Best Option for Replacing a Single Missing Tooth By Dr. Damon on December 30, 2013

People loose teeth for many different reasons, perhaps trauma, failing root canal, or some people never have a particular tooth develop. What ever the reason, missing teeth need to be replaced. In fact, cosmetic dentistry is the most in demand service from our patients. Patients have 3 options: Implant, bridge, or a removable partial.

Single Tooth Implant-

At Texas Denture Clinic we believe that a single missing tooth should be replaced with an implant. This is the state of the art treatment, it is what I would have for myself and my family. Here are the advantages:

  • It is a conservative treatment- Adjacent teeth do not have to be crowned or even touched with a dental drill.
  • Most esthetic option- with the advent of tooth colored implant abutments and porcelain implant crowns, we can make your implant tooth look very natural.
  • The long term success of a single implant is much better and longer than a bridge. Typical success rates are 95-97% and long term success is 80-90% over a 20 year period. How long does a fixed bridge last? 50% last 10 years.

Fixed - 3 Unit Bridge or Maryland Bridge

A 3 unit bridge fills in the missing space by preparing 2 crowns on the adjacent teeth, and connecting them together with a fake tooth. This was all that dentistry had to offer in the 1960's and 70's. That was 50 to 40 years ago and dentistry has changed.... FOR THE BETTER. Here are the dis-advantages of a 3 unit bridge:

  • The cost is about the same as having a single implant
  • 2 teeth have to be "sacrificed" with all of the enamel taken down to put the restoration
  • After prepping these teeth, they can become sensitive, your bite can change if not properly designed, and as a side effect of any preparation on a tooth, you may need a root canal if the tooth gets overheated during preparation.
  • Only 50% of all 3 unit bridges are in service for over 10 years. For spending over $3,000.00 I as a dentist would expect this to last longer.
  • You can still get a cavity below the crown.

There are some advantages to this:

  • A bridge can be made in about 3 weeks, where an implant can take 4-6 months. However some of the best results do take time.
  • If a person has a serious medical condition where implants can not be placed (there are not many however) such as: Uncontrolled Diabetes, has taken IV Bisphosphonate (Zometa, Xgeva), or has had a high dose of Radiation with curative intent to treat Head and Neck Cancer.

Removable Partial

For a patient that has one or two missing teeth this is not a good option. Typically you should have 3-4 missing teeth before a partial makes sense. Unfortunately even the best designed partial only has a 40-50% compliance rate. Meaning, half of the time the partial is not used! Most of our patients who are wearing partials are in a holding pattern about to receive implants, patients who can not see the advantages and value of implants, or patients who are replacing 8 or more teeth in a single arch.

Here are the advantages of a partial:

  • economical
  • replaces more teeth (ie. 3-4)

Here are the disadvantages of a partial:

  • They move when eating, causing discomfort
  • Food gets underneath, causing discomfort. Have you had a rock in your shoe? Try a piece of meat beneath a partial.
  • Rest seats have to be prepared in teeth
  • They are removable and must be taken out at night



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