When a person loses their natural teeth due to cavities, gum disease, or trauma, there
In the pre-implant era:
The dentists would grind around the two adjacent teeth ( in most cases perfect teeth ), and use those two teeth to connect a middle tooth to it ( pontic ) to form a bridge. Bridges have disadvantages:
1- There are bone loss occurring over time, and food gets stuck under the pontic of the bridge ( because the bone under the middle tooth is not getting stimulated, so bone atrophy occurs ).
2- Dentist is grinding perfect teeth that cuts down on the longevity of the teeth.
3- If there is a problem ( cavity or fracture ) on one of those teeth, the whole bridge ( 3 or more teeth ) has to be replaced again.
4- In some cases, there are either not reliable and strong teeth around the missing tooth to be used for support.
5- If the missing tooth is the last tooth in the mouth, meaning there is no tooth behind it, cannot do bridge.
When there is a tooth missing, the root of that tooth will be replaced with an Implant screw ( made with Titanium (or Zirconia) which is biocompatible. Implant is the best replacement for natural teeth to regain the smile. People with implanted teeth have no difficulty in chewing and biting food. Implant crowns look natural, and feel like the original teeth. No need to grind the teeth adjacent to the missing tooth anymore.
When Implants are done correctly, there should not be any pain ( minimal ) after surgery. When there is a screw in the jawbone, the bone is stimulated, and stays intact overtime. The sequence is: extract the tooth > bone graft > Implant > screw an abutment that hold the crown to the implant > place the final crown. Normally it takes 3.5 months for the lower jaw, and 4-6 months for the upper jaw. In case, the patient has a lot of missing teeth and has to lose more than a few teeth,few implants are placed and either use those implants for bridges; or use them to snap a denture to them which is removable.
If the patient does not have enough bone, there is a procedure called All on 4 , that the dentist will permanently screw the bridge to the 4 implants which is fixed ( just like a table that only needs four legs ). In case the missing tooth is a molar (which has more than one root, 2 or 3), the roots are pulled, and bone grafted ; then we wait ( 3-4 months for lower jaw, and 4-6 months for the upper jaw for bone to grab the implant tightly ( osteointegration ); therefore the implant is placed in two steps. In a few cases, the implant and the crown can be done at the same time or within 2 weeks, called immediate loading ( the area needs to be out of the occlusion or bite ).
Implants are the best treatment available for people with missing teeth. Implants could last a lifetime with proper care. Implants do not get cavities, and the patient can maintain the bone health around the screw of the implant with routine cleaning, and healthy gums. Unlike popular beliefs, the implants are almost painless because there are no nerves involved; the nerve was in the root that was pulled and replaced with an Implant. As you get older, the nutrition becomes more crucial in your health; and when the patient uses implant supported bridges that can last a lifetime, a person can live longer.