It is very important to replace missing teeth. Your teeth are meant to work together as a team. When one or more of your natural teeth are lost, problems will arise. These problems include; shifting, tipping, malocclusion (crooked bite), gum disease and eventual tooth loss. There are three options available to you if you have lost one or more of your natural teeth. They are; removable partial dentures, bridgework or implants. As the first term implies, partial dentures are taken in and out of your mouth as the need arises for activities such as cleaning the denture, brushing and flossing your teeth or when you are asleep for the night. The last two options are fixed, that is they are secured in your mouth and are not removed for their life span. Removable partial dentures are anchored to your remaining teeth by means of metal clasps (clips) that lock onto your teeth when the partial denture is put in place. These clasps are part of a metal framework to which the denture teeth are attached by means of gum colored base acrylic. The framework holds the base acrylic and denture teeth in place over the edentulous (toothless) ridge of gum in a saddle-like fashion. A removable partial denture replaces all of the missing teeth on either of your arches.

Partialpre

Partialpost

This patient's missing front teeth were replaced with a removable partial denture.

Bridgepre

Bridgepost

Cracked and discolored teeth adjacent to a missing one protected by bridgework that also replaced the missing tooth.

Many patients prefer a fixed option for replacing missing teeth and two choices are available. One is bridgework. A bridge is secured by placing bridge retainers (crowns/caps) on your abutment (anchor) teeth at either side of the edentulous space with a pontic (replacement tooth) connected in between to the bridge retainers. This option is limited by the fact that one of your natural abutment teeth must be present on either side of the edentulous space for bridgework to be possible. After bridges are cemented in place, they look and feel much like your own natural teeth do. The one major difference between bridgework and your own teeth is in flossing. Since the pontic and the bridge retainers are a single unit, you cannot floss between them as you normally would. You must use a floss threader to get underneath the bridge between the anchor teeth which some patients find difficult or time consuming.

Implant

Implant

Implant

An implant with its "healing cap" on it. An "abutment" attached to the implant. The implant "restored" with a crown.

The other fixed option for replacing missing teeth is the use of implants. Implants are metal (titanium usually) cylinders that are placed in your jawbone at the edentulous space. After placement, several months are needed for your jawbone to osseointegrate (heal around) the implant and then the implant may be used to support several different tooth replacement options. An implant may replace a single missing tooth as the foundation for an implant-crown. As your normal flossing methods can be used in this situation so there is no functional difference here from one of your natural teeth. Implants can also support full and partial dentures for you as well as bridgework. In the case of bridgework, all the abutments must be implants as experience has shown that the difference between the way your jaw bone holds in implants and your natural teeth is not compatible. Bridges anchored by an implant on one end and one of your natural teeth at the other will fail in a relatively short period of time. Fully edentulous patients who do not wish to wear even implant supported dentures can have all of their teeth replaced with implant-supported crowns or bridgework. Since implants can stand on their own and do not need to be part of a bridge, they can fill any edentulous space regardless of whether there is a natural tooth on either side of it. This is why implants are the closest replacement option to your natural teeth that modern dentistry has yet devised.