you must fight on two fronts. First, you must have great home care. A diligent oral hygiene routine is essential in removing the dental plaque and bacteria that cause cavities and gum disease. Home care also includes a healthy overall lifestyle to promote good oral health. This means avoiding high levels of sugar in your diet and not smoking.
The second important factor in preventing tooth loss is maintaining regular visits to your dentist for exams, x-rays and professional teeth cleanings. Your dentist and dental hygienist can help you identify potential issues before they arise, like designing a custom-fit mouth guard for patients who play contact sports. They will also advise you on the best over-the-counter products to strengthen your teeth, and steps you can take to reduce any risk factors so that you can prevent disease at home.
Missing Teeth: Your Next Steps
Our teeth are necessary in maintaining good oral and overall health. Replacing missing teeth can improve a person’s appearance, digestion and quality of life. If you already have a missing tooth or are planning an upcoming tooth extraction, now is the time to meet with your dentist to discuss your replacement options.