I'm missing a tooth

An implant is a titanium post, cemented in the bone, substituting for the root of the tooth and supporting a crown. Implants are an excellent replacement for missing teeth. They restore both appearance and chewing ability.

In dentistry they are regarded as being the gold standard of replacement of a missing tooth.

What makes them better than all other alternatives?

They are fixed in the gum – like a tooth.

They are very lifelike – like a tooth

They help to preserve the remaining teeth – like a tooth

A denture is designed to be removed during sleep.

It can be made out of either plastic or cobalt-chrome. It is generally constructed over 4 visits, taking between 3 to 8 weeks.

It’s main advantage is that it is a much cheaper solution to the replacement of missing teeth than implants, particularly with multiple missing teeth.

It’s main disadvantage is that the denture touches many other teeth in the mouth – allowing plaque to build up between the denture and the tooth, starting or worsening any gum infection or inflammation

All-on-4 is a great replacement for the person who has already lost all of their teeth and  is wearing a full denture but cannot stand it. OR a person who knows their remaining teeth are going to be lost and doesn’t want to ever have to wear a denture.

How does it work?

It is,  at its simplest, a denture which is screwed to the jawbone by 4 implants.

It is fixed into position so that it doesn’t move at all, like your teeth

Why wouldn’t everybody just get All-on-4 instead of a denture?

They do require maintenance, like your natural teeth.

They don’t feel exactly like your real teeth, although other people could think they are your own.

It is probably the single most costly procedure in dentistry although it can still be great value for those who get it because it is transformative.  Even at the price I have heard patients who have had it done say it was the best money they ever spent at the dentist.

Why should I even consider it, then?

They can transform the appearance of your smile because you can ask to have them set up with straight teeth (great when your natural teeth were never straight!) and you can pick whatever colour you want them to be (great when your natural teeth never looked white!). And the denture never comes loose, ever.

A bridge is a false tooth which is attached to one or more teeth.

There are 2 types

• Fixed bridge – where a tooth or teeth beside the false tooth are cut down in order to create space to cement on the abutment support for the false tooth. This is generally quite destructive on the tooth and should only be done when the abutment tooth already requires crown placement.
• Maryland bridge – where the false tooth can be supported by 2 thin metal wings cemented to the tooth. The advantage to the Maryland bridge is that it is less destructive on the supporting tooth. The disadvantage is that the metal wing is more obvious in the mouth and can only be placed when there is room for the metal.

A seductive process which is easy to start and hard to finish (well).

How so?

What can happen is that the patient is in agony from toothache and generally when people are in that situation all they want is the quickest resolution to their pain – an extraction.

So they have the tooth taken out, then nothing seems to happen. No major changes in the mouth. Easy!

But the conditions that caused the need for extraction in the first place are still there so sooner or later another tooth is in agony, the extraction worked quickly before with no consequences so no reason not to have another extraction?  Another step on the slippery slope. And another. Then another.

By the time people get to this stage they are no longer on the flatter part of the slope but getting much closer to the more vertical part – after which it becomes increasingly difficult to arrest downward progress.

It can still be stopped at this stage but with increasing time in the dental chair and cost.

The best way to avoid it? Don’t start on it.