Missing Teeth
 

Why would you have Missing Teeth?

Some people visiting this page will have just one tooth missing, others may have many teeth missing. I have done my best to answer all the questions with this in mind

What if you Choose to do Nothing?

The potential consequences of doing nothing are discussed in consequences of missing teeth-none, some, or all of them may occur to a greater or lesser extent. Whilst teeth can over-erupt, not every single one does and many people are happy with the aesthetics and the function of the teeth that they already have.

Generally, I would advise that a space is dealt with sooner rather than later. If it's left too long (years), providing a solution may become much more difficult and expensive, especially if things have moved and the gap has closed to a point which makes treatment impossible without opening up the space a bit again.

If finances are a problem, it's often advisable to choose a cheaper removable option for the time being, thus maintaining the space and teeth position, whilst saving for a fixed alternative. Plan this- so you know how much it is going to cost and set a realistic time frame.

If the benefits of having the space filled do not outweigh the disadvantages, ultimately it may end up doing you more harm than good. In such cases, maybe doing nothing is a better option.

It is always important to ask "What are my alternatives?" The solution is always going to be a compromise in one way or another.

What is the Concept of the Shortened Dental Arch?

This is the idea that if you have at least five teeth in each quadrant of your mouth (that's a total of twenty teeth), then you have sufficient teeth for both looks and function- allowing you to eat and smile normally.

Because these teeth are nearer the front of your mouth, they are easier for you to keep clean and therefore you are more likely to keep them for the rest of your life. This concept generally applies to middle/older age individuals and occasionally younger people who are expected to lose their back teeth as a result of decay or gum disease.

All efforts are focused on keeping and caring for your incisors, canines and premolars- only if one of these teeth require extraction does it need replacing.

Some people would rather have this situation in their mouth than wear two removable partial dentures if an implant retained bridge was out of the question. Some facial changes and additional wear may be expected as the cheeks no-longer have the same support and the remaining teeth are required to take extra chewing force- but this depends on the individual.

To Fill or not to Fill? How do you make the Decision?

See a dentist- get a full dental examination and discuss the various treatment options with them. It is likely they will need to take some X-rays to provide more information about your teeth; perhaps they will take study models to look at your mouth in more detail and they will ask you questions to find out your thoughts and feelings. Fixed options generally require more planning than removable options.

You have just had a Tooth Removed and want your Gap Filled- What should you do?

This situation requires special consideration.

If you have just had your tooth removed, your gums will shrink and change, as the bone is no longer needed in that area to support your tooth. Most changes will have occurred within 3-6 months. Whilst the gums heal, most people are generally happy to do without the cost and hassle of a temporary tooth, if the tooth concerned is in the back of the mouth.

However, if it is in the front of your mouth then you most likely will not want to be walking round looking like a pirate, so a temporary solution will be needed- most of the time an immediate denture is used. This is where the tooth is removed and a fake tooth on a removable plate is put straight back in.

Following healing and maybe a re-line, fixed options can be considered or you can continue as you are. If the tooth that was extracted is at the back of the mouth, then it can just be left to heal for this period of time.

It is crucial to let the gum settle. If you make an implant or a bridge too soon and the gum continues to heal and shrink up, it won't look very good long- term and the margins of your bridge (where they meet your tooth), or the base of the implant that was once hidden, will now become visible- I doubt after spending all that money that this will make you happy. So patience dear patients!

There are a couple of other less commonly used solutions to this problem which have their place in the certain circumstances. If you have made a decision to get a dental bridge then an immediate temporary bridge may be placed straight after the extraction. As healing occurs, a new temporary may be needed if the aesthetics become unacceptable before you are ready to have the permanent bridge constructed.