Nebula D - what option do i have for a replacement false tooth?

I must be moving up in the world! A question directed at me!





Generally, there are three ways of replacing a missing tooth:





1. A bridge (known in the dental profession as a "Fixed Partial Denture" or FPD)





2. A removable denture.





3. Implant.





Each has very distinct advantages, and your dentist should discuss the treatment options with you. He/she can choose the course of treatment that is appropriate for you.





In a nutshell, however, I'll describe the three of them for you.





A bridge is much like a crown. Teeth on either side of the edentulous area (i.e. the toothless area) are prepared down to a smaller size. An impression is taken of the prepared teeth, and a dental lab makes a bridge whose end caps fit over the two prepared teeth, with a fake tooth suspended between the two end caps. The advantage of FPDs is that they are fairly cosmetic (more than adequately cosmetic in posterior areas of the mouth), they are not removable, and they require no surgery and are generally cemented into your mouth within three weeks of preparation of the supporting teeth. Finally, insurance often covers them. The disadvantage of FPDs, however, is that they are nothing more than caps (i.e. crowns) on two supporting teeth, and like crowns they can decay underneath. Get decay under one of the two supporting teeth, and you often lose the whole bridge. Additionally, bridges are generally suitable only for edentulous spaces where teeth are present anterior and posterior to the space. Of course, there is such a thing as a cantilever bridge, but some dentists are very hesitant to make them (and that includes yours truly). Another downside to FPDs is that the supporting teeth (properly known as "abutment teeth") have to be generally periodontally healthy. Loose teeth are not suitable support, and teeth that are tilted excessively in one direction are not suitable abutment teeth. Another problem with FPDs arises when the two teeth adjacent to the edentulous space are "virgin teeth", i.e. holding no dental work. Remember, abutment teeth must be shaved down to have the bridge placed on them, and any good dentist hates to do this to virgin teeth. Finally, FPDs possess another major disadvantage when placed on maxillary anterior teeth: they can be unaesthetic at times, even when an experienced dentist places it. Part of what makes a healthy smile is healthy gingival tissue supported and kept in place by healthy bone. Lose a tooth, and the bone supporting that tooth will resorb and cause the gingival tissue to sink away from the gingival tissue of the adjacent teeth. Place an FPD across such a space and you'll see what I mean.





"Root Form" implants are, with some exceptions, the best treatment option. While it is a surgical process, implants replace natural natural teeth without involving the adjacent teeth (as FPDs do). If the implant fails, the adjacent teeth remain in the same condition. "Root form" implants are essentially titanium screws that are placed into the bone, on top of which prosthetic tooth is placed. A period of healing where the bone will actually grow against the implant is required. This process is known as "osseointegration", without which the implant would not be able to support a prosthetic tooth. There are varying opinions as to its duration. In the vast majority of cases, expect a wait of at least three months before a prosthesis can be placed on the implant. Placing implants is relatively simple. Treatment planning them, however, can be a bit tricky. Implants have a very high success rate, but poor treatment planning can lead to failure. Implants, unlike natural teeth, are generally not suited to taking lateral forces. Implants should only take forces axially, i.e. along the long axis of the implant. It is sometimes tough to achieve this. Oblique and lateral forces against the implant, especially hard ones, can cause the bone to resorb around the implant and cause it to get loose...which would be considered implant "failure". This can and does happen to implants that had previously successfully osseointegrated. Additionally, because implants must have bone heal around them to function properly, patient health is far more imporotant than it is for placement of an FPD or removable denture. A patient with poor oral hygiene is a poor candidate for implants. Smoking, uncontrolled diabetes, bone diseases, etc. can all make people less than good candiates for implants. Additionally, implants are by far the most expensive treatment option and is often not covered by insurance.





Finally, removable dentures. They are easy. They are the cheapest option. Insurance is likely to cover them. They can be placed with minimal work on the adjacent dentition (when I say minimal, I do mean that SOME modification of the adjacent teeth is required, but it is small), and they are the quickest treatment option. Their downsides are: 1. they are removable, 2. often, metal can be seen when smiling wide, 3. fit can change, 4. they can break like any other form of dental work...but fortunately, when they do, there is no harm done to your mouth.





As I said, this is just a brief description of these options (there is so much more to discuss). Your dentist needs to make a plan based on your circumstances.





Good luck.

Nebula D - what option do i have for a replacement false tooth?
What ever you do DO NOT GET A ROOT CANAL!!!I mean it it hurts like hell. The dentist actually drills holes in your nerves screws two little needle things and shocks the nerve to kill it. You are not suppose to be able to feel it. But bull **** it hurt like hell. Just get a cap instead trust me on this one..
Reply:if you're looking to replace a missing tooth (like you just had it pulled or has been pulled for a while) the best option is an implant. an oral surgeon places a titanium screw into your jaw ( you are completely numb and can have IV sedation if you want). the second best is to do a bridge, which basically involves crowing two teeth on either side of the missing tooth. a pontic (fake tooth that looks just like a crown) is then placed in the middle. the last tooth replacement is a partial denture. if you're missing more than one tooth, a partial is better. if you're only missing the one, it's a not of hardware to replace a single tooth with a partial denture. and by the way, a root canal has NOTHING to do with replacing a missing tooth.



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