By Brian P. Hall, DMD
Often, when I see patients for second opinions on restoring a space where a tooth was lost, the patient believes that the only option is an implant. It is true that an implant, essentially a titanium or ceramic post surgically inserted into the bone with a new crown placed on top, is the best treatment and should be recommended.
However, there are many other options to consider. Some of the things I want to discuss in this article are the pros and cons of each technique for replacing missing teeth so that you, the reader, will know what your options are if this ever happens to you.
Let’s discuss implants first since they often are the best option:
The pros of implants are that they rarely fail, they never decay, they don’t put any stress on the neighboring teeth (nor do they rely on them for support), and they are not (easily) removable, meaning, you don’t take them in our out at night.
The cons of implants are that they often take six months to a year to complete from the date of the extraction and they are relatively expensive, compared to the other methods (there is a separate fee for inserting the implant and restoring it with a crown), they may require bone grafting to have enough room for the implant.
On the other hand, another option is the traditional bridge:
The pros of a traditional bridge include: they are much faster than an implant (usually taking a couple months from the date of extraction), they are less expensive than implants (but still more expensive than the other options) and they rarely require any bone grafting.
The cons of the traditional bridge are that they heavily rely on the neighboring teeth (if either of them fail through fracture or decay, the bridge will fail), they normally have a shorter lifetime than an implant, which can be significant in anyone under the age of fifty, and they involve removing significant tooth structure (unless they are already crowned) of the neighboring teeth.
Another option is the partial denture (a removable denture that has some teeth but also hooks to existing teeth):
The pros of the partial denture are that it’s more affordable than either option above, it can replace multiple teeth for the same cost, it can be removed and serviced, upgraded, and repaired.
The cons of the partial denture are that it is removable and the patient doesn’t forget about it when it’s in the mouth, it can be less comfortable than either options above, it can trap food around the edges, it can be less esthetic than any other option, and lastly, it can stress the neighboring teeth that hold it in place.
Finally, the last option is the Maryland bridge (a bridge for front teeth that doesn’t involve moderate removal of tooth structure of the neighboring teeth):
The pros of the Maryland bridge are it’s usually very affordable and very esthetic, and it doesn’t involve much chair time.
The cons of the Maryland bridge are that they sometimes come loose from the neighboring teeth and have to be reattached, and they don’t work well in the back of the mouth and with some types of bites.
Well, I hope this helps you as a patient to understand your different options if you happen to lose a tooth.
Dr. Brian P. Hall General Dentistry is located at 1180 Resurgence Drive Suite 300, Watkinsville, GA 30677 and can be contacted by phone at 706.549.8737. www.halldental.com