Missing a Single Tooth

Missing Tooth Replacement Options

Several options can replace a missing single tooth, including:

• Removable partial denture called a flipper
• Essix retainer
• Three-tooth or three-unit bridge
• Maryland bridge
• Single dental implant

Partial Denture

A single tooth partial denture is also called a dental flipper.

A partial denture is a quick, cost-effective, and non-invasive solution and consists of a gum-colored denture base with a single denture tooth attached. A dental flipper is usually only considered a temporary solution for tooth loss because it is quite unstable.

It is difficult to bite or chew on the denture and can be uncomfortable to use. A one tooth denture can be a useful solution while still deciding how best to replace a single tooth permanently. It is also sometimes used during dental implant treatment as a temporary solution until a dental implant heals and can be restored with a permanent implant crown.

Essix Retainer

An Essix retainer is a thin clear hard plastic retainer (similar to an orthodontic retainer) that contains a tooth inside which replaces the missing tooth (a pontic).

The pontic is shaped and sized to have a natural appearance, as well as having a natural color that blends in with the rest of the teeth.

The advantage of an Essix retainer over a flipper is that an Essix retainer has a more stable fit, because it fits snugly around the teeth, and for the upper arch, it does not cover the palate, making it more comfortable.

Because its retention is fully tooth-supported, this does not place any pressure on the gums, which can negatively affect the underlying implant. The Essix retainer is a temporary solution to replace a missing tooth while the implant heals.

Three-Unit Bridge

A three-unit bridge is a traditional method of replacing a single missing tooth, using teeth crowns that cover the adjacent teeth attached to a replacement tooth, called a pontic. The pontic rests directly on the gum and is carefully contoured, creating an attractive replacement tooth that looks very natural.

A three-unit bridge is strong and stable and takes two weeks or less to complete. It is a popular solution for tooth loss because it is relatively non-invasive and fast to complete.

However, it is necessary to reshape the adjacent teeth, called abutment teeth substantially, to place the crowns. These teeth must be ground down to create enough room for the crowns to fit properly without looking and feeling bulky and unnatural. Once tooth structure is removed, it will not grow back and can only ever be restored artificially, meaning these teeth will always need to be protected with crowns.

A three-unit bridge may be beneficial if these abutment teeth are already decayed and infected or are not an ideal shape and size and will benefit from being crowned.

Another potential problem can occur as the restoration ages and may begin to leak. Harmful bacteria can penetrate the teeth underneath the crowns if a bridge leaks. These bacteria can cause infection and decay.

After a natural tooth is removed, the bone that previously surrounded the tooth root begins to remodel and resorb. This is the bone directly underneath the pontic. As the bone resorbs, it can create an unsightly gap between the base of the pontic and the gum.

Maryland Bridge

Also called a sticky bridge, a Maryland bridge has two wings made to fit the inner surfaces of the adjacent or abutment teeth.

The wings support the pontic between them and are bonded onto the inner surfaces of the abutment teeth. Because the wings are thin and small, only minimal tooth preparation is needed to fit a Maryland bridge. However, this type of bridge is only generally suitable for replacing a missing front tooth because it isn’t very strong.

If the bridge comes under significant pressure, it will likely become dislodged and need re-bonding back in place by a dentist.

Single Dental Implant

A single dental implant is the most modern solution for replacing a missing tooth.

It can provide excellent results, and a well-contoured implant crown will look like a natural tooth emerging from the gum. A well-made implant crown can be virtually indiscernible from a real tooth. We will almost certainly recommend this option if we feel you are suitable as there are several advantages in choosing this procedure compared to the alternatives.