Implants

Implants

If you’re missing one or more teeth, you may be all too aware of their importance to your looks and dental health. Your teeth are designed to work together to help you chew, speak, and smile. When teeth are missing, it is difficult to do these things. Even the loss of a back tooth may cause your mouth to shift and your face to look older. Fortunately, missing teeth can be replaced.

The following are three options your dentist may suggest, depending on your needs. Replacement teeth should last for years at a time, so it is important to choose a treatment that’s right for you.

  1. Implants
  2. Fixed Bridges
  3. Removable Partial Dentures
  4. Full Dentures
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Position of teeth immediately after a tooth is lost
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If the tooth is not replaced, other teeth can drift out of position and change the bite. Shifting teeth can possibly lead to tooth decay and gum disease.

1. Implants

Many patients choose implants to replace a single tooth, several teeth, or to support a full set of dentures. Implants are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth. They are made of titanium (a strong, lightweight metal) and other materials that are accepted by the human body.

Most patients find that an implant is secure and stable-a good replacement for their own tooth. However, implants are not an option for everyone. Because implants require surgery, patients should be in good health overall. Patients either must have adequate bone to support the implant, or be able to have surgery to build up the area needing the implant. Patients also should be ready to commit to a daily oral care routine and to regular dental visits.

Chronic illnesses, such as diabetes or leukemia, may slow healing after surgery. Patients with these issues may not be good candidates for implants. Using tobacco can also slow healing. Your dentist can help you decide whether implant treatment is a good option for you.

single-implant

What’s Involved?

There are many different kinds of implants. Treatment can take only one day, or it can take several months, or somewhere in between. Your dentist can outline a treatment plan that is most likely to be successful for you.

There are three general phases of implant treatment:

1. Placement of the implant: The dentist surgically places the implant into the jawbone. There may be some swelling and/or tenderness after the surgery, so pain medication is usually prescribed to ease the discomfort. Your dentist may recommend a diet of soft foods during the healing process.

2. The healing process: What makes an implant so strong is that the bone actually grows around it and holds it in place. This process takes time. Some patients might need to wait until the implant is completely healed, up to several months, before replacement teeth can be attached to the implant. Other patients can have the implants and replacement teeth placed all in one visit.

3. Replacing your missing tooth or teeth (prosthesis): The dentist or a lab will custom-make a crown, bridge or dentures to fit your mouth and your implants. Once completed, the man-made teeth are attached to the implant posts.

The prosthesis usually takes some time to make. In the meantime, your dentist may give you a temporary crown, bridge or denture. This can help you eat and speak normally until the permanent replacement is ready.

Advantages of Implants:

An implant is most similar to a natural tooth.

Nearby teeth do not have to be involved in the placement procedure.

Implants may last for many years, even decades.

Some types of implants and artificial teeth or dentures can be placed in just one or two visits

Implants may help prevent shrinkage of the jawbone from tooth loss.

Disadvantages:

Implants are not right for everyone, since they require surgery.

Implant placement may take longer and may require more dental visits than other options.

Implants may cost more than other treatments.

Implant-Supported Bridge
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Missing teeth
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A bridge is placed on implants
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After the bridge is placed

2. Fixed Bridges

Another tooth replacement option is a fixed bridge. This is a restoration that fills the space where one or more teeth have been lost. A fixed bridge is bonded or cemented into place – only a dentist can remove it.

How is a bridge placed?

Placing a bridge usually takes more than one dental visit. On your first visit, your dentist prepares the teeth on either side of the gap. The bridge will later be attached to these teeth.

Your dentist then takes an impression of your teeth and the space and sends the impression to a dental laboratory. Technicians at the lab make the bridge out of metal, ceramics, glass-ceramics or a combination. Your dentist will place a temporary bridge to protect your exposed teeth while you are waiting for the permanent one.

When talking about bridges, your dentist may use these terms:

Pontic : the replacement for your missing tooth

Crown: a “cap” that covers the attachment tooth

During one or more follow-up visits, the bridge is fitted, adjusted and cemented in place.

Bridge Placement

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Before the bridge, teeth are shown with the space where a tooth has been lost.
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Teeth next to the gap are prepared for placement of the bridge.
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The custom-made bridge is placed over the prepared teeth.
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The bridge is cemented into place.
Advantages of fixed bridges:

look, feel and function like natural teeth

don’t require removal for cleaning

cost less than implants

Disadvantages:

likely to be more expensive than removable bridges

affect the teeth next to the bridge

may require extra effort to clean under the pontic

3. Removable Partial Denture

As its name describes, a removable partial denture can easily be taken out of the mouth for cleaning. Partial dentures usually have replacement teeth fixed to a plastic base that matches the color of your gums. The plastic base may cover a metal framework. Partial dentures often have some form of clasp that attaches to your natural teeth.

Your dentist may also recommend crowns, or “caps,” on your natural teeth. Crowns may improve the way a removable partial denture fits your mouth.

Getting used to a removable partial denture

It takes practice to put in and take out a removable partial denture. It may feel odd or tight for the first few weeks. But in time, you should get used to it. Never force it into place by biting down. This could bend or break the clasps.

Removable partial dentures should not be worn 24 hours a day. Your dentist may tell you to take out the partial denture at bedtime and put it back in when you wake up. Usually your dentist will make follow-up appointments to look for pressure points or sore spots. He or she will adjust your denture so it fits comfortably.

Once your missing teeth are replaced, eating should be a much more pleasant experience. Since missing teeth can make it difficult to speak clearly, wearing a removable partial denture can help with that, too.

Over time, as you age and your mouth changes, your removable partial denture may no longer fit well. It also could break, crack or chip, or one of the teeth could loosen. Sometimes dentists can make the repairs, often on the same day. Complex repairs may take longer.

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Partial denture being placed
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Partial denture in the mouth (showing clasps)
Advantages of removable partial dentures

usually less expensive than fixed bridges or implants

usually easier to repair than fixed bridges

Explore All Your Options

How best to replace missing teeth is an important decision. Your dentist may refer you to a dental specialist for additional care. Here are some of the dental specialists who may be called upon:

• Prosthodontist – restoration and replacement of teeth

• Oral and maxillofacial surgeon – dental surgery and treatment of the entire oral cavity, including neck and face

• Periodontist – treats periodontal (gum) diseases

4. Full Dentures

If you have lost some or all of your natural teeth, dentures can replace your missing teeth and improve your quality of life. With a little practice, dentures can make eating and speaking easier. You can smile freely without feeling embarrassed.

Dentures can be made to look like your natural teeth. There may be only a small change in how you look. Full dentures may even give you a better smile. Dentures also support the cheeks and lips so the face muscles do not sag and make you look older.

Types of Dentures

Complete dentures have replacement teeth fitted into a plastic base. The base is made to closely match the color of your gums. If you still have some natural teeth, they will be removed before your dentures are placed.

Conventional Complete Dentures

A conventional complete denture is made and placed in your mouth after the teeth are taken out and the tissues have healed. Healing may take several months. The base of the upper denture covers the palate (the roof of the mouth). When the base of the upper denture rests against the gums and palate, it makes a seal to hold the denture in place.

The lower denture has a horseshoe shape so there is room for the tongue and muscle attachments. It rests on the gum and bone tissues of the dental ridge. A thin film of saliva holds it in place. The cheek muscles and tongue also help hold the lower denture in place.

Conventional Complete Dentures
Implant-Supported Complete Dentures

A complete denture may also be attached to dental implants, which provide a more secure fit. Implants are posts that are surgically placed in the upper or lower jaw. Properly placed implants make the denture stable and can help reduce bone loss.

Many patients find that implant-supported dentures are more comfortable and secure than conventional dentures. However, not everyone should get implants. Patients must be in good health and have enough bone to support the implants. Ask your dentist if you are a good candidate for dental implants.

Implant Dentures

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Before
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With implants and posts (abutments)
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After
Immediate Dentures

Some patients may have the option to get immediate dentures. These dentures are made before the remaining teeth are removed. Once the denture has been made at the lab and is ready for you at your dentist’s office, the dentist removes your teeth and the denture is placed right away. With immediate dentures, the denture wearer does not have to go without teeth during the healing time. Once healing is complete, the dentures may need to be adjusted or relined. Sometimes a new denture needs to be made.

Getting Used to Your Dentures

New dentures may feel odd or uncomfortable for the first few weeks. This is normal. Keep wearing your dentures until you get used to them. The lower one may feel especially loose until the muscles of your cheeks and tongue learn to hold it in place. You may have extra saliva for a short time. Some soreness should be expected for the first week or two. Your dentist will check on your progress and make any adjustments needed to make you more comfortable.

When you replace missing teeth, eating is easier. But it takes practice. Here are some things that can help:

Begin by eating soft foods cut into small pieces.

Chew on both sides of the mouth to keep the pressure even.

Do not eat very sticky or hard foods or chew gum.

You will also need to practice talking with your new dentures. Try reading out loud and repeating tricky words in front of a mirror. Talk slowly to prevent muffled speech. If your dentures slip out of place when you laugh, cough, or smile, bite down and swallow to reposition them.

When you get new dentures, your dentist may tell you to wear them most of the time. After the adjustment period, dentures should not be worn 24 hours a day. Your dentist may tell you to take out the denture at bedtime and put it back in when you wake up. Do not wear dentures around the clock because tissues that are covered with denture material all the time can become irritated.

Denture Adhesives

Your new dentures should fit securely, but the dentist may tell you to use a denture adhesive as you get used to wearing them. A denture that does not fit well may cause irritation, mouth sores and infection. While denture adhesive can help a loose-fitting denture for a short time, using adhesives all the time is not recommended. If the denture is loose, have your dentist check it. If you are using an adhesive, make sure you follow the instructions for use.

Caring for Dentures

Like natural teeth, dentures require daily oral hygiene. Here are some tips to care for your dentures:

• Clean your denture each day. Take it out of your mouth and carefully rinse off loose food particles. Wet the brush and put the denture cleaner on it. Brush all the surfaces gently to keep from damaging the plastic base.

It is best to use a special brush made for cleaning dentures, but you can use a toothbrush with soft bristles. Do not use hard-bristled brushes because they can damage dentures.

A liquid soap can be very effective when used with a denture brush. However, toothpaste should not be used to clean dentures. Some toothpastes have abrasive particles that can damage the denture base and teeth.

Your denture is very delicate and can break if dropped even a few inches on a hard surface. Stand over a folded towel or a sink filled with cool water when holding your denture.

• Keep your denture in water when you are not wearing it. Do not let it dry out or it can lose its shape.

Your dentist can tell you how to care for your denture and if you should use a denture soaking solution.

Rinse the partial denture well after using any denture cleanser. It may contain chemicals that are not intended to go into the mouth.

Look for denture cleansers with the American Dental Association Seal of Acceptance, a symbol of safety and effectiveness.

• Keep your denture away from curious children and pets when you are not wearing it.

Caring for Your Mouth

Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue, and palate every morning with a soft-bristled brush before you put in your dentures. This increases circulation in your tissues and helps remove plaque. Eating a balanced diet is also important to keep your mouth healthy.

You will still need regular oral exams by your dentist even after you have lost your teeth. The dental office will tell you how often you should have dental visits. During a visit, the dentist will look for signs of disease such as cancer of the head and neck. Your dentist will also check to see if your dentures fit well or might need adjustments.

Denture Adjustments

See your dentist if your dentures break, crack, chip, or if the denture starts to feel loose. Your dentist is the only one who should make repairs to your dentures. A person without the proper training will not be able to fix a denture. Do not try to adjust them yourself. This can harm both the denture and your health. Do not use over-the-counter reline materials or glues on dentures. They may contain harmful chemicals and are not a long-term solution for fixing dentures.

Denture Replacements

The normal lifetime of dentures is about 5 to 10 years, but this can vary widely depending on the patient. Over time, dentures may need relining, rebasing, or replacing. Relining is when the dentist adds new material to the underside of the denture base to fit to your gums. Rebasing is when a new base is made using the existing denture as a model. The artificial teeth from the old denture are used on the new base.

The mouth changes naturally with age. Jaws may line up differently as bones and gum ridges recede and shrink. At some point your dentures will no longer fit well and they will have to be remade. It is important to replace worn or ill-fitting dentures before they cause problems. Your dentist will let you know when it is time to replace your dentures.

Your New Smile

You are the key to your new smile’s success. These four tips will help:

Give yourself plenty of time to get used to your dentures.

Eat a balanced diet for good health.

Practice eating and speaking with your denture.

See your dentist regularly.

Talk to your dentist. He or she can answer your questions and help you decide which option will work best for you: implants, a fixed bridge or removable partial denture.

Request an Appointment.