Missing Teeth – Risks and Possible Solutions
Ocean Township, New Jersey
There’s a lot of misconceptions about missing teeth. There are some myths and some realities about it that I’d like to clarify for you.
Sometimes the least expensive treatment for a tooth that is bothersome and sometimes the only treatment for a tooth that’s bothersome is its removal. And that, to me, is very sad.
Let’s think about this from a number of different points of view.
Our jaws are made to have between 28 and 32 teeth to do the work of chewing your food. When a tooth is missing, we lose a bit of efficiency and a bit of power of our chewing and the burden of chewing is put on fewer and fewer teeth, and that means that those teeth have to do more work, they are subject to more forces than they are designed to be subject to. And as teeth drop one by one, because it’s usually not one tooth that’s lost when a tooth is lost, it usually leads to a cascade of tooth loss. The teeth come under further strain, they break, they drift, they flare. And all of a sudden, you have a perfect storm for total tooth loss on your hands.
What do we do about it?
A lot of people think that if a tooth is missing and you can’t see it, it’s not a big deal. I’m not sure that that’s correct, because the further back in your mouth you go, the more pounds per square inch a tooth has to absorb. Most of your chewing power comes in the back of your mouth. So you’re losing a tremendous amount of chewing efficiency.
If you lose a back tooth in the short run, it’s painless, in the long run, it’s very serious.
If a tooth is lost, the tooth above it, below it, in front of it or behind it will tend to drift into the space that is vacated by the missing tooth.
What that means is teeth are going to tilt. And if vertical force is put on a tilted tooth, it will not react well to that force. It will tip even further and you’re likely to lose it or break it.
If teeth shift and drift, the naturally designed, beautiful, functional plane of your bite is altered. Those forces once again will be distributed in an unhealthy way that will not only foul up the remaining teeth, but it could potentially foul up your jaw joint and the muscles that control the movement of your jaw. Missing teeth can lead to TMJ problems. And again, you’re on a downward spiral.
But if you lose a tooth, you’re faced with a conundrum of how to replace it. More than that, you’re faced with the problem of the financial commitment it takes to replace a missing tooth.
So you need to sit down with your dentist and find out the most ideal way to replace a tooth, the most affordable way to replace the tooth, and the best way that fits your situation.
I can tell you that doing a dental implant is the most effective way to replace a tooth. But dentistry is not one size fits all. There are many options, a dental implant is wonderful. It’s the most predictable, surefire, efficient, strong way to replace a missing tooth. But, if your jaw bone is not conducive to supporting an implant, you have a problem.
Sometimes a three unit bridge, a bridge that is made by putting crowns on the teeth in front of and behind the space might be your best answer.
Some of these options are also a little bit costly, and if, in fact, if your budget does not allow for it, maybe a Unilateral Removable Partial Denture, or a Nesbit denture, could be made to halt the shifting and drifting, and the pathology that happens if a tooth is lost. A Unilateral Removable Partial Denture is very inexpensive and can hold teeth in their place until you’re ready to replace the missing tooth with something more definitive.
Another possible solution is to use a simple night guard. A well fitting, well-adjusted night guard might hold teeth in their place until you’re ready to replace your tooth. And it also could keep you from grinding your teeth, and relieve some of those TMJ issues that we talked about.
Let me address one other thing about missing teeth. There are people who, sadly, have lost all their teeth, or sadly, their teeth have deteriorated to a point where they are not salvageable. It is more common, unfortunately, than you think.
And I want you to know something. If you have severe gum disease, if you have multiple loose teeth, multiple disfigured teeth, multiple teeth that have lost their proper position and are sources of disease and discomfort rather than sources of health, comfort, function, aesthetics, there are answers. And the most amazing, miraculous answer that we have come up with in the last few years in dentistry is something called all-on-four. We are now able to put four implants into the upper arch or lower arch, and we are able to literally screw an arch full of teeth into your mouth. And when that process is all done, you are able to take a bite out of an apple as though you were 15 years old, with that perfect, beautiful, youthful, functional set of teeth.
All-on-four is here. It’s here for people with disfigured teeth. It’s here if you have a denture that no longer fits or that wobbles around and you desire some stability.
Dental implants and an all-on-four gives you functionality. It is life changing. It brings you a level of gratitude that you’ve never experienced. We do this well with our surgical team. It is comfortable. It’s doable. And it gives you something if you’re missing teeth, a lot of teeth, or if your teeth are in bad shape or if you have a loose fitting denture. It gives you function and aesthetics back to you.
There are many different combinations of treatments to replace missing teeth. The key is to sit down with a dentist who knows how to listen, and figure out what your best way forward is, short term, long term or both.
That is what we do best in our office. We listen. We know how to diagnose. We know how to do the treatment. But the most critical thing is that we know how to listen to you and help you make your best decisions to replace missing teeth and keep you from going down that downward spiral that leads to being what they used to call in dental school, a dental cripple. We don’t want that to happen. We want you to have your health, comfort, function, aesthetics to the greatest degree that you could handle it for as long as possible.