Whether you lose a tooth due to an accident, gum disease or decay, that tooth is no longer helping to evenly distribute the forces among the remaining teeth. As a result, the remaining teeth take on more forces than normal, which may cause more fractures and loss of other teeth over a person's lifetime. After losing a tooth, you may tend to favor the side with the most teeth, thus creating a shift in your remaining teeth that could lead to an unstable bite. Then over time, the bone where the tooth was lost will begin the process of resorption. Bone resorption or “bone loss” can cause facial and jaw structural changes which would affect your appearance. Waiting too long to replace the missing tooth could also be problematic as the remaining teeth will begin shifting, closing the gap between them. These factors can significantly complicate and increase the complexity and costs of fixing the space.
LOSING A FRONT TOOTH: When you lose a tooth especially in the front of your mouth where the bone is very thin, the bone will usually start to melt away rather quickly, giving the appearance that the bone and gums are caving in, or collapsing.
Very often, this defect is visible when smiling and many people become self-conscious about their appearance as a result.
The teeth on either side of the missing tooth drift and the opposing tooth (directly above in this case) supra-erupts to close in the gap.
This drifting causes the bite to be off, making gaps develop and misalignment.
Over time, the remaining teeth begin to break down causing more and more damage.
As you lose more and more teeth, facial structures begin to change. Your mouth will begin to appear sunken in, and your chin and nose will appear elongated.
The adjacent teeth next to the space are prepared for crowns or “caps” and a false tooth is created in between the two prepared teeth. This has been the treatment of choice for many years because of the ability for this device to be permanently stationed in the mouth and it keeps the teeth it supports from drifting. Unfortunately, even if the adjacent teeth are relatively healthy, the dentist will still have to drill into (or prepare) the neighboring teeth to be outfitted with crowns that will support the false tooth. And should one of those teeth develop a cavity, the entire bridge would need to be redone. In addition, a bridge creates more difficulty for the person to keep the area clean which can lead to further gum problems. And last, the possibility remains there will be bone loss over time.
Removable bridge or denture. The removable bridge, flipper, denture, or stay plate are all forms of the same appliance which can be removed from the person's mouth and placed back in when eating and speaking. The main advantage of these devices is the relatively inexpensive cost and with constant wear, can prevent the teeth it supports from drifting. However, they can vary in comfort and the wearer may have trouble adapting to a removable appliance. Also, it doesn't address the problem with bone resorption. Over time, as the bone recedes, the denture will need to be adjusted and/or replaced and will become less and less effective and less comfortable for the wearer.
What has become the tooth replacement of choice is the dental implant. In essence, it becomes the root of the missing tooth. A crown is then placed on top to resemble and function just like a real tooth. Several advantages include that it is permanent, healthy neighboring teeth do not have to be drilled on, it prevents shifting of teeth, and you can clean and floss it like the other teeth. Also, unlike the prior traditional methods, an implant helps avoid bone loss at the site of the missing tooth (bone resorption). It feels like you have your natural tooth back. .
There are different options to replace teeth with implants. Either by placing an implant and implant crown for every missing tooth, or by using an implant 'supported' appliance.
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