by Dr. J. Slaven
Implants have become the standard of care for the replacement of missing teeth. Prior to this development, our choices for replacing missing teeth were fixed bridges or removable partial dentures.
Replacing missing teeth with fixed bridges involves preparing the teeth on each side of the missing teeth for crowns, which are attached to the artificial tooth replacement as one piece that is cemented to the prepared teeth. While this is still an acceptable treatment it has the downside of doing a procedure on two good teeth and turning a one tooth problem into a multiple tooth problem. Every time a tooth is subjected to a procedure that involves removal of tooth structure its living part, the pulp, becomes inflamed, and it never recovers from this 100%, which can lead to problems such as the need for root canal therapy in the future. The happiest tooth is one that has not been drilled or ground down, which the teeth supporting a bridge have been.
If there are not teeth on either side of the missing tooth or teeth the non implant option is a removable partial denture. This also has problems associated with it. The clips or clasps that hold the partial denture to the supporting teeth put unnatural pressures on these teeth because even the best fitting partial denture will move slightly when chewing. This can damage the gums and bone around the supporting teeth over time. I liken this to what happens when you rock a fence post. Partial dentures require meticulous oral hygiene to prevent decay or gum infection of the supporting teeth. The clasps create what I call the perfect English Muffin full of nooks and crannies that trap food and allow plaque accumulation. Although a partial denture is still considered an acceptable option for replacement of missing teeth, the patient must understand its limitations.
The limitations of both fixed bridges and partial dentures that I have explained do not apply to replacement of teeth with implants. Implants provide permanent tooth replacement that is as close as we can get to your own natural tooth and are the better choice.