Tooth Replacement

If you are missing one or more teeth (but have some natural teeth remaining) and you wish to eat your favorite foods, increase your ability to chew, and improve your appearance, speech, and self-esteem, Cincinnati Dental Services offers several solutions. All of your teeth work together to help you chew, speak, and smile. When teeth are missing, these things become more difficult. Even the loss of a back tooth may cause your mouth to shift and your face to look older. Teeth adjacent to the missing tooth space can drift and cause your remaining teeth to come together without intermeshing correctly. This may lead to joint and muscle problems and headaches. A person who has missing teeth puts unnatural wear and stress on his remaining teeth when they are forced to do the added work of the teeth that are missing. 

Fortunately, missing teeth can be replaced. The technology and the materials available for tooth replacement have evolved rapidly in the past decade. Implants, an option that was in its infancy twenty-five years ago, have moved into mainstream as dependable, natural, comfortable replacements for lost teeth.

Choosing the correct treatment is very important. The doctors of Cincinnati Dental Services can provide any of three options for tooth replacement---depending on your needs and the best way to meet them.

A dental implant is much like a natural tooth and is the current state of the art method for replacing teeth. A natural tooth has a root portion that is anchored in your jawbone. It is topped by a crown (the part of the tooth that you can see). When you need an implant, your dentist inserts a metal post beneath your gum and into the bone. It fuses to the bone in your jaw and acts like the root of the tooth. Your dentist attaches a replacement crown to the metal post. This crown is designed to blend with the way your natural teeth look and feel. Implants can also be fitted with special posts that can be used as anchors for dentures.

Most of our patients find that an implant is secure and stable and closely replicates the look and feel of a natural tooth. Implants, however, are not an option for everyone. Because implants require minor surgery, patients should be in good health and have healthy gums. Smoking makes the likelihood that an implant will fail much greater. In addition, patients who choose implants must either have adequate bone to support the implant or be good candidates for surgery to build up the area needing the implant. Patients who have implants must be committed to maintain very good oral hygiene and having regular dental check-ups.

How are implants placed? 
First, minor surgery is performed to place the root portion of the implant in your jaw bone. Following this placement, up to six months of healing time may be required for the bone to grow around the implant and hold it firmly in place. In some cases your dentist may use a technique that allows immediate use of the implant. Some implants require a second step in which a post is attached to connect the replacement crown. With some implants, the implant and post are one unit placed in the mouth during the initial surgery.

After healing and stabilizing of the root portion, the replacement crown is made and fitted to the post portion of the implant. 

At Cincinnati Dental Services, the placement of the root portion of the implant is done by our oral surgeon at our Mt. Auburn location. A local or general anesthetic may be used. Discomfort following the procedure is usually minimal and will be managed with oral pain medications. You will be given instructions on diet and home care. When the root portion of the implant stabilizes, the replacement crown will be placed by the Cincinnati Dental Services general dentist you normally see.

Advantages of implants
An implant is most similar to a natural tooth
Adjacent teeth do not have to be involved in the placement procedure
Implants may decrease or help prevent shrinkage of the jawbone from tooth loss

Disadvantages of implants
Not every person with missing teeth is a good candidate for implants
Implant placement takes longer and may require more dental visits than alternative procedures

Fixed Bridges
Another alternative is a fixed bridge (sometimes called a fixed partial denture). This is a restoration that replaces or spans the space where one or more teeth have been lost. A fixed bridge is bonded or cemented into place. Only a dentist can remove a fixed bridge.

Your appearance, dental health and proper functioning of your mouth all are important reasons for wearing a fixed bridge. It helps maintain the natural shape of your face and may help support your lips and cheeks.

How is a fixed bridge attached?
A fixed bridge is commonly cemented or bonded to the natural teeth next to the space left by the missing teeth. An artificial tooth (called a pontic) replaces the lost natural tooth, and restores its function. A pontic is attached to a crown (restoration that covers a natural tooth). Crowns, which are cemented on adjacent prepared natural teeth, serve as retainers that support the fixed bridge.

Different types of fixed bridges
A fixed bridge can be attached to your natural teeth. Different types of artificial teeth may be used in fixed bridges. These include gold alloys, porcelain fused to metal, and all- porcelain.

Advantages of fixed bridges
Look, feel, and function like natural teeth
No need to remove from mouth for cleaning
Strengthen adjacent teeth if these teeth are in poor condition

Disadvantages of fixed bridges
Likely to cost more than removable bridges
Attach to adjacent teeth making preparation of these teeth a requirement

Removable Bridges
As the name implies, a removable bridge (sometimes called a removable partial denture) can easily be taken out of the mouth for cleaning. Although removable bridges generally cost less, fixed bridges may feel more stable and comfortable.

Depending on the situation, a removable bridge may be for you. Removable bridges usually have replacement teeth attached to gum-colored plastic bases connected by metal framework. They may attach to your natural teeth with metal clasps or devices called precision attachments. A claspless removable bridge, when indicated, may provide better support and appearance. 

Growing accustomed to a removable bridge
Inserting and removing the new removable bridge takes some practice. Your dentist will show you the best way to do this. The removable bridge may feel awkward for the first few weeks until you become accustomed to it. Your dentist will explain how long the removable bridge should be worn and when it should be removed. He will also recommend the best methods of cleaning the removable bridge.

Removable bridges usually need adjustments by your dentist during the first weeks of wearing them. This is due to fluctuations in the contour of the ridges and gums that support it. If the bridge puts too much pressure on an area, that area will become sore, and your dentist will adjust the removable bridge so it will fit more comfortably.

Once your missing teeth are replaced, eating should be a much more pleasant experience. Since missing teeth can make it difficult to speak clearly, wearing a removable bridge can help with that, too.

Over time, as you age and your mouth changes, your removable bridge may no longer fit well. It also could break, crack, chip, or one of the teeth could loosen. Cincinnati Dental Services has our own dental laboratory. Our laboratory technicians can often make repairs or reline the removable bridge and return it to you the same day. More complicated repairs may take longer.

Advantages of a removable bridge over a fixed bridge
Usually easier to repair
Usually less expensive

Removable bridges can be less stable than alternative choices
They can break or be lost
They must be removed to clean them and your remaining teeth every time you eat 
Some people find removable bridges uncomfortable and do not tolerate them well
Some people are embarrassed to take out their teeth for cleaning

Explore all your options
Your Cincinnati Dental Services dentist will be happy to discuss your options for tooth replacement with you and answer any questions you may have. Your dentist can recommend the best option for you and show you examples of each alternative.