• Dr. Greg Grobmyer

Closing the Gap

Updated: Jan 31, 2019

Missing teeth are fairly common in adults, and it is a problem that can have serious consequences! There are many people who have had teeth extracted who have simply left the space open and not replaced the tooth, especially when it is in the back of the mouth. They feel if it is not a tooth that can be seen when the smile, they don’t care. Can’t be any harm in it, right? Well, let's explore that thought and then discuss options for replacing teeth.

Each and every tooth plays an important part in the function of chewing. Different teeth are designed to do different jobs. If the tooth is gone, that job is compromised. The front teeth, or incisors, are made like scissors to cut off pieces of food as you bite. The canines or eyeteeth, on the corners of your smile, are long and pointed with long, strong roots and are made for tearing off tougher food that cannot be cut with the front ones. The back teeth do the job of grinding the bits of food into a pulp to make them easily digestible. Every missing tooth in the back decreases the ability to grind your food appropriately and your body cannot process it as well. You lose out on the nutrition available in the food and can cause digestive tract problems.

Missing teeth also cause the remaining teeth to shift and move. The teeth beside the space begin to tilt into the hole and the tooth above or below it will grow longer without anything to hit against. This causes the bite to look like a rollercoaster and opens up spaces between all the other teeth, which can then pack full of food and cause other teeth to be lost. Once one is gone, it greatly increases the chances of losing a bunch more. The remaining teeth also then suffer greater use and wear and the bite changes can lead to jaw and TMJ pain.

So what do you do? There are basically three ways to replace teeth; partials or dentures, bridges, or implants. Each has advantages and disadvantages and your dentist can help you decide what is right in your particular case. The first way I mentioned, partials or dentures, is usually the least expensive, but also the least like your natural teeth. Complete dentures are full plates replacing all the teeth on the top or bottom. The uppers use suction to stay in, which is achieved by covering the whole roof of your mouth. This sometimes changes the way you talk, the way food tastes, and makes some patients gag. Lower dentures cannot create suction and have a tendency to move around. Partial dentures snap onto remaining teeth and are a nicer option if some teeth can be saved. They are much more stable, but there is still quite a bit of hardware in your mouth! Dentures and partials take some getting used to, but are great options for the appropriate patient and, again, they are the least expensive option in most cases.

Bridges are the next choice for replacing teeth. They are more expensive than partials and dentures, but are much more like your natural teeth. They look and feel like your own and do not come in and out of the mouth, as they are cemented into place. A bridge is essentially several crowns that are made together and attached to teeth on either side of the open space. The downside to bridges is that these adjacent teeth have to be filed down and that the teeth are connected. You must floss under a bridge, but cannot pass floss between the teeth. You must thread it underneath. Also, if any one tooth should fail, the entire bridge must be replaced. A bridge is a great option if the teeth adjacent to the space need or have crowns anyway, if you want teeth in place immediately, and/or if you wish to avoid the surgery necessary with our last option, implants.

Implants are artificial roots of teeth surgically placed in the bone of the jaw to replicate natural teeth. The surgery is much simpler and less invasive than the removal of the original tooth. They allow single teeth to be replaced without the need to attach to the adjacent teeth. Multiple teeth can also be replaced with implant-supported bridges. They can even anchor dentures into place. The implant must usually be placed and then allowed to heal. During the healing phase, a temporary partial is often used if it is a visible tooth. After healing, a top must be placed onto the “root” part of the implant and the final restoration, be it a crown, bridge, or denture, must be fabricated to fit the implant.

There are several ways to replace teeth that have been lost, and it is very important to do so. Dentures, partials, bridges, implants, or some combination of these are all appropriate treatments. Ask your dentist what is right for you.

Greg Grobmyer

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