When one has missing teeth, one or more teeth expected to be in a certain location are not present. The problem can be congenital or acquired—from trauma, dental loss due to decay or periodontal disease. Missing teeth can be completely painless or can cause shifting of other teeth so that the bite is wrong. It can cause damage to the tooth just opposite to the lost tooth.
What can lead to missing teeth?
You can have congenitally missing teeth, usually of the adult teeth. The condition tends to run in families but it doesn’t have to be the case. Generally what happens is that the baby teeth do not fall out at all in replacement for the missing adult tooth. It is most commonly the premolars and the lateral incisors, as well as the third molars that do not form or come in. It is often the situation that only one or two teeth are missing but kids can have as many as 15 or more teeth missing when it’s time to have adult teeth.
You can have an acquired loss of teeth due to trauma, dental decay or periodontal disease. This can involve any teeth but, in the case of traumatic tooth loss, it is usually the upper central incisors that take on the most damage and are most likely to be lost.
Symptoms:
There can be no symptoms of tooth loss, especially when there is just one or two teeth missing. If several teeth are missing, there can be abnormal chewing in an attempt to get the food chewed properly. This can lead to jaw problems, including temporomandibular joint problems.
The TMJ can wear down because of the abnormal chewing behavior. This can lead to pain in the jaw or headache. It can also lead to permanent damage to the cartilage and bone of the TMJ so that the individual needs to have surgery to replace the damaged joint.
Missing teeth make chewing difficult and people can choke due to inadequate chewing of the food. Certain foods must be avoided due to the inability to actually bite or chew the food.
Oral care and prevention:
It is impossible to prevent congenital missing teeth. In acquired missing teeth, good oral care, the use of mouth guards in contact sports or sports with balls or pucks that can cause tooth loss should be considered. One should make steps to maximize tooth retention by avoiding periodontitis or severe dental caries.
Treatment Options:
There are three simple ways to fix a missing tooth or several missing teeth.
- The first involves using a fixed bridge. This employs the use of crowns on either side of the gap and a non-detachable tooth-like bridge glued to both crowns. The crowns are attached to teeth on either side of the gap with the gap filled in by the false tooth.
Having a fixed bridge is a lot like having three crowns, with the middle crown being the bridge. It has the advantage of being stable fixed and can look like your own teeth. In some cases it can appear as though you have no missing tooth at all. The main disadvantage is that you have to prep two normal teeth for crowns, which permanently alters the teeth. Two common types of bridge are the “Encore bridge” that really looks like real teeth. There is also the “Maryland Bridge”, which is cheaper but doesn’t look as nice. There are techniques that make it look as though the fake tooth is growing right out of the gum line. - A removable appliance can be used to take the place of a missing tooth. You can use a low cost “dental flipper” type of appliance or a “Nesbit” appliance that is made of sturdy metal and acrylic material. The advantages of this style are that it is more economical than a fixed bridge. You can also replace more than one tooth using the same appliance. You need a solid tooth on either side of the appliance in order to make it work. On the downside, a removable appliance is not as aesthetically pleasing as a fixed dental bridge. It may be uncomfortable to wear and it isn’t as stable as a fixed bridge.
- A dental implant involves removing any residual tooth from a missing tooth and screwing in an artificial tooth—directly into the bone. The advantage is that the teeth on either side of the tooth are left intact and the tooth is very stable. It feels like your own tooth. They are costly and, in some cases, considered cosmetic meaning that insurance won’t always pay for it. It may take months to stabilize the titanium implant so that it can support the tooth.