A lost tooth can be a subject of great anxiety or “no big deal” if you grew up in a household where both your parents wore complete dentures by the age of thirty. Teeth can be lost as a result of trauma, periodontal disease, failed root canals, cracked teeth, and Diem even non restorability due to extensive decay. Regardless, loosing a tooth can create not only esthetic issues – especially if it’s a front tooth – but create long term problems to adjacent tooth structures.
Should I replace a lost tooth? The answer is almost always: “Yes”, even if it’s a back tooth you don’t see. The masticatory complex was designed to function as a unit. How efficient is riding a bicycle with spokes on the wheel missing? It puts more stress on the other spokes; hit a bump and you will be picking yourself and a bent wheel off the ground. When one looses a back tooth, the adjacent teeth are subjected to a greater load as you eat. Amalgams, white bonded fillings, and crowns are great replacements to missing or lost tooth structure, but the muscles of mastication are strong and put more stresses on these man made materials. Periodontal disease, an infection of the tissues surrounding a tooth not only cause infection and bleeding of gum tissues, but often causes the bone around teeth to shrink away as a result of chronic inflammation. Periodontally infected teeth get loose because there is less bone support around them. Are fence posts stronger if they are buried three inches or three feet into the ground? Loose a tooth, for what ever reason, and adjacent teeth that already suffer from periodontal disease can literally be loosened to the point of pain, increased infection, and ultimate tooth loose.
When one looses a tooth, the associated tooth structures also become compromised. A missing tooth will cause the opposing tooth to supraerupt into the missing space. Adjacent teeth also “fall” or “tilt” into the hole. Eating, clenching, and sliding the jaw left, right, backwards, and forward now creates what is called a traumatic occlusion as these teeth are in unintended positions and take the brunt of the strong, strong muscles used to chew. Hence, these teeth become more prone to breaking and periodontal disease as already discussed. Food also begins to collect in the gaps created by these moving and tilted teeth. Anywhere food impacts or collects becomes more cavity prone. Food impaction also starts the “domino effect” of periodontal disease.
The American public spends billions of dollars annually on looking younger. Begin to loose back teeth – that support the muscles and structures in your face – and you will begin to look much older than your true age. Simply put, missing teeth create wrinkles.
When a tooth is lost and no other treatment in the area is performed, the bone shrinks away. This creates esthetic issues should the area later be restored with fixed bridges, partial dentures or implants. Implants require bone to support them and sometimes cannot be placed if not addressed somewhat soon after tooth loss. People that loose all their teeth early in life become “dental cripples” in their senior years. As bone loss progresses, Quartz the ridges used to support complete dentures or removable partial dentures shrinks away and makes them fit less optimally. Dentures are meant to be worn, not carried in one’s purse and only used to go to church on Sunday.
What’s the best way to replace a missing tooth? There are a number of options with their own advantages, disadvantages and varying degrees of longevity, comfort, and costs. This is a topic for another article. Most importantly see your dentist, ask questions and be informed. All dental care should be custom tailored to meet your specific situation and needs.
Dr. Paul Callahan, DDS provides Dentistry for Seniors for comprehensive care for maintaining function and good hygiene that can prevent tooth loss and other oral health problems.