Posts for tag: missing teeth
Anyone at any age, including older children and teenagers, can lose or be born missing a permanent tooth. And while those missing teeth can be restored, replacing them in patients who haven’t yet reached adulthood can be tricky.
That’s because their dental and facial development isn’t finished. This is especially problematic for dental implants because as the jaws continue to grow, a “non-growing” implant could eventually appear out of alignment with the surrounding natural teeth. That’s why it’s often better to install a temporary restoration until the jaws fully mature in early adulthood. Two great choices are a removable partial denture (RPD) or a bonded (“Maryland”) bridge.
While “dentures” and “teens” don’t seem to go together, an RPD in fact can effectively restore a teen’s lost dental function and appearance. Of the various types of RPDs the one usually recommended for teens has a hard acrylic base colored to resemble the gums, to which we attach prosthetic (“false”) teeth at their appropriate positions on the jaw.
Besides effectiveness, RPDs are easy to clean and maintain. On the downside, though, an RPD can break and—as a removable appliance—become lost. They can also lose their fit due to changes in jaw structure.
The bonded bridge is similar to a traditional fixed bridge. But there’s one big difference: traditional bridges crown the natural teeth on either side of the missing teeth to secure them in place. The supporting teeth must be significantly (and permanently) altered to accommodate the life-like crowns on either end of the bridge.
Instead, a bonded bridge affixes “wings” of dental material extending from the back of the bridge to the back of the natural teeth on either side. While not quite as strong as a regular bridge, the bonded bridge avoids altering any natural teeth.
While a fixed bridge conveniently stays in place, they’re more difficult than an RPD to keep clean. And while less prone to breakage, they aren’t entirely immune to certain stresses from biting and chewing especially in the presence of some poor bites (how the upper and lower teeth come together).
Choosing between the two restorations will depend on these and other factors. But either choice can serve your teen well until they’re able to permanently replace their missing teeth.
For most people, replacing missing front teeth takes a higher priority over missing back teeth. The reason is obvious: others can see those missing in front, but not necessarily those in the back.
From a functional view, however, you should still consider replacing missing back teeth. Not only will it improve your chewing ability, it may also prevent a chain reaction of negative effects to your remaining teeth.
Teeth are held in place in the jawbone by a membrane called the periodontal ligament. The ligament is a living tissue that allows teeth to move to keep contact with adjacent and opposing teeth as natural wear occurs. When a space is created by a missing tooth, this natural movement accelerates and the teeth may shift beyond normal ranges.
As a result you can encounter excessive mobility of teeth from bite irregularities, uneven tooth wear, bone loss, potential painful problems with the temporo-mandibular joints (connecting the lower jaw to the skull), and a loss in facial height.
There are three basic options for this kind of tooth replacement. The best option is dental implants: these free-standing replacements don't normally affect surrounding teeth, they're easier to clean, and they help support the bite. On the downside, there must be enough remaining bone to support the implant.
The next best option is a fixed bridge. This option only works, however, if there are teeth on either side of the missing tooth space capable of supporting the bridge, and they must be reduced in size by removing the enamel with the dental drill. They also have a tendency to retain plaque, the main cause of gum disease.
That leaves the last, and least favorable, option, a removable partial denture. They may also trap food and be difficult to wear. They can move in the mouth, stressing — and possibly loosening — the remaining teeth that hold them in place. With all its drawbacks, though, if a partial denture is the only solution to missing back teeth, it's a better alternative than doing nothing and risking long-term problems.
If you would like more information on replacement options for back teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Replacing Back Teeth.”