There are various reasons a tooth may need to be extracted- severe decay, fracture, bone loss. For many people the first question that comes after they find out they need a tooth extracted is, “how do I replace it?” Thankfully, there are multiple ways to replace a missing tooth.
Dental implants have become an extremely popular choice in restoring a missing tooth. An implant is a metal screw-like fixture that is surgically placed in the bone to replace the root of a missing tooth. It is important that the site that the implant is being placed in has plenty of bone available to fully support the implant. If there is not enough bone then sometimes additional procedures such as bone grafting or sinus lift procedures are required, which can add to time and cost. Once the implant is placed it needs a period of time (typically 4-6 months, but case dependent) until the permanent crown can be placed on the implant. This is because the implant needs to fully integrate with the bone for proper stability. Dental implants are an excellent replacement option because they are a fixed option and function very similar to the original tooth. However, implants do have a significant cost and their success is very much dependent on proper anatomy and bone availability in the placement site, so case selection is important.
Figure 1. Implant
A bridge is another way to replace a missing tooth. A bridge is made up of two end crowns and in the middle is a ‘pontic’ which connects the crowns together and replaces the missing space with a filler tooth that sits just above the gums. Bridges are another fixed option, meaning that the bridge is cemented to the neighboring teeth and will stay in place. A bridge does not depend on the bone levels in the site of the missing tooth since the root aspect of the tooth is not being replaced, but it does depend on the neighboring teeth being stable enough to support it, so that is an important consideration when planning for a bridge. Another thing to consider is that because a bridge connects multiple teeth, it is dependent on these teeth staying healthy. If a tooth involved in the bridge gets future decay or periodontal problems then it could compromise the integrity of the entire unit.
Figure 2. Bridge
Another way teeth are replaced is with a removable device such as a partial denture, flipper, or essix retainer. A partial denture is typically made of metal and/or acrylic and clasps onto surrounding teeth as anchors. A flipper is made of acrylic and snaps into place. An essix retainer is a clear tray that sits over top of your teeth similar to an orthodontic retainer. All of these devices have replacement teeth attached to fill the empty spaces. Flippers and essix retainers are more suited for just esthetics whereas a partial denture is proficient for both esthetics and chewing function. Removable options are nice because they can replace many teeth at one time and typically are more affordable. However, many people shy away from these options because they do have to be taken out (at nighttime for example), and can have some movement to them due to not being a fixed device.
Figure 3. Partial Denture
Implants, bridges, and removable devices are some of the main ways that teeth can be replaced. Talking to your dentist about the risks and benefits of each option can help you make an informed decision that is best for you.