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March 10, 2015

Missing Teeth and Treatment Options.

Loss of one or more teeth may occur in our course of life and it can be a very traumatic experience. It can affect our appearance and therefore confidence, our speech and our ability to chew properly. The most common reasons for tooth loss are tooth decay and severe gum disease as a result of poor tooth brushing, not cleaning or flossing properly between teeth (ineffective daily dental plaque removal), and poor lifestyle choices such as smoking or a diet high in sugars and saturated fat. Other causes include injury particularly those incurred during contact sports such as rugby, football and hockey or even a bad fall or accident.

Should you lose one or more teeth, there are several options available for replacing the gap. Each one of these options have their pros, cons and risks as briefly described in the following few paragraphs.



Figure 1: Drifting of adjacent and opposing to the gap teeth.


Figure 2: Dental implant and it’s components.

A resin-bonded bridge (also called Maryland Bridge) is sometimes considered, especially to restore front teeth that don’t endure the biting and chewing demands of back teeth. It has a wings on one side or sometimes both sides to attach to the adjacent teeth. It is a minimally invasive option, as no or minimal preparation (grinding down) of the teeth is required but it is weaker than a conventional bridge and the wings may become unstuck from the support teeth.

resin bonded

Figure 3: Resin bonded bridge.

• A cantilever bridge. This design of bridge is used when one tooth next to the gap is strong enough to support a false tooth alone, which means only one tooth has to be prepared. The false tooth is attached to the single crown which then fills the gap.

Figure 4: Cantilever bridge.

• A conventional fixed bridge. This bridge is more appropriate when more than one tooth is missing. The downside is that the teeth on either side of the gap will need to be prepared (ground down) to accommodate the space required for the bridge to be fitted. It has been shown that after preparing (grinding down), a tooth for a crown/bridge there is a considerable risk that the tooth nerve may die or get infected) within the first 5 years after the bridge placement. This will result in the affected tooth requiring either root canal treatment or extraction. Adequate home care such as tooth brushing and using dental floss and interdental brushes is essential to prevent the supporting teeth (abutments), getting affected by tooth decay and gum disease.


Figure 5: A conventional 3 unit bridge.


acrykic denture                                                     chrome1

Figure 6: An upper acrylic denture.                                                                                            Figure 7: A lower chrome denture.



How can you prevent tooth loss?
It is impossible to prevent tooth loss as a result of an accident or injury as that is part of life. But if you play contact sports (e.g. rugby etc.), wearing a protective mouthguard will reduce the risk. However, the majority of tooth loss is caused by tooth decay and/or gum disease. This can be preventable if you care for your teeth. This includes daily effective removal of the dental plaque from all the surfaces of your teeth. This can be achieved by thorough tooth brushing twice a day (always at night before bedtime), with a fluoride toothpaste and also daily interdental cleaning by using dental floss or tape or interdental brushes. Use of a plaque disclosing tablet may enhance the quality of your cleaning. Furthermore, lifestyle changes can improve your overall general and oral health reducing your risk of tooth decay, gum disease and oral cancer. Reduce your consumption of sugary foods and restrict them to mealtimes only. Reduce the amount of alcohol you consume and consider quitting smoking. Last but not least, visit the dentist twice a year for a thorough dental health check!




This blog was written by Anastasios Plessas (Associate Dentist) – March 2015


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