Dr. Ed Mazer
Southwest Dental Group

Why replace my missing teeth? As many patients have said either in jest or seriously, “After all, my grandparents had dentures, and my parents had a lot of missing teeth!” Why indeed, since we have started with 32 teeth, and if we lose a few, especially the “back” ones, how much difference could it make?

When I was in the Ukraine a few years back, people came to me for dental treatment—all extractions!! They walked around with holes in their mouths, in the front teeth and the back, and they were both young and old, male and female. The common denominator for them was that they had unhealthy teeth. They complained of not chewing well, they didn’t feel well and of course wanted to get some teeth from the “American” doctor.

Since I was in dental school in the 1970’s, when more than half the population over the age of 50 had lost all of their teeth, we have come a long way. The percentage has dropped significantly, and most people who see me want to do whatever they can to save their teeth. This is a part of the story of modern dentistry. We have discovered that disease of the mouth is inclusive of the body. When one has unhealthy gums, cardiovascular disease, strokes, diabetes, and premature low birth weight babies are an increased likelihood.

It is important to understand that your mouth harbors multiple bacteria. To stay healthy, you must keep your teeth and gums clean, so that your can keep your teeth for a lifetime. There are consequences when one loses one or more of their teeth.

Is it important to replace that tooth, or can I just go on like I am? The answer is an individual one ultimately. After all, it is not a life threatening disease we are talking about. Or is it? By losing a tooth or teeth, many things are altered, through shifting of other teeth, loss of the ability to easily eat or digest ones food increased decay (since the tipped teeth are harder to keep clean) and temporomandibular joint problems, just to name a few. Pain could result, with poor eating habits leading to other medical problems and...thus indirectly we have increased our health problems.

What is the answer? First, don’t lose any teeth. Maintain good hygiene: floss, brush and eat a healthy diet. If you have to lose a tooth, varied replacement methods must be identified before you have the tooth extracted. (Provided you are not suffering and in pain). For instance, the tooth can be replaced by a traditional fixed bridge method, or by the insertion of an implant, or even by a removable partial denture (least favorable). To determine what is right for you, one needs to evaluate the cost/benefit factors.

In a fixed bridge, the dentist must reduce tooth structure for a crown and connect multiple teeth together. This is the old standard of care for replacement of a missing tooth, and in many cases should still be used today.

An implant is a titanium “screw” placed into the alveolar bone, integrated (fused) natural bone repair, and eventually, (two to four months later), a crown is attached to it. The planning for the implant should start before the tooth is extracted. With proper planning, most sites can have an implant placed either immediately or as a delayed procedure. More about this will be coming in future articles.

Most importantly, one must replace missing teeth before more damage is done. Insidious problems creep up over the years, eventually costing much more for the investment in your mouth. Be smart-keep healthy with good oral habits and you will save a lot of money over your lifetime.