How simple it is to add a tooth depends on the location of the new tooth and the design of the denture. If the base of the denture, extends near to the tooth that needs to be added, the procedure is generally quite easy.
It is easiest to add a tooth to a simple acrylic denture
and most difficult to add to a flexidenture
due to the nature of the material. This is why, when planning the most suitable denture
, it is important to make a judgment on whether your mouth is likely to change, and what potentially will need to be done. You don’t want to have a nice new flexidenture, then find out you need a tooth adding after just two months (which can't be done) and end up needing a completely new denture. I can assure you the dentist doesn’t want this either. Happy patient equals happy dentist, remember that!
Adding teeth to a cobalt chrome denture can be easy or tricky depending on the type of connector and its design. If the tooth to be added, is some way away from your existing cobalt chrome base plate, then the technician must solder an extension onto which the tooth can be attached.
This is quite an involved process, and will be reflected in the fee the lab charges, the dentist and ultimately the price you end up paying. If you lose a tooth that has been supporting the denture and it has clasps around it, the base of the denture is already in the right place for adding a tooth making it quite easy. The grip and support of the denture may be affected, having lost the tooth- this will depend on the rest of the design and which of the other teeth are missing.
Occasionally, if it is a tooth right at the back and doesn’t have a tooth opposite to bite on, nothing may need to be done. If the clasp that was holding the tooth, is now redundant and clutching thin air, the dentist may remove this and smooth the denture off, so that food doesn’t get trapped and it won't catch your tongue or cheek.
Extractions and adding a tooth- what else do I need to consider?
When you have an extraction
, the bone that was supporting the tooth becomes redundant and so shrinks a little over the following few months. Most healing and changes have occurred by around the 3 month mark, with smaller less noticeable ones from 3 to 6 months after; by which time the bone is largely stable. Yes, it will continue to resorb a touch over the years but only very slowly.
It is important you know and understand the changes that are likely to happen and what will need to be done. Imagine the dentist doesn’t tell you about this natural process and after 1 month your plate is beginning to rock- you're not going to be thinking too highly of their workmanship (no pun intended). If however, you know to expect such changes- everybody's happy.
So here are your choices:
- Extract the tooth and do nothing
Be aware of the potential consequences of the missing tooth
and that this isn’t always a sensible option.
- Extract the tooth wait for 3-6 months then have a new tooth added to your denture
This is most commonly done where the tooth is at the back (i.e. not in your smile) and not crucial to the stability of the denture. The main advantage lies in the fact, that you only pay for adding the denture tooth, not a reline as well, and you only have to be without your denture on one occasion, not two.
- Extract the tooth and wait a couple of weeks for the main healing to occur then add the tooth
This takes a large portion of the guesswork away from the lab technician. However, because only early changes have taken place, the denture will still need a reline after the bone levels have stabilized in a few months. The advantage is you have a tooth sooner, which will make chewing easier and the aesthetics better, but means you are going to be without the denture on two separate occasions.
- Extract the tooth and put the new denture straight in immediately
This is what we term an 'immediate tooth addition
' and tends to be reserved for cases where extracting the tooth will greatly affect your smile e.g. for one or more of your top 6 teeth- or in patients for whom aesthetics is a particular concern.
The advantage of this, is you never go without a tooth. Once your bone level has settled a standard reline can be done to improve the fit. Sometimes a temporary reline may be necessary in the interim if a visible gap develops underneath the denture.
Like an immediate denture
, an impression is taken with the tooth to be extracted still in the mouth (and the denture in place). This is sent to the dental technician, who grinds that tooth off the model to simulate the extraction and adds a tooth in its place. When you return to the dentist, they will numb you up, perform the extraction and then put the denture straight in.
This process is the same for someone who fractures a front tooth, (usually a post crown
- but not always) and needs to have it extracted. It is a way of getting something in there temporarily, whilst all the options for replacing a missing tooth
are considered and healing occurs. It is generally completed during a single day where possible, though this may depend a little on the lab. i.e. you go in the morning for impressions to be taken- you return later that afternoon for the extraction and denture to be issued.