There are three popular options for replacing a missing tooth: a Maryland bridge, a traditional dental bridge, and a dental implant. Each tooth replacement option has its own unique features, benefits, and considerations. A skilled cosmetic dentist, like the ones in our Back Bay dental office, will explore the various options available with their patient in order to help them make an informed decision. Here are some tooth replacement treatments and considerations a dentist may bring up while discussing the treatment plan with their patient.
Replacing a Tooth With a Maryland Bridge
The Maryland Bridge, also known as a resin-bonded bridge, is a conservative and non-invasive tooth replacement option. This bridge is typically used to replace a single missing tooth, primarily in the front region of the mouth. It consists of a false tooth with ‘wings’ extending from each side of the false tooth. These wings are made from either metal or porcelain and are bonded to the back of adjacent healthy teeth to hold the false tooth in place. Unlike traditional bridges, the Maryland Bridge does not require the removal of the adjacent teeth’s enamel, making it a more conservative option.
Pros of Maryland Bridges:
- Non-invasive – Since the adjacent teeth don’t have to be ground down like they do with a regular dental bridge, this treatment is less invasive. This means that the teeth remain intact and healthy.
- Aesthetically pleasing – Since the ‘wings’ attach to the back of the adjacent teeth they are not visible. Additionally the false tooth can be expertly crafted to blend in with the remaining teeth.
- Quick procedure – A Maryland bridge is a great way to quickly get a tooth replacement. The procedure itself is quick and there is no healing time required like with other options such as dental implants.
Cons of Maryland Bridges:
- Limited application – A Maryland bridge is a purely cosmetic dental procedure that can’t be used on teeth that are actually used in chewing. This limits its application to front teeth, this is still very helpful, however, especially for people who are missing teeth congenitally.
- Durability concerns – Maryland bridges are not as sturdy as other options such as a dental implant and crown or a traditional dental bridge. This is why they are often used as a transitional treatment option before a more permanent solution is implemented.
- Not suitable for everyone – The success of a Maryland bridge depends on the strength and health of the adjacent teeth. If the adjacent teeth are not structurally sound they cannot be used to support the prosthetic.
- Bone Loss – The jaw bone needs to be regularly engaged in order for the body to maintain it, resulting in a use-it-or-lose-it scenario, where the body starts absorbing the bone if it’s not being engaged. People who lose a tooth and replace it with a bridge are no longer engaging the bone, resulting in bone loss. This is why dentists often recommend dental implants as the optimal solution for missing teeth.
Using a Traditional Dental Bridge to Replace a Missing Tooth
A traditional dental bridge is a popular tooth replacement option that consists of one or more false teeth held in place by dental crowns placed on the adjacent teeth. The adjacent teeth are shaved down carefully by the dentist in order to provide enough space for the prosthesis and in order to create a surface with optimal support. The cosmetic dentist then cements the supporting crowns onto the healthy teeth on either side of the gap, providing stability and support to the artificial tooth or teeth in between. This provides both a cosmetic and functional solution to the patient.
Pros of dental bridges:
- Stability – Compared to a Maryland bridge or a flipper tooth, this solution is extremely stable and can be used in areas of the mouth that are used for chewing. The adjacent teeth and dental cement ensure stability for a long time.
- Versatility – Unlike a Maryland bridge or flipper tooth, a dental bridge can be used in both the functional and cosmetic regions of the mouth. It can also be used to replace more than one tooth since the strong support allows for stability over a larger gap.
- Durability – The dental bridge is one solid piece, ensuring durability for a very long time under the strenuous conditions of the mouth.
- Relative non-invasiveness – Compared to dental implants that require actual surgery to place the dental implant in the jaw, a dental bridge is relatively no invasive. Compared to a Maryland bridge, however, it is invasive since it necessitates the shaving down of the adjacent teeth.
Cons of dental bridges:
- Enamel removal – Preparing the site of the dental bridge involves the removal of a significant amount of dental enamel, even more than is required for dental veneers. This means that perfectly healthy teeth are being damaged in order to fill the gap of the missing tooth.
- Potential for decay – The adjacent teeth that the bridge is placed on can, in some cases, become decayed. Since this decay happens underneath the dental bridge it can be extremely challenging to treat and it can put the structural integrity of the dental bridge at risk.
- Bone Loss – Just like with the Maryland bridge, since the bone underneath the bridge isn’t being engaged it is at risk of getting resorbed, which may necessitate a grafting procedure at a later date in order to rectify.
Replacing a Missing Tooth With a Dental Implant
A dental implant is the preferred long-term solution for replacing missing teeth. The dental implant procedure involves a dentist or periodontist placing a titanium screw-like post into the jawbone to act as an artificial tooth root. After a healing period, a dental crown is attached to the implant via a connecting piece called an abutment, creating a natural-looking and functional replacement tooth.
Pros of dental implant tooth replacement
- Long-lasting – Dental implants have the potential to last a lifetime with proper care. The crown on top of the dental implant is not susceptible to dental decay like a normal tooth would but the site still needs to be cleaned regularly to ensure that the supporting gum and bone remain healthy.
- Bone preservation – Since dental implants stimulate the jawbone, they prevent bone loss at the site of the missing tooth.
- Versatility – Due to dental implants acting like natural teeth, they can replace a missing tooth in any part of the mouth, whether it’s in the esthetic or functional zone.
Cons of dental implant tooth replacement
- Surgical procedure – The implant placement requires a surgical procedure, which makes it the most invasive option. If there isn’t enough supporting tissue, a grafting procedure may also be necessary.
- Healing time – Healing at the site of the dental implant surgery can take a couple of weeks and the full integration of the implant with the jawbone takes several months.
- Skill availability – Placing dental implants requires additional training, sometimes requiring a specialist like a periodontist to place them. Dentists that specialize in dental implant placement may not be easy to find.
- Cost – While dental implants are worth every penny and can be affordable, especially with payment plans and installment, dental implants are the most expensive solution for replacing teeth. This reflect how dental implants have been engineered to be the most foolproof long term solution for teeth replacement. This is also a reflections of the additional training and skill required to place dental implants.
- Not an option for children or teens – Since children’s bones are still growing, dental implants are not a viable solution for them. This rules out young patients who are missing teeth congenitally. For these patients, a temporary Maryland bridge might be the preferred solution until a dental implant can be placed.
Other Options for Replacing a Tooth
There are other options for replacing a tooth, though they are not as common and may not be brought up during treatment planning for most cases. Sometimes a dentist will recommend shifting a tooth using orthodontics in order to close a gap left by a missing tooth. Another option a dentist might recommend is replacing the missing tooth with a flipper tooth, which essentially a denture-type prosthetic that only replaces one tooth instead of a while row of teeth.
When it comes to choosing the most appropriate tooth replacement option, there is no one-size-fits-all solution. Each individual’s dental condition, oral health, budget, and personal preferences play a significant role in the decision-making process. A good cosmetic dentist will guide a patient through the options, highlighting the strengths and weaknesses of each one based on the patient’s circumstance.
If you are looking for a cosmetic dentist in Boston for a consultation about replacing a missing tooth, the team at Warshauer & Santmaria is a great choice. The team has two prosthodontists, specialists in replacing missing teeth, as well as a periodontist that specializes in placing dental implants. Don’t hesitate to call our Boston dental office and book a cosmetic consultation with one of our dentists.