Teeth are lost because of trauma or disease. Trauma may come in the form of an accident or excessive biting forces. Disease is generally tooth decay or periodontal disease [gum disease] but there are other categories such as cancer and various neoplasm’s of the jaw that may result in tooth loss. Studies show that more than 50% of the population have one or more missing teeth. Trauma commonly causes the loss of a single front tooth. The effect this has on a persons’ well being is obvious. Fortunately an experience dental implantologist can usually remove the remaining root, place a dental implant, and secure a new tooth to that implant in one visit of an hour or two. The loss of a single tooth in the back is usually caused by tooth decay or periodontal disease. Sometimes this can be treated just like front teeth but for various reasons it is often more time consuming.
More often than not the treatment for a single missing back tooth is as follows:
1. Extraction of the damaged tooth and grafting of the root sockets. Wait 4 months then
2. Placement of a dental implant to replace the root of the single missing tooth. Wait 4 to 6 months then
3. Placement of an abutment on the dental implant and record taking for the fabrication of a crown to replace the single missing tooth. Wait 3 weeks then
4. Permanent attachment of the abutment to the implant and cementation of the crown to the abutment. TREATMENT COMPLETE
The need for replacing a single missing tooth in the back is often times not as intuitively obvious as the need for replacing a single missing tooth in the front; but it is important. Teeth are very movable. We’ve all witnessed an Orthodontist putting tension on a tooth with a small rubber band and moving it where ever he wants. Each tooth in the mouth has a position and a purpose. When there is a single missing tooth the body’s natural reaction is to drift adjacent teeth into the void that is created. Over time a single missing tooth may actually cause a change in the position of every other tooth in the mouth. Malocclusion may then develop contributing to TMJ [tempromandibular joint] dysfunction, headaches, muscle spasms in the neck and shoulders, food impaction between teeth, tooth decay, periodontal disease, and other problems. Because these problems don’t always develop and because they may occur years after the single tooth is lost, people often times don’t associate the loss of their tooth to the problems it caused. It is a shame that a single missing tooth is frequently ignored in light of the possible consequences but the development of dental implants for the replacement of a single missing tooth is encouraging many more people to seek early treatment.
Multiple missing teeth usually follows a single missing tooth. Each time a tooth is lost and not replaced it accelerates the process of losing more teeth. As multiple teeth are lost all of the problems associated with a single missing tooth are exaggerated. But there are additional concerns as well. Those would include but not be limited to:
1. Collapse of vertical dimension- As multiple back teeth are lost the mouth loses their support when we close causing the chin to get closer to the nose. This has the effect of deep folds at the corner of the mouth and thinning of the lips. It can easily age a persons’ appearance by 10 to 20 years.
2. Collapse of facial structure-As multiple back teeth are lost facial support of the cheeks is lost causing a sunken in look. Once again the result is premature aging.
3. Bone loss- The bones of our upper and lower jaws have only one natural purpose; the support of our tooth roots. When the roots are lost the bone begins to melt away much as a muscle does that is not used. This results in further lose of facial support and can make the wearing of artificial prosthetics such as dentures impossible. It can also make the placement of dental implants more challenging.
4. Inability to chew foods properly-The mouth is the first in a series of organs designed to assimilate and digest foods. The more thoroughly we can chew the food the better the whole system works. Mom wasn’t wrong when she admonished all of us to chew our food more slowly and thoroughly.
5. Inability to eat a healthy diet-As more and more teeth are lost it becomes increasingly difficult to eat a balanced diet. Important staples such as raw vegetables and nuts become impossible to eat and we lose out on the many vitamins and minerals they provide.
6. Inability to eat the foods we enjoy-Corn on the cob, ribs, steaks, fajitas, etc. become impossible to eat. Many people don’t know how much being able to eat what they want means to them until it’s too late.
7. Embarrassment-There is a social stigma associated with missing teeth. Many people simply quit smiling or hide their smiles with their hands. That is unfortunate because we know of very few people who lost their teeth because they wanted to. Each person has their own story and all of them or sad.
These are but a few of the problems that people face because of single and multiple missing teeth. Now, dental implants offer amazingly simple and dependable solutions. Dental implants for single missing teeth or multiple missing teeth are artificial roots made of titanium that replace the roots of natural teeth. For a single missing tooth one implant is placed and a crown is attached to it. The result is a natural looking tooth that functions and works just like the natural tooth that was replaced. Many people think that with multiple missing teeth that one dental implant is required to replace each tooth; that is not usually the case. For example if three teeth in a row are missing it is often possible to replace them with only two dental implants and a fixed bridge between them. With the amazing All on 4 protocol and entire arch [16 teeth] can be replaced with only four implants and a fixed bridge.
The placement of a dental implant is usually quick and almost painless for those who are candidates. One requirement is an adequate quantity and quality of bone. As mentioned previously when a tooth is extracted the bone that once secured its’ root begins to melt away. Some studies indicate that up to 40% of the bone volume in that area may be lost in the first twelve months. Modern dentist with an understanding of oral surgery and implants place materials in the sockets where the tooth roots were to prevent this from happening. The result is a healthy site for the future placement of a dental implant. Dentist with a more advanced understanding of dental implants may actually place an implant into the socket when the tooth is extracted. When this can be achieved it is the best and simplest solution for preventing bone loss. But because many dentist do not understand dental implants and the protocols necessary for preserving bone, and because many patients take a cavalier approach to the loss of a tooth, sometimes there is a need for an implant but not adequate bone to support it. Modern implant designs minimize this as do implant placement protocols such as those of the All on 4 technique but they cannot eliminate the occasional need for more bone.
When there simply must be more bone, bone regeneration procedures are required. This normally incorporates one of many different types of materials that replace the lost bone volume and encourage the formation of new bone. With the advent of stem cell and bone morphogenic enhanced materials this has become far simpler and more predictable. What once required a maxillofacial and an orthopedic surgeon in a hospital setting can now be predictably performed by a well trained dental surgeon in his office. Once this new bone has matured, usually 4 to 6 months, a single or multiple tooth replacement dental implant can be placed just as predictably as if the graft had not been required.
Single Dental Implant Procedure:-
Steps for placement of a single dental implant in the site of a single missing tooth
• After conscious sedation is administered the placement site of the single missing tooth is infiltrated with local anesthesia.
• A small incision is made in the soft tissue covering the bone in the single missing tooth site and an osteotomy is prepared. An osteotomy is the same thing as a pilot hole made prior to the placement of a screw in wood. Once the osteotomy is completed a single dental implant is threaded into it. Now we have a man made root where the natural root was. Just like a natural root this dental implant is beneath the gums and in the bone and cannot be seen in the mouth. A piece called an abutment is screwed into the single dental implant. The abutment provides the transition from the dental implant beneath the gums to a tooth above the gums. Impressions are taken of the abutment and they are sent to a dental laboratory
• In about three weeks a crown is returned from the laboratory and it is secured to the abutment with glue [cement]. You now have a new tooth that looks, functions, and feels just like a natural tooth.
Dental implants for the replacement of single missing teeth and multiple missing teeth have become as routine for dental implantologist as fillings are at your family dentist. For those with single missing teeth they offer an exceptional replacement solution that can help prevent future problems. For those who have lost multiple teeth or all of their teeth dental implants can give them back their smile, confidence, and self esteem. It can truly give them a second chance.