If you are short a permanent tooth or two, you are not alone. More than 120 million Americans have one or more missing teeth. That’s nearly one-third of the entire U.S. population. Up to 20% of adults have at least one congenitally missing tooth, often a second molar or upper lateral incisor. Gum disease, tooth decay and injury are the most common causes of non-hereditary tooth loss.
Many people assume replacing a tooth is a matter of aesthetic concern. While there is nothing wrong with desiring a better smile, medical factors also can compel tooth replacement.
When teeth are missing, jaw bone atrophy can occur around the site of the gap, as that part of the jaw no longer receives the stimulation it needs to maintain bone density. If teeth are lost from the back upper jaw, the sinus cavity above will start to expand and further erode the jaw bone.
If a gap exists where a tooth is missing, the surrounding teeth will shift to fill it in. This can destabilize the teeth, as well as cause problems with alignment that could affect biting and chewing. Missing teeth also can create changes in speech, causing difficulty pronouncing certain sounds or creating a whistle when you talk.
Missing teeth also can cause pain. When the remaining teeth no longer have an opposite to rest upon or bite against, they may start to overerupt and damage the opposing gums. This can lead to chronic facial pain and cause stress on the jaw joint leading to inflammation of the TemporoMandibular Joint (TMJ). This can, in turn, cause the patient to suffer from chronic headaches, migraines, or jaw pain.
Removable dentures are typically an option when you are missing several or all of your teeth. This dental appliance consists of artificial teeth attached to a base, which fits snuggly over the gums and is matched to the color of the gums and teeth. There are several types of dentures, including some that use a clasp to attach to the adjacent teeth. Dentures typically will last about 5-15 years before needing to be replaced.
The downsides to dentures are that people find the fit over the gums to be uncomfortable in some cases, and the dentures need to be removed and diligently cleaned each night. They also should not be worn while you sleep, which some patients find awkward. Additionally, both partial and full dentures can allow the bones under the false teeth to atrophy, which can create changes in the appearance of your smile and face.
The cost for dentures can vary dramatically–from the hundreds to several thousands of dollars–depending on whether you need full or partial arches and the type of material you choose. In general, cheaper dentures will need to be replaced more frequently than more expensive ones that are made through a heat-cured process.
Implants are a great option for patients who want the appearance and sensation of a natural tooth. Dental implants can be custom colored to match the shades of the surrounding teeth so they remain totally inconspicuous.
Most people are candidates for dental implants, which can replace one, several or all of the teeth. You will need to have healthy gums and enough bone support to anchor the implants, which are usually made of titanium and other materials that are compatible with the human body. Dental implants are permanent, so they will not need to be replaced and are not susceptible to the wear, decay and damage that other teeth can experience.
Placing the implant involves a multi-step procedure, and the length of time from beginning to end will depend on your dental health. If your jaw bone is not thick enough to support the implant, the surgeon will have to graft the bone prior to placing it. If you need both orthodontics and dental implants, then orthodontists usually recommend braces first. Because an implant is fixed into your jaw, it cannot move like a regular tooth.
The implants consist of a titanium post, which an oral surgeon inserts into the jaw to replace the missing tooth. He then attaches a prosthetic crown–the visible part of the tooth–which functions like a regular tooth. This is an invasive surgical procedure that requires a significant amount of work by the dental surgeon and a substantial healing period of several months before he can fix the crown to the post. Creating a near-perfect replica of a natural tooth also comes at a cost, as a single implant can range from about $3,000 to $6,000.
A dental bridge is another option for replacing missing teeth. A bridge closes the gap caused by missing teeth, using a prosthetic or artificial tooth that the dentist will bond using cement.
You can choose to have your natural teeth support the bridge, in which case your dentist will place crowns over the teeth adjacent to the missing ones and use cement to fix the bridge in place. A tooth-supported bridge can replace one or more missing teeth.
However, if you are missing several teeth in a row, another option is to get an implant-supported bridge. In this case, an implant is surgically placed at each end of the missing row of teeth and used to anchor the bridge as natural teeth would.
Similar to implants, dental bridges feel like natural teeth and won’t require daily removal for cleaning. Dental bridges typically aren’t permanent, but they last a long time–with proper care, it’s common for them to last 15 years or longer. It is important to follow specific hygiene instructions for dental bridges, as cleaning will sometimes need to involve the gum underneath the adhesive part of the bridge
Dental bridges also are a less expensive option compared to individual implants. Costs can vary but most patients pay between $300 and $1,000 per tooth.
Braces and Missing Teeth
In some cases, it may be possible to use braces to close the gap created by a missing tooth. This is most likely to occur with patients who already are experiencing significant overcrowding, in which there wasn’t adequate space for all the teeth in the first place. In other cases, your orthodontist may recommend using braces to create a gap in which replacement teeth will be fitted later so that your finalized smile is just as perfect as it would be with all-natural teeth.
Even if you don’t have an overcrowding issue, you can still receive treatment with braces if you are missing a tooth. You don’t want to add to your dental problems by ignoring misalignments and bite abnormalities where the jaw structure needs to be corrected.
Having a missing tooth or two can be alarming, but it’s perfectly normal. Schedule a free consultation today with one of our board-certified orthodontists to discuss options for replacing your missing teeth and getting the smile you deserve.