You may have wondered whether you can get braces if you have one or more missing teeth. The good news is that the answer is most likely yes. In fact, braces can be a great option for people missing a tooth, as they can close or widen gaps to leave the perfect amount of space for a replacement.
Why Teeth Might Be Missing
You might be surprised to learn that up to 20% of adults will have one or more congenitally missing teeth, often the second molars and upper lateral incisors. This is the result of an inheritable genetic trait in most cases, although rarely it can also indicate a genetic disorder.
Gum disease, tooth decay and injury are the most common causes for non-hereditary tooth loss. Gingivitis, or gum inflammation, is a sign that something is wrong. It is important to treat gingivitis as soon as it begins. Untreated, the inflammation can lead to periodontitis, which is an actual infection of the gums that leads to tooth loss.
You can prevent gingivitis and periodontal disease by diligently following the instructions your dentist and orthodontist give you for caring for your teeth, especially as you age. It also is important to see a dental professional at least twice a year (higher risk patients may require more visits) to have the teeth professionally cleaned.
If you are wearing braces and are seeing an orthodontist regularly, it does not excuse visiting your dentist for routine cleanings. It would not be worth your while to spend years in braces only to lose teeth later.
Problems Missing Teeth Can Cause
For missing teeth that are visible in the smile, many patients might seek to replace them for aesthetic reasons. However, a number of health problems can occur as a result of missing teeth, whether hidden in the back or right up front in your smile.
When teeth are missing, jaw bone atrophy can occur around the site of the gap. The strength of the jawbone is maintained through the force it exerts while biting and chewing. It’s much the same concept as building and maintaining muscle mass. The more you exercise, the stronger your muscles will become, but stop all activity and the muscles quickly begin to shrink. When a tooth is missing, 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 no placeholder exists between the site of the missing tooth and the surrounding teeth, it won’t be long before the teeth begin to shift to attempt to fill the gap. This can destabilize the moving teeth, loosening them and possibly leading to further loss. You also might experience difficulty biting and chewing if the teeth aren’t aligned properly. Many people with missing teeth will elect to eat only soft foods or drink liquid meals, which might not provide adequate nutrition.
Even if you aren’t worried about the cosmetics of your smile, missing teeth can actually distort the appearance of your face. Without teeth being in place to support the facial structure, you might experience sunken cheeks or wrinkling around the mouth. A lack of certain teeth also can cause changes in speech. You may notice that you have difficulty pronouncing certain sounds, or have a whistle that echoes with your speech.
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.
Children And Missing Teeth
In the case of younger children, teeth are often missing when the primary teeth have fallen out and the permanent teeth have not grown in yet. While it is most common for children to wear braces after all the permanent teeth (but before wisdom teeth) have finished growing, in some cases orthodontic treatment is necessary before that.
Kids who are still in the process of losing their baby teeth might have jaw issues or misalignments that will prevent adult teeth from growing in correctly without orthodontics. In this case, a child might need treatment while teeth are missing.
It is also possible that a child will lose teeth while wearing braces. In this case, the orthodontist will remove the bracket or band from the loose tooth so that it can fall out, and, if necessary, will reapply the bracket once the new tooth comes in.
Options To Correct Missing Teeth
Dental implants are an option if you’re missing a single tooth or your missing teeth are scattered. To perform an implant, the dentist will surgically mount a titanium post or frame into your jaw to anchor in a replacement tooth. The base or pole will be permanent, though the tooth itself may need to be replaced over time (but they usually last at least a decade).
A fixed dental bridge is another option, and might be best suited for patients missing multiple teeth in the same area. A bridge closes the cap caused by missing teeth, using a prosthetic or artificial tooth that the dentist will bond using cement. Similar to implants, the bridges will feel like natural teeth. However, some of the existing teeth may need to be shaved or altered to accommodate the bridge, and it can be difficult to clean teeth under it.
Removable partial dentures also are an option when you are missing several 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. Some dentures have a clasp that adjoins to the adjacent teeth.
Braces With Missing Teeth
In some cases, it may be possible to use braces to simply close the gap created by the missing tooth. This is most likely to occur with patients who already are experiencing significant overcrowding.
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 titanium anchor does not contain ligaments that allow for tooth realignment. The orthodontist will create a deliberate space reserved for a restoration in the future or secure a placeholder in the existing space so that the gap remains the right size.
However, if the teeth surrounding the implant are not targeted for orthodontic treatment, then it is typically feasible to place the implant prior to braces. Additionally, if the dental implant needs to serve as an anchor point so that the appropriate forces can be applied to reposition the other teeth, the patient would likely get the implant before the braces are put on.
Losing a tooth can be a traumatic experience, but it doesn’t mean that you can’t fulfill your dream of having a beautiful, straight smile. Work with your orthodontist to determine the best care plan for you.