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Center For Aesthetic & Implant Dentistry
Jennifer N. Nguyen, D.M.D, F.A.D.I.A  & Associates
3232 W. Lake Mary Blvd. #1400
Lake Mary, FL. 32746  




Single-Tooth Replacement Options

Jennifer N. Nguyen, D.M.D, M.A.D.I.A

Loosing a tooth or several teeth, especially in the front can be a very traumatic experience. There are many possible options to replace a missing tooth.

1. Dental Implant

Why dental implant is the best way to replacing a missing tooth? It removes the need to grind down the two adjacent teeth next to the space as with a traditional bridge. The grinding procedure usually leads to other problems such as a root canal or an eventual fracture in the root due to the physical stresses of chewing on the remaining teeth that the bridge sits upon. Often times, these root fractures lead to more tooth loss. When bridges get decay (and they almost always do) it often results in more tooth loss. Tooth loss will lead to bone loss. Dental implants can't get decay! The scientific data clearly shows that using a dental implant results in a least chance of more tooth loss in this situation. If any doctor doesn't give this option when a tooth is missing, it is a good idea to quickly get a second opinion before you begin a domino effect of further tooth loss.

2. Fixed Bridge

A traditional bridge involves grinding down the teeth next to the empty space to support the bridge. It provides good esthetics and function and is fairly easy to for most dentists to do. However, this alternative has some very significant disadvantages that create more problems and costs later. One is the sacrificing of healthy tooth structure from the teeth next to the space to make room for the bridge. The damage and heat that occurs due to "grinding" of the two teeth along with the excessive pressures applied to the remaining teeth during chewing over several years almost always results in more long term tooth loss.

What are some disadvantages of a Bridge?

Excessive physical stresses on support teeth

Must grind/shave down support teeth

High risk of decay

High risk of root canals

High risk of root fractures

High risk of more tooth loss

Jaw bone erodes where tooth is missing

Loss of facial support due to bone erosion

3. Removable Partial Denture (Flipper)

This is not a permanent alternative to a lost tooth. It is very unstable and loosely attached, which makes it less comfortable and ineffective for eating. The only benefit is that it is easily and quickly installed and relatively cheap. Most often this is used as "temporary" or "healing" teeth while permanent dental care is being performed. For example, when patient needs an extraction of a tooth due to infection, and an immediate placement of implant is not recommended until healing is complete and adequate bone is established.

What are some disadvantages of Partial Denture?

Supporting teeth have more looseness and tooth loss from stress

High risk of decay, bone loss, and tooth loss from both problems

Food collects beneath the partial


Accelerates jaw bone destruction


4. Bonded (Maryland) Bridge

Metal wings are bonded to the adjacent teeth providing a good temporary solution while healing. This procedure has a very poor long term success rate and will not work in the back chewing areas of the mouth. As a matter of fact, if you are having a Maryland Bridge, you need to have it check for any recurrent decay on the adjacent teeth, as we have removed many of these due to decay.

6. Not Having A Missing Tooth Replaced

Research has shown that 40-50% of bone loss occurs as soon as the tooth gets extracted without bone graft. Then 0.4-0.5mm of vertical bone loss will occur every year. The edentulous ridge will collapsed. As a result, the adjacent teeth will drift into the empty space where the tooth is loss, causing a "bite collapsed." Once the bite is "collapsed," the vertical dimension of the teeth gets shorter. The only method to straighten the teeth is orthodontic treatment, called "molar up-righting." The opposing teeth drop down ward, into the missing tooth's space, called "extrusion." Eventually, this upper tooth has to be extracted if it drops down too far, hitting the empty ridge below, causing pain and discomfort. So you see, missing tooth can affect both esthetic and function of your teeth. Replacement of a missing tooth as soon as possible is a good idea.