When several teeth are missing, or require removal, one must take significant steps to restore the functional bite. Proper chewing, speech and muscle integrity occur only when teeth, or their replacements, are arranged side-by-side and in an upright position. After all, a normal, closed bite creates approximately 120 pounds of pressure. They need as much support from their neighbors as they can get!
The absence of teeth has a huge impact on patients. Data demonstrate a higher likelihood of systemic disease, gastrointestinal disorders, premature aging, and facial collapse. It may cause healthy teeth nearby to move out of position, creating an ugly, crowded, or awkward bite that causes pain in the temple or ear. Teeth may become longer in appearance, almost resembling a fang. The effects of tooth loss are insidious. They happen over time and, being part of the human race, people usually make adaptations to solve the problem – but they are the wrong adaptations. Here is an example. If one ankle is injured, people shift their weight and balance to one side. Without realizing it, they create an imbalance not only the legs, but in the neck and back muscles, too. When teeth are missing or hurt on one side, people do the same thing.
Here is a strange, but true, statement:
People with missing teeth do not even realize that they are not adequately chewing or digesting food.
When chewing food, enzymes from saliva mix with food to begin the digestion process. Missing teeth translates to missed opportunities for thorough enzyme activity and therefore, it challenges the gastrointestinal system. In this situation, people actually eat enough but do not get the proper nutrition, which lowers their metabolic rate! Elderly people also have a lower metabolic rate. Broken or missing teeth allow them to only eat “easy” food, like coffee cake, which forms a bad habit over time. Some are actually malnourished and less able to fight off disease. One can easily see how human adaptation is not always a good thing!
A symbiotic relationship exists between the teeth and bone. In essence, the more teeth lost, the more bone lost. All facial muscles attach to the bone, so lost bone creates the loss of facial tone and, therefore, wrinkles. Conversely, one retains bone by replacing missing teeth shortly after they are lost.
Removed teeth typically cause surrounding teeth to shift. That is why the very first step of the dental exam must include a complete evaluation of all remaining teeth BEFORE the problem is fixed. The remaining teeth may not rest in the correct position or have adequate bone support to ensure a stable solution for the long term. Facial structures, such as nerves and sinuses, may also rest too close to an area that needs repair, and dentists can only determine this with a 3-D CAT scan or specific x-rays. Patients sometimes switch dentists after repeated adjustments to a partial denture yield no success, for one of the reasons given. The new dentist often discovers that the design for the partial denture repaired a problem, but never carefully addressed the long-term solution for comfort and optimum health.
What Can Be Done?
When missing multiple teeth in one specific area of the mouth, there are three procedures for replacement. One can wear a partial denture, which resembles a saddle for a horse. So when the horse moves, so does the saddle. Because it is the least expensive option, it is popular. Forty-percent of patients adapt to partial dentures – but the other 60% find them uncomfortable to wear. If there are teeth missing on both sides of one dental arch, a removable partial denture – made from acrylic and chrome – can hook onto the remaining teeth and stabilize the bite. Removable partials only work when front teeth are healthy, strong, and stable, if most back teeth are gone. If these are initially not designed correctly, patients find that they trap food or feel bulky. Therefore, it is important to work with a dental specialist experienced with this design. For longer durability and benefit to the gums, partial dentures must be removed at bedtime and cleaned at least once daily.
The second procedure is a bridge that connects to teeth on either side of the “gap”, resembling the structure one would use to cross the wide Mississippi River. If that bridge was held in place by only two footings, few would have ever crossed the river! Similarly, the design for a dental bridge needs carefully planning or it will cause excessive wear and tear on the natural teeth to which it is attached. Utmost care is required to keep the bridge clean and, most importantly, to clean the natural teeth next to the bridge. Decay repeatedly occurs on these teeth if they are not kept clean.
When patients want the most predictable, long-term result to replace multiple teeth, they should consider dental implants. They consist of metal posts that are surgically implanted in the jawbone, and left to heal and integrate with the jawbone for several months. Sometimes, patients are also required to wear a temporary partial denture for 6 months, as an interim step, to re-shape the bone, improve the function, and enable permanent reconstruction of the proper bite. The end result is custom-made false teeth that are anchored to these posts to provide years of service.
So these dental treatments provide effective long term solutions for people missing multiple teeth, and a conversation with your dentist can determine the correct treatment plan for your smile.