Dental Implant Decisions

Dental Implants as a Treatment Option for Missing Teeth

If you are missing a tooth, there are many good reasons to have it replaced.
A single missing tooth can be replaced with a Dental Implant, or a Bridge

.

A bridge requires that the teeth on either side of the missing tooth be prepared for crowns. The bridge is cemented to place.

A dental implant is an artificial tooth root. A dental implant can be used to hold in a replacement tooth.

Deciding which treatment option is better for you…

The missing tooth is the last tooth in the arch.

This strongly favors a dental implant. Bridges are normally supports by a tooth on either side. Although it is possible to make a ‘cantilevered’ bridge, with support on only one side, they tend to have a higher failure rate. If there is not a tooth on either side to support a bridge, then an implant is the answer.

The teeth on either side of the space have never had a cavity or any fillings.

This favors a dental implant. When a bridge is placed, the adjacent teeth have to be cut down to allow for the thickness of the materials that the bridge is made of. A tooth that has been cut down is more susceptible to future harm than a healthy, unprepared tooth. Implants replace missing teeth while preserving the adjacent teeth.

The teeth on either side of the space have large old fillings.

This favors a bridge. Fillings are not forever (although we wish they were!). Teeth with fillings may need treatment in the future. If the failing filling is large, this may mean that the tooth will need a crown. A bridge is essentially two crowns attached together by the replacement tooth. Placing a bridge in this situation may improve the condition of the adjacent teeth.

One or both of the teeth next to the missing tooth has had a root canal treatment.

This favors an implant. Statistics show that bridges placed in this instance have a shorter average lifespan than when an implant is used. The reason for this is that, of necessity, when root canal treatment is performed, some of the tooth structure needs to be removed from the inside of the tooth. This weakens them a bit. When bridges are placed, we ask the roots of two teeth to essentially support the chewing load of three teeth. Although the remaining tooth structure after root canal treatment may be very well be strong enough to support the chewing force of one tooth, it may not be strong enough to support the chewing load of more than one.

Esthetics. Whether a bridge or an implant is the treatment of choice, obtaining good esthetics for a front tooth replacement can be a challenge. You may have a particular situation that would favor either a bridge or an implant over the other.

Medical Issues. Diabetes, if poorly controlled is considered a relative contra-indication for dental implants. Uncontrolled diabetics have poor bone healing. Smokers have more problems with implants than non-smokers. Actually, smokers have more dental problems in general, but the problems are harder to treat when implants are involved.

The above should be considered as a guide and a basis of discussion only. Many other factors go into the decision as to what would be best for you.