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Missing Teeth, Dental Implants, and Non-Implant Options

10/21/2015 Anant Goel & Dr. MK Garg, DDS, FAGD

Despite improvements in dental care, millions of Americans suffer tooth loss─ mostly due to tooth decay, gingivitis (gum disease), or injury. For many years, the only treatment options available for people with missing teeth were bridges and dentures. But, today, dental implants are available.

First, let’s talk about non-implant options for restoring teeth…

Although dental implants are the best, longest-lasting options to restoring missing teeth, there are other treatment options available:  

Non-Implant Options for Replacing a Single Tooth 

A tooth-supported fixed bridge is the most common alternative to dental-implant supported restoration of a single tooth. It has several disadvantages when compared to dental implants. Placement of a tooth-supported bridge involves grinding away – or damaging – healthy, adjacent teeth, which will be attached to, and used to support, the bridge. Natural bone underneath a tooth-supported bridge is not stimulated as it is with dental implants, and may deteriorate over time, ultimately changing the appearance of your smile and face. A tooth-supported bridge also may not last as long as an implant-supported bridge, and it requires more ongoing care and maintenance.

Removable partial dentures don't require grinding down adjacent teeth but are not nearly as stable or comfortable as dental implants and can affect speech and eating. This type of restoration is less expensive but doesn’t look as natural or function as well as an implant-supported ceramic crown.

A resin-bonded bridge (also called Maryland Bridge) is sometimes considered, especially to restore front teeth that don't endure the biting and chewing demands of back teeth. It has wings on each side to attach to healthy, adjacent teeth but usually doesn't involve preparing, or grinding down, other teeth. A resin-bonded bridge looks and functions better than a removable denture but isn't as strong as fixed bridgework and typically doesn’t function or last nearly as long as dental implants.

 

A removable partial denture, an alternative to restore multiple teeth, is not nearly as stable as dental-implant restored teeth. The device can interfere with speech and eating. This type of restoration is less expensive but doesn’t look as natural or function as well as implant-supported teeth.

Non-Implant Option for Replacing All Teeth

A removable complete denture, an appliance that sits on top of the gums where the missing teeth were, is a low-cost alternative to dental implant restoration. It can be uncomfortable, affect the ability to experience the full taste of food, cause sore gums, and shift and click in the mouth when one speaks, eats, smiles, yawns or coughs.

Why Dental Implants?

Dental implants are modern dentistry's best option for replacing missing teeth. They offer a highly successful, long-lasting, and totally natural-looking substitute that actually becomes part of the jawbone and helps maintain its health. There are now more than 40 different types of dental implants, and millions of people worldwide have a better quality of life because of them.

What Are Dental Implants?

Dental implants are replacement tooth roots. Implants provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

In order to understand exactly what an implant is, you first have to picture a natural tooth, which essentially has two main parts: 1) the crown, which is the part you see in the mouth above the gum line, and 2) the root, which is inside the bone. A dental implant replaces just the root part of the missing tooth. The implant is then topped by a realistic-looking dental crown.

In order to understand exactly what an implant is, you first have to picture a natural tooth, which essentially has two main parts: 1. the crown, which is the part you see in the mouth above the gum line, and 2. the root, which is inside the bone. A dental implant replaces just the root part of the missing tooth. The implant is then topped by a realistic-looking dental crown. 

What Are the Advantages of Dental Implants?

There are many advantages to dental implants, including:
  • Improved appearance. Dental implants look and feel like your own teeth. And because they are designed to fuse with bone, they become permanent.
  • Improved speech. With poor-fitting dentures, the teeth can slip within the mouth causing you to mumble or slur your words. Dental implants allow you to speak without the worry that teeth might slip.
  • Improved comfort. Because they become part of you, implants eliminate the discomfort of removable dentures.
  • Easier eating. Sliding dentures can make chewing difficult. Dental implants function like your own teeth, allowing you to eat your favorite foods with confidence and without pain.
  • Improved self-esteem. Dental implants can give you back your smile and help you feel better about yourself.
  • Improved oral health. Dental implants don't require reducing other teeth, as a tooth-supported bridge does. Because nearby teeth are not altered to support the implant, more of your own teeth are left intact, improving long-term oral health. Individual implants also allow easier access between teeth, improving oral hygiene.
  • Durability. Implants are very durable and will last many years. With good care, many implants last a lifetime.
  • Convenience. Removable dentures are just that; removable. Dental implants eliminate the embarrassing inconvenience of removing dentures, as well as the need for messy adhesives to keep them in place.

What are the Treatment Options for Dental Implants?

Dental implants can support a variety of dental restorations:

  • Single tooth replacements: one implant and one crown replaces a single tooth.
  • Multiple tooth replacements: multiple missing teeth can be replaced with multiple implants supporting fixed bridgework. For example, a three-unit bridge to replace three teeth in a row will be comprised of two implants and three crowns; or multiple implants can support an even greater number of false teeth. Usually four to eight implants are needed to replace a full arch (jaw) of teeth (10 or more crowns) using fixed bridgework.
  • Combinations of fixed and removable bridgework: implants support a section of fixed bridgework, to which a removable section is attached.
  • Over-dentures: where two or more implants provide stabilization of a denture (set of removable false teeth). Over-dentures are now considered the standard of care for those who have lost all of their teeth in one or both jaws.
  • Anchorage for tooth movement (orthodontics): temporary implants can serve as very stable anchor units for orthodontic devices to allow quicker and easier tooth movement.
  • Temporary bridgework: micro-mini implants can be used to support bridgework temporarily while permanent implants are healing… so that at no time the person be without teeth.

How Successful Are Dental Implants?

Success rates of dental implants vary, depending on where in the jaw the implants are placed. In general, dental implants have a success rate of up to 98%. With proper care, implants can last a lifetime.

Can Anyone Get Dental Implants?

In most cases, anyone healthy enough to undergo a routine dental extraction or oral surgery can be considered for a dental implant. Patients should have healthy gums and enough bone to hold the implant. If you are considering implants, talk to your dentist to see if they are right for you.

Does Insurance Cover the Cost of Dental Implants?

In general, dental implants are not covered by dental insurance at this time. Coverage under your medical plan may be possible, depending on the insurance plan and/or cause of tooth loss. Detailed questions about your individual needs and how they relate to insurance should be discussed with your dentist and insurance provider.

What Is Involved in Getting a Dental Implant?

The first step in the dental implant process is the development of an individualized treatment plan. The plan addresses your specific needs and is prepared by a team of professionals who are specially trained and experienced in oral surgery and restorative dentistry. This team approach provides coordinated care based on the implant option that is best for you.

Next, the tooth root implant, which is a small post made of titanium, is placed into the bone socket of the missing tooth. As the jawbone heals, it grows around the implanted metal post, anchoring it securely in the jaw. The healing process can take from six to 12 weeks.

Once the implant has bonded to the jawbone, a small connector post (called an abutment) is attached to the post to securely hold the new tooth. To make the new tooth or teeth, your dentist makes impressions of your teeth, and creates a model of your bite (which captures all of your teeth, their type, and arrangement). The new tooth or teeth is based on this model. A replacement tooth, called a crown, is then attached to the abutment.

Instead of one or more individual crowns, some patients may have attachments placed on the implant that retain and support a removable denture.

Your dentist also will match the color of the new teeth to your natural teeth. Because the implant is secured within the jawbone, the replacement teeth look, feel, and function just like your own natural teeth.

How Painful Are Dental Implants?

Most people who have received dental implants say that there is very little discomfort involved in the procedure. Local anesthesia can be used during the procedure, and most patients report that implants involve less pain than a tooth extraction.

After the dental implant, mild soreness can be treated with over-the-counter pain medications, such as Tylenol or Motrin.

How Do I Care for Dental Implants?

Dental implants require the same care as real teeth, including brushing, flossing, and regular dental check-ups.

What Causes Dental Implants to Fail?

Although it is rare, an implant can fail to fuse to the bone properly or it can come loose from it for a variety of reasons. This is why it's so important to choose a qualified professional to install your implants.

Can Periodontal (Gum) Disease Influence Dental Implants?

As with peri-implantitis, gum disease is a bacterial infection that can result in bone loss. And continued bone loss can cause implants to fail. You may be more susceptible to gum disease if you are diabetic, pregnant or taking birth control pills.

Whom Should I See For Dental Implants?

Implants are normally placed by dental surgical specialists (periodontists and oral surgeons) or general dentists who have undertaken special training in implantology.

Your general dentist is the place to start. Some general dentists have more knowledge than others in the field of implant dentistry, depending on their individual interests, knowledge and expertise.

Consult with a dental implant expert to find the treatment option for missing teeth that is right for you.

[Curated content based on excerpts from posts, blogs, media articles, and sponsored research]

 

 

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