We, at Periodontal Specialists in Kansas City, get this question a lot. Especially if the patient is missing a back tooth and they feel that no one can see it or that they are chewing “just fine”. The issue, although, is not just the chewing function for the patient. You see, when a person loses a tooth a lot of unnoticeable changes occur that can lead to other problems.
The thing to realize is that teeth like to touch, or contact, each other. If we lose a bottom tooth, the tooth on the top opposing it will start to grow down into the space. If we lose a tooth on the top, the tooth on the bottom opposing it will grow up in to the space. It is a phenomenon, known as super-eruption of teeth. Also, teeth have a tendency to shift or drift into an empty space, so that if we lose a tooth, the teeth beside the missing tooth will shift into the space. The reason this is important is that if we have teeth that a shifted or drifted, or grown up or down, as we open and close and bite side to side, those teeth will put extra pressure on the teeth that are biting them, and that extra pressure or force can get translated back to our joints and can cause temporomandibular joint pain, or TMJ. So, for your mouth and teeth to be healthy we want a full complement of teeth that bite evenly together.
Another thing that people don’t realize or know is that it’s the roots of our teeth that stimulate the bone around it. When a tooth is taken out, or extracted, the bone that was present will start to shrink, or atrophy. First it starts to shrink width-wise then it starts to shrink height-wise. Once we lose height of bone it becomes very difficult, to impossible, to build that height back in with bone grafting procedures. This can make replacing the tooth very challenging and reduce or options for replacing the tooth.
The question now becomes, “What are my options for replacing one or more teeth?”. Well, most people have three options for replacing teeth. The first is something removable that comes in and out, what we call a Partial Denture. Most patients don’t like this option due to having to take their teeth in and out. Over time the denture becomes loose and may need other procedures done to tighten it, or may need to be replaced. The clasps that help hold the denture in place can also loosen the teeth that they clasp and can endanger the life and health of those teeth. The second option is something more permanent, that doesn’t come in and out, what we call a Fixed Bridge. This can only be done if there are teeth in front and in back of the missing tooth. It requires cutting down those adjacent teeth, which might not have any problems, and placing crowns with fake teeth attached. Anytime, we as Dentists, cut on a tooth we make tooth more susceptible to problems, like cavities and fractures. Not to mention that the Bridge is completely fused together and makes it very difficult to clean around. Lack of hygiene can lead to gum disease and bone loss around the Bridge and can cause the bridge to fail.
The third option, and best option, for replacing teeth is what we call a Dental Implant. A Dental Implant is a titanium screw that replaces the root of a tooth and a crown can be placed on that implant after an adequate healing time. The Dental Implant does not affect the adjacent teeth and is like you getting your individual tooth back. It can take longer to complete, over the other options, because the Implant must be placed first and must heal for approximately 3-4 months before a permanent crown can be placed. It does have the best success over time, versus the other options, and studies going out 30 years still give Dental Implants a 95% success rate.
So, If you are missing a tooth or multiple teeth, please call your local Kansas City Periodontist, to schedule a consult to talk about your options and what would be best for you!