Once a tooth is lost, it is important to replace it in order to maintain esthetics, teeth positions, and proper chewing. Most people want to replace a missing upper front tooth because it is visibly missing. However, many people choose not to replace a missing back tooth because they can hide it and they are unaware of the poor long-term consequences. Teeth help maintain the bone and soft tissues in the mouth. Once a tooth is lost, the bone and gums shrink, the adjacent and opposing teeth move, and with upper teeth, the sinus cavities tend to expand. If left untreated for long periods, this can limit the number of treatment options and their success.
For a single tooth, the best two replacement options are a dental implant or a bridge, with the implant normally being the superior choice. The other two options are to do nothing or wear a removable partial denture. In dentistry, treatment choices often come down to time, pain, and money. Let’s explore these three things as related to the treatment options.
Time: For a bridge, you must wait at least 6 weeks after the tooth is removed before the final prosthesis can be made. The longevity of a bridge varies, but typically lasts 5-15 years. For an implant, it can take many months before the final restoration can be completed. There are multiple temporary options available during this healing period. An implant is expected to last much longer than a bridge because an implant is singular, whereas a bridge connects multiple teeth together that undergo different forces. Longevity and overall success of both the implant and bridge options depend on many factors including: overall health, oral hygiene, diet, habits, regular checkups, quality of placement, materials used, the number of teeth being replaced, the health and position of the adjacent and opposing teeth, the quality and quantity of bone, esthetic and functional demands, and the location of other anatomical structures (sinus, nerves, etc.).
Pain: This is typically not a big factor in having either a bridge or an implant. Most of the pain you will feel will be from the tooth that is being lost due to infection or trauma. Anesthesia and medications are used to minimize any discomfort during your treatment.
Money: Costs often play a significant role in treatment decisions. In the short term, a bridge is typically slightly less expensive. However, in the long term, the implant will likely be much less expensive since its longevity is usually much longer and it does not connect to other teeth. Dental insurance coverage varies widely, so you should consult with your dental office and your insurance provider to see what specific benefits are available to you.
A partial denture can act as a short-term fix but is not recommended as a permanent solution because it must be removed regularly, it is bulky and less esthetic, an it puts destructive forces on the teeth around it. Doing nothing is also not recommended, even if the missing tooth is not visible, because of the loss of function, unwanted tooth movement, and more forces being placed on the remaining teeth.
You should consult with your dentist and make the final decision as part of your total treatment plan following a comprehensive exam. I do my best to educate every patient and explain the options so that everyone can choose what best fits their wants and needs. Our goal at Gilbert Smiles is to give you the best oral health possible.