Society may place a huge emphasis on the ability to flash a “million-dollar smile” as one of the keys of likeability or business success. This may stem partially from the general disconnection between Hollywood types and the general public: the American College of Prosthodontists estimates that at least 200 million Americans suffer from tooth loss or edentulism.
However, the current abundance of tooth replacement options also plays a major part in keeping this epidemic hidden. A quick look at listings for local dentists is bound to show countless banners offering half a dozen different procedures, which often does little but increase confusion.
Is Tooth Replacement Really Necessary?
Losing a tooth often occurs as a result of deep cavities, out of control periodontitis, or traumatic accidents where the jaw bone is damaged. Long-time patients at VIPCare Dental know that all our restorative dentistry interventions are meant to prevent definitive tooth loss from ever happening in the first place – but factors such as osteoporosis and chronic metabolic conditions often get the best of us.
As this tends to happen mostly to older patients, it is easy to fall into the trap of dismissing tooth replacement procedures as a purely cosmetic concern. However, leaving gaps open in a patient’s mouth after extraction can progressively worsen their oral health: this will increase the chances of gum disease, create small pockets for infection to thrive, and even cause the surrounding teeth to shift.
Tooth Replacement Options: Which is Best?
Depending on the amount and position of the teeth lost, the available tooth replacement options and cost will vary.
Dentures are usually considered the most cost-effective route to replace a tooth. At its core, they consist of a removable prosthetic that will look and function quite similarly to real teeth – but not quite.
Dentures can be either partial or complete. Removable partial dentures are the most common of all tooth replacement methods, as they can quickly fill the gap left following a surgical extraction.
Complete dentures, on the other hand, are reserved for complete tooth loss. Patients with advanced tooth loss are at a high risk of gum infection and shrinking. In such cases, we commission two sets of complete dentures: a temporary or immediate one to be used right after an extraction, and a permanent one that will be fitted after the gums have finished healing and shrinking.
The main advantage of dentures will always be their relatively small cost. However, they can be difficult to deal with: they can slip during the day, especially after biting too hard. They also need to be removed every night or before going to sleep – and forgetting to do so to take a quick nap can be dangerous. Finally, the constant manipulation they require can also cause gum injury.
The purpose of bridges is to “bridge” the gap between one or more missing teeth. At first glance, bridges are pretty similar to partial dentures, although they do not need to be taken out every night.
There are a variety of bridge models and materials, but they all follow the same basic structure: a tooth-shaped pontic or crown, which will stand in for the removed tooth, will be anchored to the adjacent teeth and held together by an adhesive or screwed on by a small implant. Depending on the available budget and their position, crowns are usually made from porcelain, gold, or different metal alloys.
As a general rule, porcelain bridges are more expensive, but they offer more realistic results. This is why they are often the first-choice material for people who have lost their front teeth. In addition, bridges can either be fixed, bonded, or cantilever bridges.
A traditional fixed bridge consists of porcelain or metal crown attached to the adjacent teeth with a small crown. They are ideal for replacing up to two consecutive missing teeth.
Cantilever bridges, on the other hand, are usually attached only to one side of the gap. They are more unstable and do not prevent the adjacent tooth to shift. This is why they have largely fallen out of favor, except for temporary tooth replacement interventions.
Bonded or Maryland bridges are a low-cost alternative to traditional bridges. They are made from a combination of porcelain or metal framework, which is bonded to the crowns using resin. The framework, which is usually shaped like a wing or a butterfly, is then attached to the palate on one side and to a healthy tooth on the other one.
Although a bit pricier than dentures, bridges offer the following advantages:
- They are more functional, and feel more similar to real teeth
- They have a smaller chance of shifting or moving out of place
- They permit speaking more comfortably and chewing harder
- Unlike implants, they can be installed even when the surrounding facial bones are weakened or damaged
However, they also have the following disadvantages:
- Since they always need to be attached to a nearby tooth, they are not a good option for patients with advanced or total teeth loss.
- They usually last up to 10 to 15 years. After that, they will need to be completely replaced.
- They need frequent refitting
Out of all options for tooth replacement, implants are usually the most expensive one. However, they also offer the best long-term results and can help preserve and improve oral health in patients with advanced teeth loss.
Dental implants are small screws attached directly beneath the gums or on the bone plate directly under or above the teeth (the jaw or the maxillary bone). These are inserted through a surgical procedure which, although more complex than just fitting a set of dentures, still rarely requires a hospital stay. These implanted screws hold the crown in place.
Traditional dental implants use one screw per crown. These provide a very realistic and functional solution for patients who needed a good single tooth replacement option.
Patients who need an entire row of teeth replaced, or who have lost more than three consecutive teeth, are usually recommended an all-in-four dental implant instead. This procedure uses just four screws to attach an entire plate of teeth, and therefore requires a very deft hand.
Getting dental implants installed can be quite pricey, especially if high-end implant materials such as titanium are used. Fortunately, more and more insurance companies are now covering implants, at least partially – and you’ll find us very willing to help you figure out how to best apply for it. This is because:
- Dental implants provide the most realistic and functional results: patients can chew, bite, and roll their tongues in the same way that they would with real teeth.
- They have a lower rate of complications or accidents than temporary tooth replacement options such as dentures.
- They last a lifetime.
- They offer long-term protection from gum disease.
- They don’t shift or fall out of place.
- They don’t require any adhesives, which lowers the risk of an adverse reaction.
Unfortunately, no single method or dental technology is absolutely superior for all cases. Patients who have lost bone density, have a pre-existing bone condition, or who do not respond well to general anesthesia, may not be good candidates for implants.
Cosmetic dentistry services often feel like an extensive, free-for-all menu. However, the importance of professional advice should never be overlooked. At VIPCare Dental Ocala, FL clinic we can provide you with a full consultation, take a hard look at your history, and help you reach the right decision for your mouth.