Replacing a missing tooth

There are three basic ways to fix a missing tooth or teeth.

• A fixed bridge
• A denture
• An implant

Here are the pros and cons of each treatment:

A Fixed Bridge

A Bridge

Having a bridge is like having three crowns. The teeth on either side of the missing tooth are prepared for crowns, an impression is made, and the case is sent to a dental laboratory. The laboratory then makes the bridge which is cemented in place permanently. The advantages of a bridge are that it is fixed, stable, and feels like your own teeth. In most cases it can be made to look just like you never had a tooth missing. The disadvantage is that you have to treat two teeth besides the one that was extracted - these teeth may otherwise be perfectly sound with nothing wrong.

A Denture

Dentures are false teeth that are removable by the patient. They replace missing teeth and the associated gum tissue. They can be made to look very natural when viewed from the front.

The advantages of the removable appliance are that it is a more economical way to replace missing teeth than a fixed bridge. Also, you can replace multiple teeth with one appliance. If the span of missing teeth is three or more, or if there are not solid teeth on both sides of the missing teeth, a fixed bridge may not work.

The disadvantages are that it may not be as aesthetic as a bridge. Clasps will be required to retain the removable partial, and it may not be possible or practical to entirely conceal those (though that problem can be avoided often with a "precision attachment" partial). Also, there may be some discomfort with wearing removable hardware in your mouth, and it is not as stable as a bridge.

An Implant

An Implant

An implant is an artificial "root" that is implanted in your jaw, and then a tooth is placed on it. Biologically, it is like placing an entirely new artificial tooth in your mouth. The advantages of an implant are: No teeth on either side have to be prepared for crowns, so there is no grinding on "good teeth" - you just fix the missing tooth. Implants can also span the space of multiple missing teeth. There is no limit to the span they can cover, as long as the patient's health is good and there is healthy and adequate bone to support the implant. An implant also is fixed and feels just like your own teeth.

The disadvantages of implants are that they are expensive and time-consuming. You will likely have to deal with two dentists - the dentist who does the surgery to place the implant, and the dentist who puts the false tooth on top of the implant. There is also a delay in getting the false tooth or teeth - a healing interval of several months may be required before the artificial root can have a tooth placed on it. There is also surgery involved with its attendant discomfort and healing period.