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Week 8- I'm missing some teeth. What can I do to get my beaming smile back?
Missing a tooth or more can cause both psychological and physical issues. If you were to liken your mouth to a building, every tooth would be a building block. Every tooth gone destabilizes the “building”; the more teeth are gone, the more unstable your bite becomes.
You can lose a tooth or more for various reasons- gum disease, accidents, failing dental work, etc. Most people can’t bear the embarrassment of missing a front tooth, so they usually seek a solution immediately when a front tooth is gone. However, they may have a slightly different attitude towards losing a back tooth. Over the years I have seen a lot of patients who got their back teeth taken out without getting replacements. They often tell me that they did not consider replacing those teeth because “others can’t see the spaces in the back.”
Yes, the gaps/spaces in the back may not be all that visible, but teeth start moving when there is nothing opposing them. What you see in the above image is a common scenario; back teeth start tipping in the presence of a gap. Another common scenario looks like this:
In this case, lower teeth moved up because there is nothing opposing in the upper jaw. Even if we wanted to put tooth replacements in the upper jaw, it would be very challenging because there is just not enough space there.
Front teeth (narrow and long) are designed to cut things while back teeth (wide and short) are designed to mesh things. Patients who are missing a lot of back teeth often end up wearing their front teeth down because their front teeth do what back teeth are supposed to.
Long story short, not replacing a tooth or teeth after they are gone will eventually lead to a significant damage to the remaining teeth. Also, waiting too long to replace a missing tooth can deprive you of possible replacement options.
With that said, let me talk about tooth replacement options. People who are at risk of losing all teeth need some form of complete dentures. Here, I will talk about options for “short-span” gaps only.
Dental Implants - Replacement option #1 for missing teeth
Slide left and right for before and after photos
- Fixed- no wobbling
- No need to touch natural teeth
- Slows down bone loss if done properly
- Gives you great chewing power
- Most expensive option
- Expected timeline for treatment completion is 6 months- 1 yr
- Most technique sensitive- need to see someone who is very highly trained for good results
Until the tooth regeneration technology becomes commercially available, this will remain the most ideal tooth replacement option. The technology has come a long way, and Comfydent Smiles has the luxury of having Dr. Sara Elhusseini, who I think is one of the best, if not the best, implant surgeons in Greater Austin.
Dental Bridge - Replacement option #2 for missing teeth
- Fixed- no wobbling
- Can be done relatively quickly
- Need to reshape natural teeth to place a bridge
- Not feasible if the gap between two remaining teeth is too wide
- You can always get decay underneath
- Not easy to keep clean
This option has been around for a very long time, and this used to be the best treatment option for replacing missing teeth when implants weren’t available. Some patients who want implants are not viable candidates for implants (due to insufficient bone, etc.), and I still recommend dental bridges to those patients.
Partial Denture/Flipper - Replacement option #3 for missing teeth
- Cheapest option
- Can be considered when the gap between two remaining teeth is too wide for a bridge
- Least stable option out of the three, especially unstable if you are missing all molars
- It comes in an out of the mouth (psychological disadvantage)
- Least amount of chewing capacity provided
I personally see this option as more of a temporary solution than a permanent solution. It has been my observation that patients who wear removable appliances have the hardest time getting used to them.
I want to offer you a few words of caution; none of these options will be as good as healthy, untouched natural teeth. Although it is easier said than done, keeping your teeth healthy is the best thing one can do. However, if a tooth has to be removed or has been removed recently, replacing the tooth ASAP will minimize the breakdown of the “building.”
Embarrassed about missing a front tooth? Or did you recently get a tooth pulled in the back? Our doctors can help you restore your smile and bite.