Options to replace a front tooth...dental implant or dental bridge?

Q:
Via email Saturday February 6, 2010 from Hillary
Two years ago I was in a car accident and lost one of my front top teeth. At the time the dentist I was seeing took the rest of the tooth out that was remaining and provided me with a denture to replace the tooth. I am very unhappy with my smile as the denture does not look like my other teeth, as well the denture moves and food gets stuck underneath it when I eat. I am only 30 years old, I want my smile to look like others my age. Are there any other options other than a denture for my missing tooth?

A:

Thanks for your question. Please be aware I am answering this question broadly concerning your specific situation as I haven’t examined your mouth, thus making a diagnosis via computer is impossible as many other factors exist which can direct us in one direction or another.

A first option for tooth replacement is a dental implant. A dental implant is very similar to a natural tooth as it is composed of a root portion that is implanted into the jawbone and a crown portion, that part that is visible above the gumline (like the enamel portion of your tooth). Dental implants are wonderful because they can completely replace a tooth that is missing as well, once they are in and restored they can function just like a natural tooth. When assessing whether dental implant is an option we would like at the quality and quantity of bone that is present at the site of the missing tooth, the bone is very important because this is what holds the implant in the jawbone. If not enough bone is present a procedure called bone augmentation can be done to increase bone in the area prior to implant placement. Occasionally if a tooth has been missing for a long period of time and a person has not worn anything like a denture to maintain the space, the remaining teeth can shift into the open space. In this situation we need to assess whether the space is large enough for an implant to fit. A big benefit is that other teeth are not prepared in order to put a dental implant in. To see how a dental implant is made you can see photos at Dr.Nathan Haas' Dental Implants



A second option is a dental bridge. We all know what a bridge does-it spans an empty space-this is exactly what a dental bridge does as well, it spans the space of a missing tooth. A dental bridge connects on one tooth, spans the space where the missing tooth is with what is called a pontic (an artificial tooth) and connects on the other side to an existing tooth. Bridges are an consideration if space is too small for a dental implant and tooth movement to reopen the space is impossible. Dental bridges can give good aesthetics but the lifespan is not indefinite, a typical bridge can have a lifespan of 10-20 years (of course there are always exceptions). One downfall of a bridge is the fact you need to prepare the teeth that will hold the bridge, this means they will need to be shaved down so the dental bridge can be cemented on top. To see how a dental bridge is made you can see a photo at Dr.Nathan Haas' Dental Bridges

I hope this helps you in your decision to restore your missing front tooth.

Nathan