Ask An Expert With Dr. Craig Smith.
Many patients ask me what are my options when faced with the fact that they are losing a tooth. Well here they are all spelled out:
1) Extract the tooth and leave it.
This is the cheapest option but can be a costly option in the future. The two resulting consequences that can occur are: teeth moving or bone loss. Teeth like to be in contact with each other. When one tooth is removed, teeth near it try to fill in the gap. This can leave wider gaps near these adjacent teeth which tend to be food traps. Food traps lead to more cavities. Correcting crooked teeth can be done with orthodontic work or simple crowns to fix the gaps. So, losing that one tooth could result in more dental work on adjacent teeth. Bone loss also occurs. Imagine when a tree stump is removed from an area. Unless backfill is placed where that tree once was, a divot, or low-lying area is left in its place. At least consider a bone graft in that area to help preserve the bone. A bone graft is just like backfill when a tree is removed. Not doing this can result in a more expensive implant procedure in the future to correct the problem.
2) Replace the missing tooth with a partial denture or bridge.
Bridging the gap where a tooth once was can be done with a removable option such as a partial denture or a more fixed option such as a porcelain bridge. Unless a patient is missing multiple teeth, most patients don’t consider the removable option as it’s too annoying. But it is available, so ask if interested. The fixed option involves altering the two or more teeth in front and behind the missing teeth. A fixed bridge, basically 3 crowns attached together, is fabricated and cemented in place. Pros about bridges are that they are slightly cheaper than implants. They are faster to complete as they can be completed between 2 and 6 weeks depending on healing. During the healing phase, patients are given a temporary. Cons about bridges are that they alter the teeth adjacent to the extracted tooth. The teeth a bridge sits on are still susceptible to decay and might need to be replaced after 20 years depending on the care of them by the patient. They are also more difficult to clean as patients have to floss or clean under them.
3) Replace the missing tooth with a dental implant.
I call an implant a one tooth one solution option. The only tooth that is touched is the broken tooth. Depending on if a tooth is infected or not, an implant can be placed immediately or when healing is complete after an extraction. Once placed, the area needs to heal. Depending on the situation and dentist, some may place a temporary on the implant. Most leave it alone so that the bone can integrate with the implant. Healing can take anywhere between 4 and 9 months. Then a permanent crown can be placed. Cons about implants are the healing time and they are more expensive today. Pros are that you can floss and clean around them like a normal tooth.
So, if faced with losing a tooth, patients can leave it alone, bridge it, or place an implant. I like implants because they generally have less problems in the future. Leaving it alone and bridges can cause more problems to adjacent teeth which cumulatively cost more money and dental visits in the future. Less dental problems equals a happier patient.
About Dr. Craig Smith:
Dr. Craig Smith was born in Murray, Utah and spent his childhood in Salt Lake Valley and Arlington, Texas. He attended the University of Louisville in Kentucky for his doctorate degree with internships in pediatric dentistry at the Cincinnati Children’s Hospital and the University of Colorado. He has practiced in the areas of Sandy, Draper, West Jordan and currently Holladay, Utah for the past 11 years. Dr Smith thrives on continuing education and has completed more than 195+ hours of supplementary training and courses.
Article originally published at yournewteethnow.com.