Dental implants give us a remarkable way of replacing missing teeth without relying on the teeth around them.
It consists of a titanium post that is surgically placed into the bone of the jaw, once this has healed, attachments can be fixed so that it can support a single crown, bridge (through multiple implants), or a denture (again through multiple implants). In the case of crowns and bridges these are fixed, dentures remain removable but take a lot more effort to get out!
A bridge uses a tooth or teeth next to a space to support a false tooth.
Conventional bridges are prepared like crowns so that the supporting tooth or teeth are reduced in size to allow the bridge to fit over the top. These can be made from gold, porcelain fused to metal or entirely from porcelain, depending upon the area of the mouth they are to function in.
Adhesive bridges use a ‘wing’ to wrap around the supporting tooth with a false tooth suspended from it. This type of bridge tends to be made from porcelain fused to metal.
The main advantages of conventional bridges are that they are fixed to your teeth, can be used to replace multiple teeth, look very pleasing and have good longevity when planned and maintained well (they do require lots of cleaning). The downside to them is they require removing a lot of tooth tissue from the supporting teeth/tooth and as a result some teeth die (approximately one in five) and need further treatment (either a root treatment or extraction).
Adhesive bridges tend to be used for single missing teeth and can also look very good. Their main advantage is that they require little or no preparation of the supporting tooth but the downside is that the cement sometimes fails and they come out. However, as long as there is no decay or fracture of the underlying tooth, adhesive bridges can usually be recemented back in.
Sometimes teeth are not suitable to retain bridges or the space is too large to replace with a bridge. In these instances a partial or a full denture may be the preferred means of replacing those missing teeth. Dentures are removable (we recommend you keep them out at night) and are made of either plastic or a combination of metal and plastic. One of the great advantages of dentures is that they can help to restore your profile when the gums and bone have shrunk back causing the lips and cheeks to fall in. The main disadvantage is they are removable and this means that they will move whilst you wear them to a greater or lesser degree, people usually find that this is worse in full lower dentures.
Sometimes we use a denture as an intermediate restoration whilst your mouth heals after extractions or to help us judge where we want the teeth on future restorations to be. These are then replaced later by a bridge, implants or sometimes a definitive denture.