Posts for tag: missing teeth
There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.
The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.
Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.
If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.
It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.
If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.
Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.
Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.
For most people, replacing missing front teeth takes a higher priority over missing back teeth. The reason is obvious: others can see those missing in front, but not necessarily those in the back.
From a functional view, however, you should still consider replacing missing back teeth. Not only will it improve your chewing ability, it may also prevent a chain reaction of negative effects to your remaining teeth.
Teeth are held in place in the jawbone by a membrane called the periodontal ligament. The ligament is a living tissue that allows teeth to move to keep contact with adjacent and opposing teeth as natural wear occurs. When a space is created by a missing tooth, this natural movement accelerates and the teeth may shift beyond normal ranges.
As a result you can encounter excessive mobility of teeth from bite irregularities, uneven tooth wear, bone loss, potential painful problems with the temporo-mandibular joints (connecting the lower jaw to the skull), and a loss in facial height.
There are three basic options for this kind of tooth replacement. The best option is dental implants: these free-standing replacements don't normally affect surrounding teeth, they're easier to clean, and they help support the bite. On the downside, there must be enough remaining bone to support the implant.
The next best option is a fixed bridge. This option only works, however, if there are teeth on either side of the missing tooth space capable of supporting the bridge, and they must be reduced in size by removing the enamel with the dental drill. They also have a tendency to retain plaque, the main cause of gum disease.
That leaves the last, and least favorable, option, a removable partial denture. They may also trap food and be difficult to wear. They can move in the mouth, stressing — and possibly loosening — the remaining teeth that hold them in place. With all its drawbacks, though, if a partial denture is the only solution to missing back teeth, it's a better alternative than doing nothing and risking long-term problems.
If you would like more information on replacement options for back teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Replacing Back Teeth.”