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Missing a Single Tooth

Many people are missing a single tooth and might not be in a hurry to replace it. However, there are several reasons why you need to consider all possible options so the tooth can be restored promptly.

The Consequences of Leaving a Gap in Your Smile

Because your teeth are designed to work together, even the loss of a single tooth can affect the remaining dentition. A complete set of teeth helps ensure you can bite and chew food thoroughly, and each tooth prevents its neighbor from shifting position. When you have a space left by a missing tooth, the adjacent teeth will soon begin to drift out of place, moving towards the gap, destabilizing them and creating new unsightly spaces between them. At the same time, unwanted tooth movements can negatively impact your bite. Once teeth have moved out of place, it can be very hard to correct this problem, and it can make it significantly harder to replace missing teeth in the future successfully.

Missing Tooth Replacement Options

Several options can replace a missing single tooth. These include a removable partial denture called a flipper, an Essix retainer, a three-tooth or three-unit bridge, a Maryland bridge, or a 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.

Patient’s
Success Stories
★★★★★

Staff was wonderful

I'm happy I found this dentist because I had a missing tooth for almost 7 years and it was really embarrassing for me. The entire staff was wonderful and made me feel really welcomed. Dr Russo gave direct answers so that I could see the whole picture and decide what to do next. My smile was dramatically enhanced by his incredible dental work.

Michael D.

Three-Unit Bridge

A three-unit bridge is a traditional method of replacing a single missing tooth, using 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.

The success rate of dental implants is extremely high, typically 95% or higher. A single dental implant is easy to look after, and with the right care, it should provide many years of problem-free use so that it can be an excellent investment in your dental health.

A dental implant is self-supporting, so we do not need to modify the adjacent teeth. Instead, the dental implant helps ensure these adjacent teeth remain firmly in place, providing additional support and stability. Initially, a single dental implant can be more expensive than a three-unit bridge, but it is more cost-effective in the longer term. Eventually, you will need to replace your chosen restoration, and it is more expensive to replace a three-unit bridge than a single implant crown.

Treatment consists of a small implant screw or post called the implant body that is surgically inserted into the jawbone. An abutment is attached to the post, protruding just above the gumline, supporting the implant crown. Because the implant body artificially replaces a real tooth root, it provides the necessary stimulation to ensure the surrounding bone remains strong and healthy and will not resorb.

The procedure to place a single dental implant is relatively quick, taking as little as an hour to complete. Afterward, we will cover the implant and leave it to heal, or we may be able to fit a temporary tooth that is purely for cosmetic purposes. You will not be able to use the cosmetic tooth for chewing or biting while the implant is healing. Once healing is complete, after 3 to 6 months, we replace the temporary tooth with a permanent crown.