Dr. Pranav Nirmalbhai Shah
Dr. Suhani P. Shah
Missing Tooth
Unfortunately, sooner or later, every one of us will lose one or more teeth for some reason, either tooth decay or gum disease. Even those who take good care of their teeth with daily oral hygiene may eventually lose a tooth due to an accidental mouth injury or due to simple daily wear in old age.

If someone is missing several teeth, it is obvious that beyond the esthetic problems, they will also have problems in eating and speaking properly.

Missing teeth can affect:

Appearance: Even if a single front tooth is missing, it can seriously affect the person's appearance, self esteem and social life. With today's standard of life, it is not socially acceptable to show a missing tooth while eating or smiling.
Eating: Missing several teeth can reduce the ability to eat certain foods, resulting in bad nutrition and a poor quality of life.
Speaking: The absence of one or more teeth can disturb your speech, cause a lisp and also change the way your voice sounds.

Why should you replace missing teeth?

Losing one tooth may not be considered by many people as a major problem, unless it is one of the front teeth affecting their appearance. We insist that every missing tooth should be replaced because the following problems can occur:
• Adjacent teeth movement: the structure of your mouth is strong because each tooth supports the ones next to it. If a tooth is lost, this lateral support is lost and adjacent teeth may shift towards the empty space. The adjacent teeth may become loose and fall out by the time this occurs or if you decide to replace the lost tooth after this shift has occurred, it is difficult for your dentist to create the space to replace your tooth.
• Jaw bone loss: The presence of the tooth roots in the jaw bone provides a stimulus to the bone cells that keeps them from dissolving away, due to an effect called the piezoelectric effect. If the root of a tooth is missing, the bone cells in that area start to die and the bone dissolves. If several or all teeth are missing, the process may result in dramatic loss of jaw bone, causing jaw shrinkage. This is what gives a caved in look to the faces of some people and makes them look much older than they really are. This is what is called a "facial collapse".
The major problem of bone loss, beyond the obvious esthetic ones, is that any remaining teeth will eventually fall out and dentures will then be hard to fit because there won't be enough bone to support them.

What are the ways to replace your missing teeth?

The methods of replacing teeth are determined by the location of the gap in your mouth, its size and the presence or absence of adjoining teeth. The options available are:

• Bridge: it is permanently fixed to the teeth on either side of the gap. • Removable denture: it is a common way to replace teeth. It can be partial or full.

It is the most modern method that dentistry has to offer for replacing missing teeth. The cost of dental implants is higher than other alternatives, bridges or dentures. But if you want to restore the esthetics, functionality and feel of your missing teeth, dental implants are the only solution that can provide them all. They are the closest you can get to natural teeth.

Dental implants are small devices that play the role of artificial tooth roots. They are surgically placed in the jaw bone to replace the root part of the missing tooth and provide a solid base to support a dental restoration that will replace the missing tooth's crown.

Parts of a dental implant as compared with that of a natural tooth:

Implant Post / Fixture:
An implant post or implant fixture is a titanium made, screw-like or cylindrical component of the implant that is surgically inserted and embedded into the bone of the lower or upper jaw. The implant post is a non visible part of the implant that holds the 'artificial' tooth in place and it can be considered as the equivalent of the root part of the natural tooth. The external surface of implant posts is usually threaded and sometimes coated with a biocompatible bone-regeneration material to help mechanical stability and osseointegration.
An abutment is the part that connects the implant post with the restoration and it is attached on the top of the post with a screw protruding over the gum line. The central part of the post is usually hollow and internally threaded where the abutment will be fixed. Different types of abutments can be used (both in shape or material) depending on the type of restoration that will be supported. In some types of implants (such as mini dental implants) the abutment is not a separate part but it is fixed with the implant post.
The restoration (that replaces the visible part of the tooth) is a crown, usually made of porcelain fused to a metal alloy, but also could be an all-metal or all-porcelain crown. The crown is attached (screwed or cemented) either to the abutment or directly to the implant.

Who can benefit from dental implants?

Dental implants are a suitable option for replacing missing teeth, if an adult has good dental and general health, and there is enough strong bone in the jaw, to support the implant.

Certain medical conditions such as immunodeficiency, osteoporosis, diabetes and others contraindicate the placement of dental implants increasing the risk of complications or failures.

The dental implant dentist will examine your dental and overall health condition to determine if you are a suitable candidate for dental implants.