Everything You Need to Know About Dental Implants and Alternatives

The Implications of Missing Teeth

If you have lost teeth, whether from an accident or due to poor dental hygiene causing them to fall out or needing to be extracted, but have not done anything to replace them, you may not realize just how much danger you are putting your oral health in.

Yes, chewing and speaking clearly may be more difficult with missing teeth and you may lack the confidence to smile fully if you don’t have every single tooth in its proper place (teeth also support the face and missing ones can make the face seem older than it is). But those uncomfortable experiences are nothing compared with this simple fact: unless you replace a missing tooth quickly you are on the path to potentially losing all your teeth. Why? Many people do not find out how the teeth and gums adjust to missing teeth until it is too late.

Bone and Tissue Shrinkage

“One consequence is bone and tissue shrinkage, otherwise known as atrophy,” wrote Scott Frank, DDS, an oral and maxillofacial surgeon, in A Reason to Smile: Fixing Broken Confidence With Cosmetic Dentistry. “A ‘socket’ results in the jawbone where the tooth roots existed. The socket becomes filled with a blood clot and wound healing immediately begins. The bone socket heals like a broken bone. The blood clot creates a matrix for bone cells from the blood to collect and begin bone healing. But the bone around the socket is no longer supported by the tooth root and begins to contract or shrink to eliminate the bone defect. Unfortunately, the shrinkage of the bone and tissue continues to occur over time, much like a slowly melting ice cube.”

The Domino Effect of Missing Teeth

This creates a chain reaction of nearby teeth gradually leaning towards the gap where a tooth once was, causing them to become looser and, in turn, others on the same arch (the set of teeth in the lower or upper jaw). If the original cause was due to periodontal disease (the bacterial infection of the gums that hold up teeth due to inadequate brushing and flossing) and your habits do not change, you are headed for losing all your teeth.

Importance of Regular Dental Check-ups

Even without a gum infection, you need to prevent one from leading to tooth loss by having your Wilshire Smile Studio dental hygienist do a professional cleaning at least twice a year. She can clean off plaque (the bacterial film that forms around food particles not cleaned off) or tartar (the hardened version of plaque) with special tools and she can reach places in the mouth that are hard for anyone to clean effectively. She can also treat serious infections with an antibacterial solution.

Periodontal Disease and Systemic Health

Not only can treating gum infections and missing teeth become expensive, but periodontal bacteria can spread throughout the body and significantly raise the risk for diabetes, cardiovascular disease, cancer, and Alzheimer’s.

Dental Implants Vs. Bridges and Dentures

The big advantage of dental implants is that they are the only solution that replace the tooth root.

The primary component of an implant is a screw made of a biocompatible metal like titanium or zirconia. This is inserted into the empty socket and the jawbone beneath it by your dentist in a painless procedure that starts the process of osseointegration, with the implant becoming firmly integrated with the jaw. This stops the process of losing bone and the loosening of neighboring teeth, as if the tooth had never been missing. After a few months, the top of the screw is attached to a dental crown that looks like the tooth that was once there, matched to the shade of the other teeth (or you could have them whitened in advance to a brighter color).

Longevity and Success of Dental Implants

With proper care, brushing and flossing the implant like the teeth, an implant might be a permanent solution with many lasting more than 20 years when placed by an experienced specialist. According to Dr. Frank, the rate of success is 95-96% in the upper jaw and 96-98% in the lower. “There are very few medical or dental procedures that enjoy such high success rates,” he wrote.

Candidacy for Dental Implants

However, not everyone can qualify to have implants done. For those who have inadequate jawbone to hold an implant, in many cases a bone graft will remedy this, but it takes 3-5 months to integrate before the implant can be inserted and that takes several more months before the crown is attached. Depending on the individual’s overall periodontal health and the number of individual implants to be done, the process can take from a few months to a year, including having a top dental lab craft each one. Wilshire Smile Studio can provide you with a temporary in the meantime so that you can chew, talk, and smile normally.

The All-on-4 Implant Platform

Another option for those with many missing or loose teeth in the upper or lower jaw is the All-on-4 implant platform. This allows those who might have weak jawbones to be able to replace all or many of the 16 teeth with just four implant screws inserted into the arch, while the platform holds all the crowns for the missing teeth. This is quicker and less expensive than having many individual implants.

Limitations of All-on-4

But not everyone can have even the All-on-4. These include heavy smokers, patients with severe osteoporosis (bone loss), uncontrolled diabetes, someone whose teeth in the sinus area that have been missing for a long time, and children and teens, since their jaws are still developing.

Dental Bridges as an Alternative

Another alternative to having individual implants is a dental bridge. If the tooth that is missing was between two healthy teeth (or even implants), your dentist can remove some of their enamel to have crowns placed over them that will hold an artificial tooth over the gap. This solves both the cosmetic problem and keeps the other teeth in the arch from becoming loose and misaligned. A bridge can be created and placed much quicker than having an implant, but it typically will only last 5-10 years.

Dentures for Multiple Missing Teeth

Of course, a majority of those who have many or all their teeth missing wear dentures. While they do enable one to smile, chew, and speak almost normally if well-designed, they usually are not anchored into the jawbone, since many patients that need them do not qualify or are able to afford to do so (or may not understand the implications). If they are not anchored, then the jaw will continue to shrink and the dentures will have to be adjusted continually to fit the changing jaw.

Partial and Full Dentures

A partial denture replaces some missing teeth and can be attached to the gums with clasps, so it can be removed at night and placed into a cleaning solution. However, it could be fixed into the jawbone to prevent misalignment at a much lower cost than having many implants. Conventional full dentures (replacing many or all teeth) are attached to the gums with adhesives. Overdentures can fit over remaining teeth or implants and be anchored, if the patient qualifies.

Conclusion: Ensuring Your Dental Health

If you have lost some teeth, you should schedule an appointment for a full dental examination so that you know what your best options are for having the smile you deserve.