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There are many different methods to replace a missing tooth. Which one is the best for you?

There are many reasons why you could be missing a tooth or even multiple teeth for that matter. Your teeth may have been decayed, loose due to gum disease, or maybe you fractured them due to an injury. There are plenty of other reasons for missing teeth but whatever they may be, you now need to think about permanent tooth replacement [1].

There are several methods for permanent tooth replacement with some being superior to others. Let us start with the best choice and then move on down the list.

Dental Implants

If there is one thing that has completely revolutionized the way dental treatment is carried out and improved the quality of life that patients can expect after treatment, then it is the predictable and successful integration of dental implants.

Dental implants are made of a titanium alloy that is completely biocompatible. This means that it does not cause any allergic reaction or foreign body reaction inside the body. It also a material that is not magnetized and people with dental implants can safely use MRI scans or go through airport security without having to worry about setting off any alarms [2].

The idea behind the use of dental implants is pretty straightforward. Tooth implants are designed to mimic the natural roots of the teeth in both shape and size [3]. Space is then created for these implants inside our jaw bones at predetermined places by using bone drills and then these implants are placed inside the bone.

Once the bone heals around these implants, a process that is called as osseointegration [4], a crown is placed on top of the implant.

The biggest advantage of this procedure is that it does not require any support from any other tooth. This means that it can be carried out in places where adjacent teeth are missing or in people that have absolutely no teeth at all.

The resulting prosthesis is usually fixed so that patients do not have to take them out at all, although in case of implant supported dentures that may not be true [5].

Advances in this technology have meant that people can walk into the dental clinic with a missing tooth and come out with a permanently replaced tooth in a matter of hours [6]. Dental implants are also extremely successful, with reports ranging up to 98% success.

The one disadvantage of dental implants is their cost. They are more expensive than other forms of permanent tooth replacement and that can quickly add up when multiple implants are needed. Dental implants also require a certain minimum of medical fitness from the patient to be able to be placed successfully.

People who are suffering from uncontrolled diabetes, are undergoing radiation therapy, are on bisphosphonates or have severe osteoporosis cannot undergo implant treatment [7]. Since implants are going to be embedded in the bone, they are susceptible to inflammation and bone destruction similar to that occurs in gum disease.

All things considered though, we have no trouble in advocating dental implants as the best choice for permanent tooth replacement wherever it is possible and affordable for patients.

Crowns and Bridges

The next choice for tooth replacement would be crowns and bridges. These are also fixed, in that the patient cannot remove them by themselves, but they require a certain sacrifice from the neighboring teeth.

A crown is also called a "cap" in common parlance and is used to cover a single tooth. If you are missing a tooth, however, then you require a bridge [8]. To replace one missing tooth, we require the support of at least one tooth each on either side of the tooth.

Both these supporting teeth will have to be prepared or ground down to receive the supporting units of a bridge with the missing teeth attached in between. Like there are actual bridges of different spans across different widths of water bodies, so can different bridges in your mouth be increased or decreased in length to replace the missing teeth.

The biggest advantage of this method is that it is very quick. All it requires is one sitting for the supporting teeth to be prepared and impressions to be taken, after which the next appointment will be for fitting the bridge.

The drawbacks are pretty serious though. A bridge requires the sacrifice of healthy tooth structure from a minimum of two supporting teeth, possibly more if the span of the bridge is longer. This can result in the development of sensitivity, eventually requiring root canals in the supporting teeth as well [9].

Bridges are also not an option for people who do not have teeth on both sides of the missing area as well as for those who do not have any teeth at all.

For a lot of people though, bridges provide a good balance between being affordable and providing them the comfort, function, and aesthetics they desire.

Dentures

The last option on this list is also the oldest method of replacing teeth. Removable dentures. They can either be complete dentures for people who do not have any teeth in their mouth or partial dentures for people who still have some teeth remaining [10].

Dentures do have a lot going for them, and that is why they are used extensively even now.

They are affordable, easy to make and can be adapted to any situation. This means that you can get a denture made for one missing tooth or for fifteen. Patients of any age and under almost any medical condition can get dentures made and they are easily replaceable or repairable if they get damaged.

Now for the bad part. Dentures simply cannot restore the function of natural teeth to the extent that other choices can. They are removable, which means that they are not fixed and so need to be removed, cleaned and cared for by patients.

Dentures also have a long learning curve to them where patients have to adjust to having a foreign body that extends well beyond their teeth in their mouth, learn how to chew with the dentures and speak with them.

There is some amount of social embarrassment that is associated with needing to remove your dentures as well which could put some people off them.

Conclusion

It can be overwhelming to try and listen to choices and make a decision at the dentist’s office so it is better to do your homework and go prepared. Your dentist will help you figure out what is best for you and there are no real bad choices here except to leave missing teeth unreplaced!

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