Replacing Missing Teeth

Your teeth affect your whole body. When they’re healthy, you’re healthier too. A missing tooth can affect your bite, speech and eating choices. As you rely more on your remaining teeth, you increase the chance they will wear out prematurely, be damaged or lost. You may also experience headaches and/or jaw pain.

Premature tooth loss may lead to atrophy of your jawbone. That’s the natural consequence of missing teeth – the jaw literally melts away. Generally, people may lose 50% or more of the bone in the first 6 months after tooth loss. Dental implants are more easily placed when teeth are first extracted because bone replacement therapy may be performed at the time of extraction.

Your teeth affect your whole body. When they’re healthy, you’re healthier too. A missing tooth can affect your bite, speech and eating choices. As you rely more on your remaining teeth, you increase the chance they will wear out prematurely, be damaged or lost. You may also experience headaches and/or jaw pain.

Premature tooth loss may lead to atrophy of your jawbone. That’s the natural consequence of missing teeth – the jaw literally melts away. Generally, people may lose 50% or more of the bone in the first 6 months after tooth loss. Dental implants are more easily placed when teeth are first extracted because bone replacement therapy may be performed at the time of extraction.

Tooth Replacement Options

Fixed Bridge

A fixed bridge is a connected set of replacement teeth. For support, it is cemented into position on top of the teeth adjacent to the empty space. The protective outer layer of these teeth is usually removed or ground down prior to attaching the bridge.

Flipper

A fragile, temporary and inexpensive solution is a removable plastic tooth with a plastic retainer, often called a “flipper”.

Metal Partial

A less fragile option is a removable partial denture cast in metal and plastic. It is held in place by wire clips. A removable partial denture can be removed and reinserted when required by the patient.

Denture

The most common solution for people missing all teeth in one or both jaws are complete dentures. Some people adapt well to dentures. Others find them uncomfortable, even intolerable, because of differences in jaw size and shape.

Dental Implants

Dental implants are the most comfortable and permanent solution. They form a strong foundation for teeth and keep the jaw healthy and strong. Implants support individual replacement teeth or secure specialized dentures in place. Unlike bridges, no healthy teeth are damaged. Implant-supported replacement teeth can be attractive, stable, and comfortable for almost any patient, and with proper maintenance in an infection-free mouth, can afford many years of service.

Why select dental implants over more traditional types of restorations?

There are several reasons: A dental bridge can sacrifice the healthy sound structure of surrounding good teeth to bridge the space of the missing tooth/teeth, which often leads to further treatment (i.e. root canal treatment). It also requires adjacent teeth to support additional weight, which may result in a fracture. Performing proper oral hygiene is harder under a bridge, which leaves the supporting teeth at greater risk for future decay.

Furthermore, dental implants maintain the jawbone even after the tooth is lost, something that neither a fixed bridge or a removable appliance are capable of doing. Finally, removing a denture or a “partial” at night may be inconvenient, not to mention dentures that slip can be uncomfortable and rather embarrassing.

Missing All Upper or Lower Teeth

Missing All Lower Teeth

Although many patients have no problem wearing an upper denture, some people find it difficult to wear and eat with lower dentures. Several implant-supported replacement options are available if you are missing all of your lower teeth.

Implant Supported Denture

One option is to have 2-4 implants placed in your lower jaw and a denture made that snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants.

Bar Attachment Denture

Another option involves placing four to six implants, depending on your jaw size or shape, into your lower jaw. After healing is complete, the implants are connected with a custom-made support bar. Your denture will be made with special internal retention clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called an “overdenture.” The advantage of this option is that it is much more stable than the first option and allows very little denture movement. Your denture is still removable for easy cleaning and maintenance.

Screw-Retained Denture

A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws or clasps that secure it to the support posts or bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at some maintenance visits. Although cleaning under your denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.

Individual Implants

The final option is to have all your teeth replaced with multiple implants so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires five or more implants (depending on each individual’s needs). Separate abutments or support posts for each one of these implants will be made and crowns for each missing tooth will be placed. Overall, this is the most costly option, because it requires the most implants and individual replacement tooth fabrication. Your replacement options may also be limited by the current size and shape of your jawbone.

Implant Retained Upper Denture

Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature. Your denture will feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier.

Individual Upper Implants

If you want a restoration that is similar to your natural teeth and therefore not removable, you probably will need eight to ten individual implants placed. This is followed after healing by the placement of the abutments and new replacement crowns.

Frequently Asked Questions

Frequently Asked Questions

What is Osseous, or Periodontal Surgery?

Osseous surgery is a procedure that provides access to clean pockets that are too deep to reach with scaling and root planing, known as a “deep cleaning”. The gum tissue is gently reflected so that the roots of the teeth can be seen. Calculus, or bacteria that has hardened to the root surface, is a brown color under the gum tissue.  It attaches to the white root surface and can be visualized and thoroughly cleaned with this procedure. Osseous surgery also gives us access to add a bone graft material to regenerate the lost bone around the teeth.

What is Bone Grafting?

The bone graft that we use is a donor or cadaver bone graft. It is real bone that has been sterilized and processed so that all of the cellular components are removed.  There is no immune reaction to the bone graft. We draw blood from the patient prior to beginning the procedure to concentrate the healing cells and growth factors using platelet-rich fibrin (PRF). The patient’s own growth factor concentrate is mixed with the sterilized bone graft particles to make a bone putty. This accelerates the healing and makes the bone graft easy to work with and to shape to the defects around the teeth.

What is a Dental Implant?

An implant is a titanium post that replaces the root of the tooth. Implant dentistry involves teamwork between your restorative dentist and your periodontist. First, the implant is placed in the bone by your periodontist. Once the implant has healed, your general dentist creates a tooth that screws into the implant. An implant provides a fixed (non-removeable) option to restore a missing tooth without compromising the adjacent teeth. It is a single-tooth solution to a single-tooth problem. 

What is Crown Lengthening?

When decay or a fracture extends below the gum line, crown lengthening is indicated to allow your restorative dentist access to the lesion.  Crown lengthening removes gum and bone tissue to expose additional healthy tooth structure.  It makes the tooth longer so that there is more tooth structure to work with and to retain the crown. Without crown lengthening, the crown margin may be located too deep under the gum tissue for proper cement isolation and access to remove all decay. Crown lengthening improves retention of the restoration and keeps the crown from falling off over time. Crown lengthening can also be done for esthetic reasons to lengthen anterior teeth and enhance gingival symmetry.

Do you offer Sedation?

We offer multiple forms of sedation for our periodontal procedures.
Oral sedation: A pill is prescribed before the procedure to make you comfortable and relaxed
IV Conscious sedation: This is known as twilight anesthesia. The patient often falls asleep during the procedure but can be woken up if needed. They can respond to commands such as “take a deep breath” but will remember very little, if anything, from the procedure. IV conscious sedation makes time pass more quickly and can make a 4-hour procedure feel like 30 minutes.

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