Unfortunately, it isn’t always possible to repair and save a tooth every time and in such situations we have to remove them. There are also situations where teeth are missing because they simply did not form – the three most commonly missing teeth in people are third molars (wisdom teeth), second premolars and lateral incisors.
If the gaps resulting from missing teeth cannot be closed with orthodontic treatment patients can consider having the missing teeth replaced.
Undoubtedly the best method of replacing a missing tooth, implants involve the surgical placement of a titanium screw-like fixture into the jawbone. After the bone has healed around it, a crown is attached to the implant to provide your replacement tooth. Implants can also be used to support bridges and to help dentures remain in place.
At Banyo Dental, we can provide the crown, bridge or denture on the implant(s) for you. The implant surgery will be carried out by an Oral Surgeon or periodontist that works with us closely to provide the best long-term result for you.
At times, surgery may need to involve modification of the floor of your nasal sinus cavities (for upper teeth) and/or bone grafting (if the initial extraction was quite extensive or the tooth was extracted a very long time ago). A cone-beam CT scan will be needed prior to your implant to check the quality and density of bone available to place the implant so that the provider of your implant surgery can best advise you about what procedures are required to place the implant.
Implants may not be suitable for patients who are smokers, diabetics with poor blood-glucose control, are allergic to nickel or titanium or are otherwise unable to tolerate surgical procedures.
Bridges involve artificial teeth that are supported by crowns or overlays on nearby teeth. At times this may involve preparing one tooth next to where a tooth is missing (cantilever bridge), other times this may involve preparing teeth on either side of the gap (traditional bridge).
This is a suitable option for patients who may not be able or willing to have implants but would like something that is fixed into the mouth.
Less costly than implants and bridges, dentures can be used where implants and bridges are impractical or unaffordable.
Full dentures involve replacement of all teeth on an upper and/or lower jaw. Full dentures rely on suction with your gums, cheeks and lips and also rely on the presence of a ridge on your jawbone. Patients who had their teeth extracted a long time ago can often lose that ridge, making the wearing of a full denture very difficult and necessitating the use of adhesives like Polident. Implants can be used to help hold dentures in place in situations where extra help in holding onto a denture is required.
Partial dentures can be used where there are some teeth remaining. There are two types of partial dentures:
- Acrylic partial dentures – these rest on the gums and clip onto your remaining teeth. These are the least expensive option but are often very difficult to tolerate. These are best used as temporary devices, for situations where a denture is required quickly with a tooth extraction or for patients who are likely to need multiple tooth extractions in the near future.
- Cobalt-chrome partial dentures – also known as metal dentures. These are often far easier to tolerate and are the standard of care for partial dentures. Cobalt-chrome dentures generally rest and clip onto your teeth, minimising the discomfort for your gums.
Existing dentures can also be modified.
- Full dentures that have become loose can sometimes be relined.
- Partial dentures can also be relined for comfort, can have new clasps added onto them for additional tightness and can also have new teeth added to them should more teeth require removal after the denture has been provided.
- Worn teeth can sometimes be replaced on the same denture base.
In the ideal world, any tooth that was to be replaced after an extraction would be placed well after the extraction healing has completed. However, we are well aware that this isn’t always practical, especially in the case of teeth that are visible in the smile line.
Immediate replacements can be undertaken for all three replacement options.
- Implants - we can refer you to have an implant placed on the day of your extraction. This can reduce the treatment time considerably, though there is still some risk of complications. You may, however, need to wear an interim denture while the implant site heals.
- Bridges - immediate temporary bridges can be provided – we simply prepare the neighbouring tooth or teeth, extract the problem tooth and place a temporary bridge to remain in place while the gums heal underneath. After a healing period of 6-8 weeks, the temporary bridge is lifted off, the preparation is refined and an impression is taken, the temporary bridge is either replaced or remade and a permanent bridge is placed the following visit.
- Dentures - immediate replacement dentures can be made with any type of denture. Relining of the denture area where the tooth was removed may be required after 3-6 months after the bone and gums have healed.
- Existing dentures - teeth can also be added on an immediate basis, though they may also require relining after a few months. An impression is taken with your denture and sent to a laboratory for the necessary modification. At your next visit, either later in the day or the next day, your tooth is extracted and your denture is returned to you with the new denture tooth in place.