INCLINE VILLAGE, Nev. — Most people around the world today have lost or will lose a tooth in their lifetime due to numerous causes. Among the youth of today, the most prevalent cause of a missing tooth is usually due to trauma or absence at birth.
As for the adult population, the main cause seems to be linked to either chronic periodontal disease (gum disease) or neglect (poor home-care, smoking, etc.). Whatever the cause may be, there are many options available to replace a missing tooth.
Of all the techniques available today to replace a missing tooth, a dental implant, in my professional opinion, is the superior solution to the problem.
The untreated site
Before we begin to examine all of the different solutions to replace a missing tooth, we should first look at the numerous consequences that result from leaving the space untreated.
The first and foremost consequence is the rapid and vast amount of bone loss that occurs where the tooth has been lost. Just like anything else in the body, if the supportive bone around a tooth is not stimulated daily, it will begin to atrophy (shrink away).
When a tooth is extracted, the site will immediately begin to heal and this shrinkage will begin to occur in all directions. As the healing progresses, this shrinkage will eventually affect the adjacent teeth (teeth on either side of the lost tooth) by pulling on their surrounding gum tissue. This will at times expose some of the adjacent teeth’s root surfaces leaving them sensitive to hot, cold and other stimuli.
If a front tooth is lost and the healing of the surrounding bone is not properly controlled or stopped with a dental implant and/or bone graft (both discussed later), numerous issues can arise that will compromise the final outcome of the patient’s smile.
The most common of these esthetic complications is either a reseeded gum-line at the neck of the new tooth or an absence of gum tissue in between the new tooth and adjacent teeth. Both of these outcomes will result in what most refer to as “black holes” or “gaps.” These gaps are not only unaesthetic, but are also at risk for periodontal disease (dental bone disease).
This is because the gaps allow food to be trapped at or below the gum-line of the adjacent teeth. If these food particles (plaques) are not completely removed, an infectious process (periodontal disease) will ignite and lead to a progressive amount of bone loss in that area. This in fact, may lead to the loss of more teeth if left untreated.
The second consequence of leaving a missing tooth untreated is the movement of the surrounding teeth. Normally, a tooth moves or shifts numerous times throughout every day. However, due to the surrounding and opposing teeth, these movements are limited and temporary. Just picture a tooth embedded in a rubber mold that absorbs forces exerted on it in all directions but always bounces back to its natural position.
In contrast, the adjacent teeth which were once stabilized by the lost tooth, are now free to drift into or tip toward the space of the absent tooth. Furthermore, the tooth that used to chew against the missing tooth will begin to grow up or down into the empty space.
These types of uncontrolled tooth movements are permanent and can result in a disharmonic bite that will usually lead to problems with one or both TMJ’s (left and right jaw joints). All of which can only be treated through the use of orthodontics, crowns, splints, and possibly surgery depending on the severity of the dysfunction.
On the financial end, to go backwards and treat all or one of these signs and symptoms, it can cost a person anywhere from five to ten times more than the original cost to replace the missing tooth.
— Jason R. Doucette is a Doctor of Dental Medicine with Incline Dental Care.