Not many of us are lucky enough to get through life without losing at least one tooth. When you consider the stresses and strains that our teeth go through every day, it is amazing that they last as long as they do, and we can’t really be surprised if the odd one gives up the fight. There are plenty of ways to lose a tooth: it might be a sporting or other accident, an unfortunate bite onto something hard, the result of poor dental hygiene, poor diet, smoking, or a genetic predisposition—the day comes when, despite the best efforts of your dentist, you have to say goodbye to one of your ivory companions. Then you will have to decide what to do about the gap.
Why Fill the Gap?
If the gap is in your visible smile, then there is an obvious cosmetic reason why most people want to put something in its place. As Dr Scott Laudon of the Alcan Dental Group says, ‘Your smile is your biggest asset.’ Leaving a gap in your front teeth can have definite social consequences, and people who are aware of a gappy smile tend to smile less often.
But even if the gap is among the back teeth, it does not remain just as it was on the first day the tooth was removed. It may not be visible, and it may not significantly affect your eating, but two things soon begin to happen.
- The bone structure that previously supported the tooth is maintained by the constantly repeated stresses of chewing. When those stresses are removed the calcium from the bone begins to be absorbed back into the body (a process known as ‘resorption’) and the bone structure shrinks.
- The teeth adjacent to the gap, and those opposite it in the other jaw, tend to drift towards the gap. This can affect your bite, and can also expose the gum to infection.
So what are the options? Basically there are three, besides that of leaving the gap alone.
It is possible but not very common to provide a denture for a single missing tooth, but where there are several missing it is an economical option. A denture can be full (replacing all the teeth on a plate that surrounds the jaw) or partial (a plate that is molded to be supported by the gum and adjacent teeth).
Modern dentures are cosmetically effective and are reasonably easy to eat with. However, they take time to get used to, and need to be removed at night to keep them clean and allow the gum to relax. They do not protect the neighboring teeth and as the bone shrinks they may need to be replaced.
- Fixed Bridge
There are different types of bridge, but most involve the removal of enamel from adjacent teeth (usually one on each side of the gap) and the fitting of a cap to each of them supporting a prosthetic tooth in between.
Again this is effective both cosmetically and practically, but it does involve trauma to the otherwise healthy supporting teeth. Although it prevents drifting, the bone under the gap will continue to shrink. Cleaning the teeth also becomes a little more complicated.
- Dental Implant
The solution that most dentists now prefer for replacing a single tooth is the dental implant. This involves inserting a metal post into the bone, onto which a prosthetic tooth is fixed. It deals with most of the drawbacks of the other methods, since it does not affect adjacent teeth and provides the stimulation which maintains the bone density. It also looks and behaves exactly like a natural tooth, making dental hygiene easier to manage.
Problems with implants are rare, but this is the most expensive treatment available, and it involves months of treatment with repeated visits to the dentist. Also they represent a more extensive form of surgery so there are small risks with infection and rejection issues.
The Choice Is Yours
Most people, at some time, will face the decision of what to do about a missing tooth. Many factors need to be considered, including your finances, your age, your vanity, and your general state of health. Dentists are well used to discussing the options with their patients, and will advise you as best they can, but in the end (as with any decision) there are pros and cons to every method, and only you can make the choice.
Oscar Hunt has always been rather ashamed of his smile due to his missing teeth. But he recently plucked up the courage to get dental implants and now he wants to share his story with others who might be afraid to go down the implant path.