A. The answer to this question depends on a number of factors including the location of the tooth, the health of the surrounding teeth, gum, and bone, if there are other missing teeth in the same arch, and financial considerations.
There are essentially three ways that a tooth or teeth can be replaced and a thorough examination and discussion of the above factors is necessary to determine which would be the best option in each situation.
An implant is really a titanium substitute for a tooth root. The technology has improved greatly and the success rate exceeds 90%. Some implants are still functioning after more than thirty years.
If a single tooth is to be replaced, the adjacent teeth are healthy, and there is good gum and bone in the site, an implant would be the best choice. A surgeon places the titanium implant at the site of the missing tooth root; it is then given time to stabilize (osseointegrate). Once it has fused solidly to the jawbone, the general dentist attaches an abutment to the implant and places a crown on top of that which replaces the structure and function of the missing tooth. One advantage is that it can never decay and can be cleaned just like a normal tooth to keep the surrounding tissues healthy. Implants can also be used to support fixed bridgework where several teeth are missing or give support to a full denture which has become loose.
“Fixed” means that the bridge is cemented to other teeth and is not removable. This may be the best choice if the teeth next to the missing one have large restorations already, could benefit from crowns and still have good bone support. In this process, the adjacent (abutment) teeth are shaved down slightly and a prosthesis with the replacement tooth induced is made to fit over the abutment teeth. These can look very natural and give many years of service if properly taken care of. A floss threader must be used to help clean underneath. Sometimes a bonded bridge can be constructed that requires very little reduction of the abutment teeth, but is not as strong as the aforementioned bridge.
Removable Partial Dentures:
As the name implies, these prostheses are removable by the patient. They may be the best option where there are numerous missing teeth, where cost is a big consideration, where the other teeth are not strong enough for a fixed bridge, or as a temporary replacement before some sort of fixed prosthesis can be done.
Normally there are metal clasps which wrap partially around the existing teeth to support and stabilize it. There is a connector that runs behind the teeth to give strength and connect all the parts together. The prosthetic teeth are embedded in a pink plastic material to simulate gum tissue. There are many variations of a partial denture depending on the cost, expected longevity, and where the missing teeth are located. Their main drawback is that it does put a lot of extra material in the mouth, although most people get used to it in a short period of time. The typically do not last as long as the previous options.