While it is possible to keep teeth for life, some individuals do loose teeth. The most common reason in the population is Dental Caries or Tooth Decay which may look like:
- a tooth/teeth with extensive decay or caries that cannot be restored
- a tooth/teeth with failing RCT
- a tooth/teeth with crowns which are getting decayed on the margins
- multiple teeth with dental caries
Another cause of tooth loss is Periodontitis in which the teeth may feel very wobbly before coming out. Bleeding gums, frequent gum swelling or bad breath may be present.
How should these teeth be replaced?
Replacement of a missing tooth should be done with appropriate care so that:
- It lead to minimal damage to the neighbouring teeth and tooth-supporting structures,
- Should be done in timely manner
- Able to provide optimal function for a long term
- Looks like a natural tooth/teeth
- Does not cause un-bearable pain or any major complications (morbidity)
It is a cost effective option with a life of around 5 years. Additionally, retention of the denture (looseness) and thickness of flanges may make chewing and speech difficult. Patients with dentures generally would wish for a fixed option.
Bridge involves cutting of adjacent teeth with crowns (caps) on, which are attached with an artificial tooth (pontic) in the middle.
While most cases of bridge are highly successful over period of time, following complications may be noticed (see the images below of the bridges after 5-10 years in service):
- Around 10% of teeth become non-vital (dead) after the extensive preparation, which is generally necessary for good dental bridges.
- If margins are poorly controlled, they can be an iatrogenic cause for periodontal deterioration
- Over period of time, tissues in the missing teeth (pontics of bridge) may resorb and create a gap between the artificial teeth and gums as the above photo, this can be a major aesthetic problem.
- In long term, some patients may encounter caries and loose all the supporting teeth of a bridge requiring extensive dental rehabilitation.