How Can I Replace a Missing Tooth?

So, you’re missing a tooth. Who knows how it happened. It came out on its own. You had it removed because you were experiencing pain or sensitivity. You got into a fight with your younger brother, who used to be small, and is now bigger than you. All that’s in the past, we can’t change it. The question is, what next?

There are three main options to consider. Each of these options can vary in your personal treatment plan, depending on your health. For example, we will talk about replacing a single tooth with a dental implant here. For your case, you may be looking at replacing multiple missing teeth, and your range of options will be a bit wider. This article will at least give you a brief introduction to the types of treatments available.

At Longworth, we believe in giving you all your treatment options before partnering with you on your preferred treatment. With that in mind, let’s start with Option 0: Doing Nothing. I am a big fan of option zero: leave everything just the way it is. It’s important to remember that option zero is always the base, default option. And it is usually good for some time. The advantage to Option 0 is that it is the cheapest option for right now. The immediate cost is 0. It doesn’t take any time or energy. Option 0 also has some disadvantages. The cost for treatment down the road could go up if your health deteriorates. And if you aren’t currently satisfied with how you bite, chew or smile, that likely won’t improve without treatment.

Option 1: Placing an Implant-Supported Crown

In this case, the dental implant acts as an artificial “root” for the tooth, anchoring the replacement tooth in place. Here is the process.

Replacing a Missing Tooth with a Dental Implant

A dental implant restores your mouth to optimal bite and aesthetics. You can put pressure on it when biting (though not necessarily as much as with your original tooth), and it looks like a regular tooth when you smile. It stabilizes bones, teeth and gums around it by giving them something to lean against and hold on to.

Preparing the Site and Placing the Implant Body

The first step is to prepare the site of the missing tooth, and to place the implant body. This is the new root of the tooth. Once this is done, usually there is a temporary healing cap that can go on to help the tooth and gums heal. This can last anywhere from a few weeks to a few months, depending on your health.

Placing the Abutment

Next, an abutment is placed. This is the base of your new tooth.

Placing the Crown

Next, we place a crown on the abutment. This is what most people think of when they use the word tooth. For dentists, replacing a tooth is all of these things: the implant body, the abutment and the crown.

The Final Product

Once the implant placement is complete, your mouth is now back to optimal health. Your gums have something to hold on to. Your bone density will be maintained because they are actively holding the implant. And the teeth around it won’t drift into the space.

Disadvantages

Advantages

Requires at least three appointments over six months.

Permanent tooth replacement. Average life expectancy is approximately twenty years.

May involve additional procedures to augment bone for implant integration.

Protects the area from tissue and bone loss.

There is a chance that the implant may be rejected and need to be removed.

Prevents drifting of adjacent teeth and overeruption of opposing teeth.

A dental implant can be cared for like a natural tooth. You can floss between the teeth.

Does not require removal of healthy structure from adjacent teeth.

There is an option to have a temporary aesthetic replacement during the healing stage.

Retains 100% bite force.

Option 2: Placing a Three-Unit Bridge

For this option, we permanently replace the tooth by using teeth on either side for support.

Restoring a Missing Tooth Using a Bridge

A bridge is a single-piece restoration that uses the teeth next to the missing tooth to build a literal bridge over top. It is usually made of ceramic or a hard plastic.

Scanning the Missing Tooth Using 3D Imaging

We start by using 3D imaging to build a computer model of your teeth. We transfer this scan to a computer, to help us design the bridge. This technology reduces the time it takes to fabricate the bridge, while also making the final result fit and look better.

Preparing the Adjacent Teeth

Next, we prepare the adjacent teeth, so they can act as a support structure for the bridge. One disadvantage to the bridge is that this turns a one-missing-tooth problem into a three-tooth problem, since we need to reduce tooth structure for two more teeth in order to replace the missing tooth.

Creating Final Scan to Craft the Bridge

Now we scan the area again, so we can begin to fabricate the bridge. When possible, we digitally craft the bridge right in our Courtice dental office, which allows us to maintain accountability for the final produce in-house.

Placing the Bridge

Once we have finished crafting the bridge, we make any final adjustments right in the chair and place the final bridge.

The Final Result

At this point, we have restored the missing tooth to optimal bite force and looks.

Advantages

Disadvantages

Requires multiple appointments to complete.

Permanent tooth replacement. The average life expectancy of a bridge is approximately ten years.

Turns a one-tooth problem into a three-tooth problem, since adjacent teeth need to be reduced.

Prevents drifting of adjacent teeth and overeruption of opposing teeth.

Increased risk of bone loss over time, since the bridge does not replace the missing root structure.

Can achieve excellent aesthetics.

A bridge requires frequent cleaning to prevent bacteria buildup. It can be difficult to floss between the three teeth or under the bridge.

Can generally be completed in two to three appointments, each two weeks apart.

Risk of cavities, root canal problems, or fractures in post teeth.

100% bite force.

Option 3: Crafting a Removable Partial Denture

There are two types of dentures. Acrylic dentures are made of hard plastic. Cast dentures are made with a metal base, with hard plastic built on it to mimic gums and teeth.

In this example, we are going to look at crafting a removable partial denture, since we are planning to replace a single tooth. If you are missing multiple teeth, other types of dentures are available.

The Case for Removable Partial Dentures

If your health does not allow for placing a dental implant or a bridge, another great option to replace missing teeth is to craft a removable partial denture. They look nice, by replacing the missing teeth, and also increase your ability to eat and speak.

Time Considerations

It typically takes multiple appointments to craft a well-fitting removable partial denture. They are designed in stages, where after each stage, the fit and function get better adapted to how you eat and speak.

Crafting the Removable Partial Denture

Removable partial dentures are created with a base metal frame, over which we put a resin to mimic the form and look of gums and teeth. You can put them in and take them out on your own.

Beginning the Process

First, we take several impressions of your teeth and the area where you are missing teeth.

Your Denturist's Work

Next, your denturist builds a model of your mouth. They work closely with you to design the denture.

After Each Phase

After each phase of treatment, your denturist meets with you to see how the denture is fitting. If you are experiencing any difficulty biting, your denturist will work with you to adjust the bite. It can take several fittings to ensure you have the best possible bite for you.

Eating with the Partial Removable Denture

As you adjust to the denture, and as it becomes better crafted for your mouth, you will begin to be able to eat with it in your mouth. Eating and speaking will both become easier.

The Final Result

Once this whole process has been completed, you will have a removable partial denture that mimics your natural teeth and improves your ability to eat and speak.

Advantages

Disadvantages

Needs to be relined as gum tissue shrinks.

Minimal damage to adjacent teeth.

Repair may be required if acrylic or wire breaks.

Acrylic (hard plastic) dentures can be fabricated in two appointments.

Requires time to get used to. Altered speech patterns initially. Some people have a tendency to gag.

Cast metal dentures can be fabricated in four to five appointments.

Food may get caught under the denture. Denture must be removed to clean.

Can be made without numbing.

Bone and gums shrink, since they no longer have a tooth to hold on to.

Prevents drifting of adjacent teeth and overeruption of opposing teeth.

Needs to be removed at night.

Dentures can sometimes be added to if other teeth need to be extracted in the future.

Loss of taste and sensation.

Clasps can loosen abutment teeth over time.

Not ideal for replacing only one single tooth, since it is unbalanced.

Retains 60% - 70% of your original bite force.

Looking to replace a missing tooth? Let us help!