Dr. David Scharf

When tooth is lost the individual faces many choices. The first choice is should I replace the missing tooth? The second is what is the best way to replace it? In making these decisions there are many factors to consider and research data to be evaluated.

There are three basic ways to replace missing teeth.

These include:

1) Removable partial dentures
2) Tooth supported bridges and
3) Implant supported teeth.

Removable partial dentures have metal clasps that clip onto teeth to hold the device in the mouth. Patients need to take these in and out for cleaning after eating.

Tooth supported bridges rely on the adjacent teeth for support. The teeth next to the missing tooth space are ground down and the bridge is cemented onto them. This bridge does not come in and out and relies on the integrity of the adjacent teeth for support.

Dental implants. The final method of tooth replacement is the dental implant, which is a replacement for the root of a tooth. The implant is placed where the root of the missing tooth used to be. The replacement root is then used to attach a replacement tooth.

Tooth Replacement with Removable Partial Dentures

Removable partial dentures (also called partials) have clasps that attach to the teeth. The teeth that hold the partial are called “abutment teeth”. Sometimes crowns with hidden interlocks are used to attach the partial denture so that the metal clasps do not show.

Numerous studies have demonstrated the problems clinicians and patients see with removable partial dentures. Koivumaa showed that only 80% of people still wore their partial dentures after the first year. Carlsson showed that only 60% wore them after 4 years.

Why did patients pay good money for these partials and stop wearing them? Discomfort. Wetherell showed that the teeth that bear the twisting forces of the partial denture clamps fail at an alarming rate. For patients who were able to tolerate and wear their removable partial dentures, his data showed 40% survival at 5 years and 20% at 10 years. What this means is that as a partial denture is worn longer and longer, it is more destructive to the supporting teeth. As these teeth fail, new partials are made which then begin destroying new abutments teeth. In some cases, a removable partial denture is a stepping stone to a full denture.

When an individual loses a tooth there are important decisions to be made. To learn more about tooth replacement options including using dental implants to replace a missing tooth visit http://www.drscharf.com Dr. Scharf is a board Certified Periodontist specializing in placing dental implants and treating periodontal disease in Babylon, Suffolk County, Long Island New York. You can watch Dr. Scharf on youtube.com be interviewed on “The Wellness Hour” on the topic “Who is a Candidate for Dental Implants” at http://www.youtube.com/watch?v=1nX0dDUF0T8