If you’ve been diagnosed with periodontitis, you’re likely well aware that timely treatment can help prevent tooth loss. This is because, if left untreated, progressive damage to the structures that support the teeth (namely the gum and bone) can lead to tooth loss or necessary extraction.
At EO Perio, we place utmost importance on preserving our patients' natural teeth for as long as possible. (More on this shortly, including the reasons why teeth are so important. You may be surprised.)
But, in some patients tooth loss has already occurred. In other instances, despite treatment, the teeth are irreversibly infected and can’t be saved. In which case, we’ll look at teeth replacement options. This includes dental implants, tooth bridges and dentures.
Let’s take a look at the different options for teeth replacement in more detail, including the advantages and disadvantages of each one.
Having advanced gum disease (periodontitis) doesn’t mean tooth extraction is inevitable. Many people believe there’s no hope and nothing can be done to stop the condition. This isn’t true. In fact, long-term studies have shown that periodontal treatments can be highly effective at preventing tooth loss.
It’s important to think really hard before taking the irreversible step of having one tooth or all of your teeth removed. Natural teeth are priceless. In fact, maintaining your natural teeth could help you live longer. A study looking into tooth loss and mortality found that people with 20 teeth or more at the age of 70 had a higher life expectancy than those with 19 teeth or fewer.
Only in cases where the teeth are irreversibly damaged and no longer function as they should, is it reasonable to consider whether an alternative would work better. Here are the options.
Dental implants can be an excellent option for missing teeth because they look, feel, and function like natural teeth. They can replace a single tooth or multiple teeth.
Much like natural teeth, implants are made up of a tooth root and a visible crown. Treatment involves two stages. First, the implant is positioned into the jawbone. This acts as the ‘root’, providing a solid base for the false tooth (dental crown). The gum and bone around the implant will need to heal for a few months (typically between 3-6 months). Once the gum tissue and bone have fused (a process called osseointegration) with the implant, a dental crown is fixed on top.
It’s important to know that if you’ve lost teeth due to gum disease, you can face a higher risk of problems with dental implants. This is because like teeth, dental implants can get gum disease. Gum disease (periodontitis) affects a subset of susceptible people (20-30% of the population). These people are also likely to have increased susceptibility to gum disease at dental implants.
So, it’s important to treat gum disease and get it under control before replacing any missing teeth. People with severe gum disease, even if treated, may need a bone or tissue graft. This increases the volume of bone, providing a good foundation for the implant.
If you take proper care of your dental implants and keep gum disease at bay, they can last a very long time. However, there’s no denying that it’s an expensive treatment. Whereas, your natural teeth are priceless, so it pays to hang on to them as best and as long as you can.
This dental procedure can replace all your teeth on four dental implants. It’s an option for people who need to replace all the teeth in the upper (maxilla) or lower (mandible) jaw, as it provides a full-arch replacement.
Treatment involves placing four titanium implants into the jaw. These act as roots to provide a stable foundation for a full bridge of natural-looking teeth. In some situations or with certain protocols, a bone graft is not required and a temporary bridge can be fitted on the same day as surgical placement of the implants.
This can be a good solution for people missing multiple teeth in a row. It avoids the cost of placing several single implants.
The procedure involves placing two implants into the jawbone, at either side of the gap. A tooth bridge is then fixed to the implants to replace the missing teeth. The bridge normally contains three or four larger (back) teeth or up to six small (front) teeth. The teeth in the middle of the bridge (pontics) do not need to be fixed to the gum.
Rather than implants, a tooth-supported bridge needs a healthy tooth at either side of the gap. In order to affix the bridge, the two supporting teeth need to be reshaped. Dental cement is applied to the prepared teeth to keep the bridge in place.
Due to their affordability, dentures (AKA false teeth) are a common teeth replacement option. A full denture can replace an entire set of upper or lower teeth. Or, if you have just a few missing teeth, you can have a partial denture.
A full denture rests on the gums and is held in place by a suctioning effect in the mouth. Partial dentures are attached using metal clasps that hook onto the existing teeth.
An overdenture is a full denture that’s held in place by dental implants placed into the jawbone. The denture is fitted with special attachments to help it ‘snap on’ to the implants. This is why they’re sometimes called snap-on dentures.
Like traditional dentures, overdentures are removable which makes them simple to clean and maintain, while still being stable and functional. This makes them an excellent option for people who have lost their teeth due to periodontitis (gum disease).
The answer to this question is certainly no, you don’t need to replace missing teeth. However, missing teeth can cause a range of problems. One of the biggest consequences of lost teeth is bone loss. The jaw bone is only there to support the teeth and facial muscles. So when a tooth is lost, the bone that used to support it can disappear (resorb).
In addition, the space left between the teeth can cause nearby teeth to shift out of their natural position to fill the gap. This can result in a misaligned bite, possibly leading to problems chewing.
Missing teeth can also have a significant impact on your mental and emotional wellbeing. Difficulty speaking and feeling embarrassed by the gaps in your mouth can leave you self-conscious.
Why not consult a periodontist for some specialist advice before electing to remove all your teeth? Replacing teeth with gum disease can cost 10-20 times as much as the cost of treating the gum disease. So it’s a much better option to get on top of your gum disease.
Certainly, for some people it’s impractical to continue maintaining teeth that have been severely damaged by gum disease. In this case, it’s reasonable to explore your tooth replacement options. Be sure to consider comfort, appearance, and function.
It’s also essential to think about long-term maintenance and what happens if you have implants and they fail. This is particularly important for younger patients. It is simply not realistic to expect dental implants to last a lifetime in a person who is younger than 40. When the average life expectancy in Australia is 83, it is a long shot even at age 50.
The lifespan for teeth compromised by gum disease (when treated properly) are as good and in most instances far better than dental implants.
Your dentist or periodontist will work with you to find the most appropriate solution for you.
Let us help you get your gum disease under control, so you rediscover the joy of eating, laughing and smiling with confidence.
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