By Lee R. Cohen, D.D.S., M.S., M.S. –
It is astounding how many individuals live their lives with one or more missing teeth. When asked why they have not replaced their teeth, common answers include fear, cost, embarrassment and pain. What they may not realize is that living without a proper compliment of teeth often leads to malnutrition, excess chewing on the remaining teeth (often causing them to break down even faster), tooth shifting and for many, insecurity related to their smile.
The good news is that there are numerous options to replacing missing teeth, many of which are relatively pain free and often are not astronomically expensive. Actually, costs increase as we attempt to function on the remaining teeth, asking them to carry the load of not only themselves, but of the teeth that have been lost. Overloading the teeth you still have frequently leads to their more rapid demise and the need for more extractions, dental work or tooth replacement.
The first question you must ask yourself is simple, “what do I want?” It does not matter what your friends, significant other or even your mother wants. Some will decide they want a full mouth makeover, while others simply want to have a healthy mouth with proper function. Once you decide the answer to this question, the options ahead of you will fall into place. Although there are numerous treatments available, I will focus on a few commonly chosen ones along with some of their advantages and disadvantages.
Removable Appliances (Dentures or Partial Dentures)
One of the oldest treatments that exist to help replace teeth (whether it is one or all of your teeth) is the fabrication of dentures. This treatment is often the least costly, but is also the one with the least patient satisfaction. A mold is made of your mouth and an appliance is provided to you that typically consists of a plastic like material which rests on the remaining teeth and gums. This material supports fake teeth that fill in the spaces where your original teeth are missing. Dentures are a simple and affordable way for you to regain function and chewing ability, but they do not come without problems. Often times they are not stable and will move while you chew and talk. Bulky material in the mouth, change in taste of food and irritation to the gum tissue are also frequent complaints.
Crowns and Bridges
Another common treatment is to replace missing teeth with crowns/bridges. Typically, patient satisfaction is very high with this treatment modality as it provides you with “glued in” teeth. Teeth adjacent (on both sides) to the missing ones are prepared to be fitted with dental crowns (also known as a cap). Consecutive crowns or caps can be joined together as one piece (known as a bridge). As the bridge is glued into place on the supporting teeth on either side of the missing ones, this empty space is filled by crowns that appear to be naturally coming out of the gum tissue but in actuality are being supported as part of the bridge connection itself. A great real life comparison is an actual bridge. Typically there is a pillar on either side supporting the bridge and the center part which has no support from beneath only from the sides.
To some this sounds very scary when in actuality it can frequently be less invasive than other options. A tooth is comprised of 2 parts, a crown (the part you see and chew with) and the root (the supporting part under the gum). A dental implant is simply a root replacement. This new root can be placed where your old root used to be. After a number of months of healing, a crown can be placed on this new root just like a crown can be placed on a tooth root. This treatment works very well in a situation when a tooth is lost between other teeth. An implant root can be placed with its own crown (a few months later) as opposed to cutting down adjacent teeth to fit a dental bridge.
All of the above treatments (and numerous others) have many variables and need to be determined on a case by case basis. A complete examination is required to help you understand the complexity of your individual situation and the options available to you. Knowing ahead of time what your overall desire is (such as a Hollywood makeover or a simple tooth replacement) will help you narrow down the options best suited to your “want.”
Lee R. Cohen, D.D.S., M.S., M.S., is a Dual Board Certified Periodontal and Dental Implant Surgeon. He is a graduate of Emory University and New York University College of Dentistry.
Dr. Cohen completed his surgical training at the University of Florida / Shands Hospital in Gainesville, Florida. He served as Chief Resident and currently holds a staff appointment as a Clinical Associate Professor in the Department of Periodontics and Dental Implantology. Dr. Cohen lectures, teaches and performs clinical research on topics related to his surgical specialty.
The focus of his interests are conservative approaches to treating gum, bone and tooth loss. He utilizes advanced techniques including the use of the Periolase Dental Laser (LANAP procedure) to help save teeth and treat periodontal disease without the use of traditional surgical procedures. Additionally, he uses in-office, state of the art 3D CT imaging to develop the least invasive dental implant and bone regeneration treatment options. Dr. Cohen and his facility are state certified to perform both IV and Oral Sedation procedures.
Dr. Cohen currently serves on the Board of Trustees for the American Academy of Periodontology and the Florida Dental Association. He is past president of the Florida Association of Periodontists and the Atlantic Coast District Dental Association. In addition, Dr. Cohen has been awarded Fellowship in the American College of Dentists, International College of Dentists and the Pierre Fauchard Academy.
Lee R. Cohen, D.D.S., M.S., M.S.
4520 Donald Ross Road, Suite 110
Palm Beach Gardens, FL 33418