If you have missing teeth, you may want to consider to replace these teeth. Fortunately, there are several solutions to choose from including the following:
• Removable partial dentures
Implant supported crowns
• Fixed partial denture, more commonly known as a dental bridge

Over time, if missing teeth are not replaced, the spaces left after teeth extraction, can cause your other teeth to move toward the open space, and can cause a lot of dental problems.
On a day-to-day basis, gaps between teeth can make it difficult to eat, speak, or feel confident. Dental bridge, is a viable treatment option, offer a solution to patients with missing teeth by filling the empty space with a artificial tooth that looks and feels natural.
Dental bridges work by placing a false tooth in the open space and anchoring it with crowns on the natural teeth or dental implants on both sides. In this post, we will go over the benefits of dental bridges, advantages and disadvantages.

IMPROVE CHEWING

After tooth loss, you may experience difficulty or even pain, while eating and chewing your favorite foods. Pain can be caused by surrounding teeth shifting toward the open space. Dental Bridge restore the masticatory function of the teeth.

IMPROVE SPEAKING

If you have lost multiple teeth, you may have difficulty pronouncing certain words or speak with a lisp. To fix these issues, you’ll need to address the tooth loss that caused your speech to suffer in the first place. Your teeth play a vital role in how you form words in your mouth. To see what we mean, try reading aloud to see how many times your lips or tongue come in contact with your teeth. Dental bridges help resolve issues with speaking caused by tooth loss.

MAINTAIN YOUR FACE’S NATURAL SHAPE

Did you know that your jawbone starts to dissolve once you lose a tooth? Tooth roots stimulate the bone cells in your jawbone. Without this stimulation, your jawbone starts to dissolve. Severe jawbone reduction can lead to further facial collapse, which affect the shape of your face.

PREVENT TEETH FROM SHIFTING

Your teeth are held in place by strong roots under your gums. However, did you know that your teeth are also held in place by nearby teeth? After significant tooth loss, you may notice your remaining teeth start to tilt toward the open space. To prevent shifting teeth, the best thing you can do is fill the space with an artificial tooth through dental bridge treatment, or other options. Teeth that move too much become loose and may lead to further tooth loss.

TREATMENT OPTIONS FOR MISSING TEETH

Removable Partial Denture

Implant Supported Crown

Dental Bridge

There are several advantages and disadvantages to each solution for replacing a missing tooth. A removable partial denture is just that, removable. A dental implant or bridge is fixated in the mouth and not removable.
We will look at the advantages and disadvantages of the two fixated options, bridges and implants.

Dental Implant Advantages:

• Improved appearance
• Better speech
• Comfortable and natural feeling
• Increased self-esteem
• Improved oral health
• Durable with a high success rate
• Convenience in cleaning
• Adjacent teeth remain untouched

Dental Implant Disadvantages:

• Cost. They can be expensive.
• Potential for complications as some implants will not integrate with the bone and fail
• They require a minor surgery
• They are a life-long commitment and require ongoing maintenance and sometimes even replacement of the crown/restoration.
• Time. Often a tooth needs be extracted, the site is allowed to heal for several months, the implant is then placed and requires several months to integrate into the bone before a crown can be placed on top of the implant. A dental bridge can be completed faster. There are some cases that a crown can be placed on top of an implant at the time of surgery and therefore can be a quick procedure. These cases are best determined by a specialist Periodontist such as Dr.Miski.

Dental Bridge Advantages:

• Improved appearance
• Better speech
• Comfortable and natural feeling
• Increased self-esteem
• Improved oral health
• Durable with a high success rate
• Adjacent teeth can benefit from the full-coverage of the bridge restoration if the adjacent teeth are in need of crowns/full-coverage restorations.
• Dental insurance coverage typically covers dental bridges more than they do implants. However, we are seeing this change and more insurance companies are covering the cost of a dental implant as well.
• Time. They are typically faster to complete than a dental implant that cannot have a crown placed immediately.

Dental Bridge Disadvantages:

• More difficult to clean than a single-tooth dental implant
• Adjacent teeth need to be prepared and reduced resulting in a permanent loss of tooth structure.
• Cost. Dental bridges can be expensive.

Dental Bridge Complications:

Even if the entire treatment was impeccably performed and the care and maintenance measures thoroughly conducted, risks or complications are not out of the question.
After all, nothing lasts forever and very few procedures in dentistry will last a lifetime. Even though the huge technical advances have significantly improved the quality of dental treatments and materials, accidents and complications may still occur and it is very good to be aware of this.
After the permanent cementation of dental restorations, various problems may arise:
• minor complications are usually remedied in one session
• other complications will require a greater effort to be solved
• finally, some of the more serious conditions will require the permanent removal of the prosthetic device and sometimes an entirely new treatment plan has to be devised.

1. Detachment of dental bridge

Sometimes, a dental bridge may fell of the abutment teeth. Bridges can become detached for a number of reasons. The most common ones are biting down onto a hard piece of food.
Another variation is that a dental restoration becomes loose, mainly because the cement washes out from under the crowns.
In both cases, it is essential that patients contact the dentist’s office as soon as possible. The worst scenario is when patients take the matter into their own hand and try to re-attach the restoration using various types of “glues” (which can severely damage the underneath teeth).
It is equally bad to do nothing when the patient feels that the restoration became loose. A loose dental crown involves the dissolution of the cement around the abutment tooth; hence, the bacteria can penetrate in the empty space leading to various infections of the dental tissues (pulpitis, periodontitis).
At the dental office, the practitioner will assess the situation: if the restoration is not damaged (fractured, chipped etc.) and all abutment teeth are healthy, the dental bridge is re-cemented on the abutment teeth using a permanent dental cement.

2. Pain, sensitivity, discomfort

Some of these symptoms may arise after a new restoration is permanently cemented. Most often, these reactions go away after several days (sometimes weeks) or after simple procedures performed at the dental office (see follow up).
The complicated problems emerge when the symptoms arise after a reasonable period of time has passed since the definitive cementation.
Types of pain
The main problem is that pain is a symptom that is differently perceived by each individual. Besides that, pain can radiate from one place to another making the diagnosis even more complicated.

Various types of pain may occur after a dental restoration is definitively cemented. Sometimes, the pain can go away after a period of time.
• Sharp pain (toothache) that increases in intensity as time passes
• Pain or increased sensitivity in the gums around the abutment teeth
• “Nagging” pains at hot or cold stimuli
• Pain or discomfort that occurs when biting down on something
• Pain or discomfort in the jaw muscles or the joint
• Other kinds of pain that can be differently described depending on the patient
In every situation, it is advisable to contact the dentist as soon as possible. The cause of the pain can be determined after a careful examination and, in most of the cases, a dental X-ray.

A-Treatment

The treatment depends on the medical cause. Because these symptoms can be caused by a variety of factors, the recommended treatment can largely differ. Here are some examples:
Endodontic therapy if the pain is caused by a pulp inflammation or inflammation of the periapical tissue (located underneath the tooth).
• A bite adjustment if the restoration was left too high. Normally, in these situations, the pain is felt when biting down on something or in the jaw muscles and mandibular joints.
• Sometimes, a conservatory treatment is no longer possible. These cases involve the permanent removal of the restoration, the extraction of the affected teeth and a new reconstruction plan.

3. Chipped porcelain restorations

Bridges made of porcelain can sometimes chip. This usually happens after biting down on a harsh piece of food. The appropriate treatment depends on the extent of the fracture.

• Reconstruction with composite materials: If the chip is small, a composite resin can be used to repair the chip with the bridge remaining in the mouth.
Specific “ceramic repair” kits are available. These kits contain, besides composite materials of various shades, specific gels that help the composite materials to be held in place.
• Replacement of the restoration: If the chipping is extensive and a significant amount of porcelain was lost, the best solution is to reconstruct the entire prosthetic device.

4. Gingival recession and gum disease

Gingival recession implies the retraction of the gingival margin from the crown of the teeth. In case of dental bridge, the process leaves the margin of the crown and sometimes a part of the tooth’s root exposed. This will produce an unsightly image.
A dark line next to the gum line may become visible if the restoration has a base metal frame (image below).

The most common cause of gingival recession is gingivitis. Gingivitis is an inflammatory disease of the gums mainly caused by an improper oral hygiene. In this case, other signs are also visible: swollen red gums, bleeding gums, bad breath etc.
Crowns can attract dental plaque that can be difficult to remove. If plaque builds at the gum line, patients can develop gingivitis and even periodontal disease.

However, when gingival recession is not accompanied by other inflammatory signs, sometimes it can be considered a physiological process that comes with the time. If a restoration is more than 10 years old and gingival recession is present, you may consider replacing the restoration.

Conclusion

To discuss replacing a broken or missing tooth, please, do not hesitate to contact us and schedule your consultation with our Specialist Periodontist, Dr.Miski.