Gaps?
Missing a tooth?
Some people
have lost one or more teeth for a variety of
reasons. Sometimes the
gap bothers them and sometimes not. The
problem with tooth loss is that it sets in
motion a cascade of events that can have an
increasingly detrimental effect on oral health. Sometimes
the effect is very minor, sometimes major.
Often when
a back tooth is lost, especially a lower one,
the tooth above the gap over-erupts into the
space below and eventually interferes with how
the “bite” functions. The
teeth behind and in front of the space fall
slightly towards the gap and finish up out
of position with slack contact points. The
slack contacts result in more food and plaque
between the teeth with more gum inflammation. The
gum inflammation can lead to more loss of attachment
of the gum to the tooth, loss of bone and recession
of the gum margin as the bone retreats.
Loss of a tooth
or teeth warrants a conversation with the dentist
about why, what, when and if a replacement
should be planned. There
are many options available including dentures,
fixed and removable bridgework, all with or
without implant retention.
Missing more than one
tooth?
When missing more than one tooth, it starts
to become even more important for the dentist
to discuss and advise you of the why, what and
when replacement of the teeth should be carried
out. There are always pros and cons, but
again a conversation is the most important part
of the process.
Missing all your
teeth?
When
someone has lost all of their teeth it can
be socially debilitating and a source of great
embarrassment to the individual. The
facial appearance ages and becomes more lined
as bone is lost where it once surrounded the
roots of the teeth, while at the same time the
attachment points of the facial muscles change
position. To make matters worse, the
teeth on a denture have to be set up on a slightly
smaller arch radius to keep them in a stable
position. This means that the lips are
less supported than they were with the natural
teeth.
However – all is not doom and gloom! There
is now a bright future for all denture “sufferers” and
implants are the key to this new dawn of denture
dentistry. In 2002 there was a conference
at McGill University in Montreal, where a panel
of experts considered the minimum reasonable
prescription for rehabilitation of patients who
had full upper and lower dentures. The
Mcgill consensus statement is that two implants
to retain a full lower denture should be the
first choice standard of care. All patients
with dentures should be offered dental implants
as a treatment option. Not only can they
be used to retain dentures, but we can also plan
more complex restorations such as removable bridges,
to reduce the amount of acrylic in a patient’s
mouth.
Implants?
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