Best Options for Replacing Missing Teeth
Surprisingly, many American adults between the ages of 20 and 64 years old are missing about seven teeth, according to the National Institute of Dental and Craniofacial Research (NIDCR). While most people living in the U.S. have 32 teeth, many of those in the above age group have about 25 remaining teeth.
Losing one or more teeth because of dental disease or another reason is unfortunate. However, you can consider several different dental options for missing teeth if you are interested in tooth replacement.
Listed below are six common options for replacing missing teeth:
- Dental implants
- Implant crown and bridges
- Implant-supported dentures
- Partial dentures
- Complete dentures
- Do nothing
1. Dental Implant
Because a dental implant integrates with your natural bone, it makes an ideal tooth replacement option for many people. For this procedure, our dentist inserts dental implants right into your jawbone, replacing a natural tooth root, which will eventually support a replacement with a dental bridge, crown or denture.
The implant which is gently placed into the jaw is made of titanium. Titanium is biocompatible and used in many kinds of implants and prosthetics, such as artificial joints. Once the implant is securely placed in the jaw and fully healed a prosthetic tooth is attached. The implant is used to anchor the bridge, denture or crown to the jaw.
Implants could be your best option if you are missing one or more of your teeth due to periodontal disease, injury or other dental health issues.
Benefits of Dental Implants
Some benefits of implants include:
- They have another 95 percent treatment success rate.
- They are permanent and durable.
- They feel more comfortable and natural and provide an appealing aesthetic.
- They require minimal maintenance other than professional cleanings, dental checkups and good oral hygiene.
- They are the best tooth replacement option to prevent jawbone loss.
- They have a long lifespan making them the most cost-effective in the long-term.
- They do not require any modification of the adjacent teeth.
- They can be done in one day, in some cases, through an immediate implant placement procedure.
Considerations for Dental Implants
Important points a patient should be aware of before having implants:
- Placement of dental implants is a minor surgical procedure that requires complete and accurate medical history.
- Minor modification to your activity level may be required 24 -48 hours following surgery, i.e. any strenuous physical activity, like gym, should be avoided for the next 2 days.
- Dental implant on it own is not a replacement option but a supporting structure for implant crown, implant bridge, or implant denture.
- As any other dental treatment to replace missing teeth, dental implants are a costly procedure. If you are worried about the cost of dental implants, you can always discuss a payment plan or other financing options with your dentist.
Best Candidates for Dental Implants
Depending on your bone health, you may be able to have your dental implants placed the same day as your tooth extraction — referred to as immediate implant placement. Upon your initial consultation, the dentist will decide if implants are a good replacement option for missing teeth and if you are a good candidate for immediate implant placement.
If you are not a candidate for the same day implants, you will require delayed implant placement. The reason for the delay is either infection in your bone that has to heal or a loss of the bone that your implant dentist has to restore using the bone graft. The healing process typically takes two months.
2. Implant Crown and Bridges
In the past, the only missing back teeth solutions were removable dentures or a dental bridge. Today, you have numerous options. A few good alternatives to the standard restorations are:
- Implant bridge
- Implant crown
- Implant-supported denture
Both implant bridge and implant crown are implant-supported restorations. The dentist uses them to replace extracted or missing teeth. An implant crown is the best option replaces one missing tooth regardless if it is a back missing tooth or a front.
Implant-supported bridge is an excellent choice to replace a span of several missing teeth — anywhere from three to 12. The number of implants and the length of the implant-supported bridge depends on the number of missing teeth. If you have no teeth, the dentist can perform a full mouth reconstruction with implant-supported dentures or dental implant bridges.
Benefits of Implant Crowns and Bridges
Numerous advantages of implant bridges and crowns include:
- The dentist will not need to grind any of your healthy teeth down to create a new bridge to replace your missing tooth.
- They function like natural teeth allowing you to eat with confidence.
- They provide aesthetically pleasing results.
- They look and feel natural, making speaking and smiling easy.
- They are easy to maintain — you brush and floss like you would a regular tooth.
- They will last a long time before you will need to replace them.
Disadvantages of Implant Crowns and Bridges
Some drawbacks include:
- The number of dental visits you will need from the initial extraction and implant placement to complete restoration with a crown or bridge will vary depending on the exact treatment and the health of your bone. Expect the total treatment length to be from three to six months.
Best Candidates for Implant Crowns
You are a good candidate for implant crowns if you are looking for stable and strong non-removable teeth. If you are missing one to few teeth. If you are looking for attractive aesthetics, great function, perfect speech, and confidence, this option is for you.
3. Implant-Supported Dentures
Implant-supported dentures are a type of overdenture attached to and supported by implants. Unlike regular dentures that simply rest on your gums, implant dentures snap onto implants using special attachments and thus provide better support. They are known among patients by many names:
- Implant dentures
- Implant-supported dentures
- Denture implants
- Full denture implants
- Snap-in dentures
However, they all mean the same thing — your implants provide complete denture support.
Like other types of implant-supported restorations implant dentures are a two-phase process. First, our dentist performs a surgical procedure where they place at least two dental implants into your jaw. These will help maintain an implant denture. An implant specialist performs this surgery. Next prosthetic dentist finishes the second phase of fitting your new custom prosthesis.
Types of Implant Dentures
- Implant/abutment supported removable denture
- Implant/abutment supported fixed denture, also known as hybrid fixed denture
Implant-supported removable denture
As with traditional denture, implant-supported removable denture has to be removed during sleep. In addition, to maintain proper hygiene, both gums and denture have to be cleaned daily.
This type of denture comes in two forms:
In either case, our dentist creates your denture out of an acrylic base, so it looks like your gums. They then will attach natural-looking acrylic or porcelain teeth to the base. Both of these will need support from a minimum of two implants.
Other types of Implant-supported removable dentures:
- All-on-four (means that four dental implants support your full denture)
- All-on-eight dentures
Implant-supported fixed denture
Unlike removable implant denture, fixed implant denture is permanently attached to the implants. Therefore, there is no need to remove it during sleep. However, keeping up oral health is extremely important to ensure the longevity of the implants. We find that use of the water pick and super floss delivers best results in achieving this goal.
This type of implant dentures is often referred to as:
- Permanent dentures
- Fixed Dentures
- Hybrid Dentures
Removable Implant Denture Vs. Fixed Implant Denture vs. Implant bridge
If a patient is in need of restoring a full arch or full mouth the common question that comes up is “what is the best restoration?” There are several factors that should be taken into consideration:
- The health of one’s bone.
- If there is enough bone, the patient is a candidate for all three types of restorations for the missing teeth.
- If there is severe bone loss (not enough bone) then Implant Denture is an excellent option. The patient may choose either type, removable or fixed. The reason why it is a preferred restoration is that it allows our dentist to replicate bone by building it out with acrylic. The patient will get an instant facelift with this restoration, see photos below. A result like harder to achieve with an implant bridge.
- Patient’s budget
- Removable implant denture is the least expensive option since it may be stabilized with as few as two to four implants.
- Fixed implant denture or implant bridge depending on the bone health will require a minimum of six implants, thus making this type of restoration more costly.
- Implant bridge is the closest match to the natural teeth, thus most of the patients may find it the most comfortable.
- As we had mentioned before, an extra effort has to be made when it comes to “teeth brushing” with fixed implant denture since special attention has to be made to cleaning between the non-removable denture & the attachments.
- Maintaining good oral hygiene with removable implant denture is easy but keep in mind that the denture must be removed during sleep.
4. Partial and Complete Denture
Missing teeth can cause embarrassment. With a removablepartial denture, you can replace your missing teeth quickly while keeping your remaining teeth. The denture is custom made based on the mold of your mouth. It is fabricated out of the pink acrylic or nylon material to mimic your gums and to provide support and stability to the denture. The teeth are the attached to the base so that once the denture is inside your mouth, the new teeth fit properly into the space of your missing teeth. A partial denture might require clasps to keep it in place. Depending on the denture type or the position of the missing teeth the clasps may be noticeable when you smile or speak.
Benefits of a Partial Denture
Some benefits include:
- They do not cost as much as implants or fixed bridges.
- They restore your smile since they fill in the gaps between your teeth.
- It is a relatively quick and non-invasive procedure.
- Depending on the position of the missing teeth and amount of the healthy bone, partial dentures may help improve your ability to eat and speak.
- The dentist might be able to add additional teeth depending on the type of denture you choose. Please clarify it with your dentist before committing to the treatment. For example, teeth cannot be added to a flexible partial denture.
Disadvantages of a Partial Denture
Some of the disadvantages include:
- They do not always function or look as natural as fixed options.
- They may require multiple adjustments by dentist until they fit comfortably
- They may be slightly obtrusive
- Use of adhesive creams may be required to ensure better fit.
- They need to be relined or replaced more often.
- You have to remove them each day to clean them and leave them out during the night so your gums can recover.
- It is easy to misplace or lose a partial denture.
- They can break if dropped.
- Slight sense of taste maybe lost due to covered palette.
Best Candidates for Partial Denture
Benefits of Complete Dentures
Unlike partial dentures that replace only a number of teeth, complete dentures, also known as full upper or full lower, replace a full arch of missing teeth.
Some advantages of complete dentures include:
- Since they replace decayed and missing teeth, they significantly improve your appearance, and thus may boost your self-confidence.
- They provide adequate lip and cheek muscle support, restore facial dimensions and create a younger appearance.
- Just like with partial dentures, depending on the health and volume of your bone, complete dentures may help make eating more comfortable and improve your speech.
- They are a relatively fast and affordable treatment option.
- They come in a variety of colors, shapes and sizes, look natural and can match your natural gums closely.
- The dentist can adjust or reline them easily to accommodate the changing shape of your jawbone.
Disadvantages of Complete Dentures
Some disadvantages include:
- With time they may become ill-fitting due to your changing jawbone shape.
- You have to remove them to clean them and keep them out overnight to let your gums recover.
- They often require several adjustments to make them comfortable.
- You may require adhesives to keep them in your mouth.
- They may break if dropped.
Best Candidates for Complete Dentures
6. Do Nothing
You can always do nothing. Some people choose this method when the missing tooth is not in the front of the mouth or apparent when smiling. Others do nothing due to the cost of replacing missing teeth. However, failing to replace a missing tooth, whether in the front or back of the mouth, can cause dental problems down the road.
Why Doing Nothing Is Not an Advisable Course of Action
If you can help it, dental professionals advise against doing nothing when you have missing teeth. The two main reasons against not restoring are tooth movement and bone loss.
There are many factors that may result in teeth movement. One of them is missing teeth. The alignment of teeth is based on the counteraction, e.i. top tooth may start shifting down if there is no opposing tooth to keep it in place. Also, if there is a missing tooth neighboring teeth will start shifting into the empty space creating gaps between teeth and affecting bone health.
The density of your jawbone decreases after the removal of a natural tooth because it no longer has root stimulation. By not taking action to replace a missing tooth as soon as possible, when it comes time for you to do so, you will likely have to make up for bone loss with a bone graft procedure.
Although you might not always be able to have missing teeth replaced right away, you should do your best to replace them as soon as you can.
Schedule a Free Consultation With 209 NYC Dental
Being a multi-specialty dental office we are able to provide our patients with the best treatment option that improves their dental health, while fits their budget. 209 NYC Dental offers options to replace from one missing tooth to full mouth, including dental implants, implant-supported dentures, implant crown and bridges, partial dentures and complete dentures. Deciding which tooth replacement option is the best for you involves weighing the benefits and disadvantages and learning which treatment will best address your concerns and dental health issues.
Contact 209 NYC Dental to schedule an initial consultation to go over your options and have your questions answered so you can make an informed decision on replacing your missing teeth. We are the oldest continuing dental practice in the state of New York, and we take our reputation and legacy of treating generations of families with responsibility. We invest in advancing our education and clinical skills to continue providing the best dental care to our patients. Call us at 212-355-2290.
Author: Dr. Ben Ifraimov