So your missing a tooth. What are the options available? Well, the first thing that comes to your mind is to do nothing. Because doing nothing, costs nothing. Is this true?
In private practice, we see many patients who present with a missing tooth. These are the options available,
1. Do Nothing
2. Denture
3. Bridge
4. Implant
Let's examine these options in more detail
1. Nothing is wrong with a missing tooth, so I will do nothing
This is the option, and the options that costs "the least". Over time, your teeth will over-erupt, the gums around it will loose attachment to the teeth. Boss loss will happen in the missing site, because nothing is there. Tissue loss will follow. Teeth on either side will tip inwards toward the gap. This creates many mid and long term issues, and yes, costs. Do nothing does not cost nothing! It carries some pretty significant mid and long term costs.
2. Give me a denture, like my parents
People often choose this option, because they know someone with a denture. This is also, well, the cheaper option. This option is acceptable short term. However, we still get the tissue/bone loss, because we haven't done anything to the site. The denture will sit directly over the tissue, and this will accelerate tissue loss. The main problem with dentures is that you often cannot chew on it, as it rocks in the mouth, and this leads to a decrease in the quality of life. It will stop teeth either site from tipping, and opposing teeth to over-erupt. As dentists, we understand this to be the cheaper alternative, but not the ideal.
3. Give me a bridge
A dental bridge consist of using teeth either side of the missing gap, as anchors. We place crowns on the teeth either side of the gap, and attaching a pontic tooth in the middle. A bridge can last upwards of 10 years, and its a viable replacement option. You can chew on this well, and there is no loss on quality of life. By definition however, a bridge , makes a 1 tooth problem, into a 3 teeth problem. We have to reduce otherwise healthy teeth on either side to make room for the bridge, and there are associated risks.
4. So what's the ideal treatment? - Implant
A dental implant is the ideal way to replace a missing gap. The main disadvantage is cost, although as discussed, doing nothing does not cost nothing. Implant prevent bone/tissue loss, it has good chewing function. Most importantly it keeps a one tooth problem to one tooth. Any treatment is limited to the missing tooth in question, and does not involve neighbouring teeth. We know that it works well, it feels natural, and it does not harm any other neighbouring teeth.