June.17: COVER STORY
How to choose between dental bridges, dentures and implants
Replacing missing teeth is much more than an aesthetic requirement
Losing a tooth can be a traumatic experience and a blow to self-confidence. Not only does one become conscious of one’s smile, speaking and chewing are hindered. Missing teeth can be replaced with bridges, dentures or implants. Each option has its pros and cons depending on the health of your teeth and budget. Your dentist will evaluate the state of your teeth and gums and recommend the best solution for you.
Expert opinion
Grahak Sathi interviewed Dr. Shweta Kumarswami, a prosthodontist (a dentist who specializes in the aesthetic restoration and replacement of teeth) with 28 years of professional experience. Excerpts
Q. What are the causes of tooth loss?
A. The main reasons are poor oral hygiene, malocclusions (improper alignment of teeth) and diabetes. Poor oral hygiene leads to accumulation of acid producing bacteria (plaque) which leads to bone loss and destroys fibres connecting tooth and bone. This eventually leads to tooth loss. Malocclusions lead to tooth loss because if teeth are not well-aligned, cleaning becomes difficult.
People with uncontrolled diabetes are more likely to have infections of the gums and bones, because diabetes can reduce blood supply to the gums. High blood sugar level may also cause dry mouth due to which plaque accumulation increases.
Q. How do missing teeth cause problems?
A. Apart from the aesthetic impact, tooth loss can cause mobility of adjacent and opposite teeth as they move from their place to fill the gap. Moreover, when a tooth is lost, the lack of stimulation causes loss of alveolar bone (bone which supports teeth). Tooth loss can lead to poor nutrition and decline in overall health due to chewing problems. Also, food accumulation in the gaps can lead to dental caries and periodontal (gum) disease.
Q. What is the procedure for fixing a bridge?
A. A ceramic bridge is used to fill the space where a tooth has fallen out or has been removed. It is a common, quick and efficient option to replace a missing tooth. A typical bridge consists of a pontic (a filler tooth) that is attached to two surrounding abutments (crowns). After completion, this bridge structure is then bonded into the mouth. A bridge is a fixed structure and does not need to be removed on a daily basis for cleaning.Â
Q. What are the advantages of dentures?
A. Dentures are removable structures, partial or complete, that replace either the bottom arch or the top arch of your mouth. They are the least invasive and cheapest treatment to replace missing teeth
Q. What are dental implants?
A. They are artificial teeth that are permanently attached to your jawbone surgically. Implants mimic the function of the root of the tooth and get integrated with the bone in a few months. After this, a ceramic crown is put over the implant which now functions as a normal tooth.
Unlike bridges, implants do not rely on neighbouring teeth for support. This can help protect remaining teeth from damage. Unlike dentures, bone loss is usually avoided since a dental implant actually replaces the tooth and its root. Also, implants look and function like real teeth, with no clicking noises or speaking and chewing difficulties that can occur with dentures.
However, if you find yourself with a mouth full of missing teeth, or several in a row, it may be unrealistic and costly to replace every missing tooth with a dental implant. As an alternative, dental implants are commonly used as an anchored support for dentures or a dental bridge.
Q. In what cases are dental implants not advisable?
A. Dental implants are not advisable when there is severe bone loss and the height and width of bone is not enough to support the implant. In such cases the dentist decides to go in for a bridge or denture. Implants are also not for chronic tobacco chewers. In cases of uncontrolled diabetes, implants are not advisable because chances of infection and implant failure are high.
Q. What is the type of care to be taken before, during and after implants?
A. The dentist thoroughly examines your teeth and jaws, using X-rays and CBCT to map out exact location of nerves, sinus cavities and other anatomical structures. Bone quality at the intended implant site is assessed. Sometimes, bone grafting is needed. Maintaining your implants with good oral hygiene and regular dental check-ups is the best insurance for long-term success.
Q. How can one take care of bridges and dentures?
A. To prevent tooth decay, keep the area below the bridge and between the supporting teeth clean. It is also vital to preserve the health of anchoring teeth. In case of temporary bridge, avoid eating hard or sticky foods and chew on the other side of the mouth.
Gently clean your dentures daily by brushing with a non-abrasive denture cleanser. Avoid hot water as it could warp the dentures. Place the dentures in water or a mild denture-soaking solution overnight. See your dentist promptly if your dentures become loose or are uncomfortable.
Q. How can one strengthen one’s teeth?
A. Adopt good oral hygiene practices like brushing your teeth twice a day and flossing every day. Rinse your mouth properly after you eat. Visit a dentist at least once a year. Avoid chewing tobacco and betelnut.
Finally, every tooth counts. It is important to have regular dental check-ups so that tell-tale signs of impending tooth loss get noticed and are treated promptly.
