Tooth Replacement Options
Imagine you break a tooth and get the devastating news that it is not restorable and can’t be saved. Once it is extracted, what are your options for replacing that tooth?
According to the dentists at Goldenberg Family Dentistry there are many reasons a tooth may need to be extracted; severe bone loss from periodontal disease, a large cavity in which there isn’t enough tooth structure remaining to restore, a tooth that breaks from an old filling, a crown that breaks off at the gumline, or even from trauma. Before the tooth is removed it is important to know what your options are and have a plan in place.
The least expensive option is to have a removable partial denture made. Usually a single tooth partial that is made for temporary use is called a flipper. It looks like a plastic retainer with one or more teeth on it and sometimes has metal wire clasps. Impressions for that can be made and the appliance fabricated before the extraction is completed so that it may be delivered the day of the extraction and the patient is never without a tooth. Another type of partial available is a flexible all acrylic partial with pink acrylic clasps that look more natural than the traditional metal clasps. This type of partial can be used on a temporary basis, but can last many years. The most durable type of partial that works best for patients who are missing a lot of teeth, especially in the posterior region and need to regain chewing ability, is a metal framework partial with natural looking teeth and pink acrylic to look like gums.
Another option to replace a missing tooth is to place a fixed partial denture, also referred to as a bridge. The teeth on either side of the missing tooth or teeth are prepared for crowns and the bridge consists of crowns fused together that will cover the natural teeth and replace the missing teeth. This is a great option if you have teeth on either side of the missing tooth. A drawback though is the neighboring teeth need to be prepared for crowns which could mean removing healthy tooth structure. Also, if in the future there is an issue with one of the teeth, the entire bridge may need to be remade.
The most natural looking and easiest option to maintain is a dental implant. Implants can either be placed at the time of the extraction or after 4 months of bone healing. Implants are titanium posts that are drilled into the bone and allowed to integrate for 3-4 months. Then an abutment is screwed into the implant and the crown can either be screwed in or cemented on to the abutment.
Advantages: low cost, quick fabrication, slight drilling on teeth, no surgical procedure, can replace multiple teeth, very little discomfort, average 10 year life
Disadvantages: must be removed daily, must be cleaned nightly, not secure, uncomfortable for some, does not maintain bone shape, does not look natural
Advantages: quick fabrication, securely cemented, looks good no surgical procedure, 15-25 year life
Disadvantages: cost, requires drilling of teeth, difficult to clean, decay around crowns possible, does not maintain bone shape
Advantages: no drilling on adjacent teeth, looks natural, securely cement into place, does not place stress on teeth, maintains bone health, easy to clean and maintain, 25+ years of use
Disadvantages: cost, surgical procedure necessary, longer treatment time from start to finish