Missing Single Tooth Replacement Options

Single tooth loss is common, and various solutions are available to replace one missing tooth. If you have a failing or missing tooth, your dentist will suggest replacing it as soon as possible, even if the tooth isn’t visible. Options can include the following.

  • Three-unit bridge
  • Cantilever bridge
  • Maryland bridge
  • Dental flipper
  • Dental implant
Missing Single Tooth Replacement Options

Three-Unit Bridge

A three-unit bridge is the most traditional way to replace a single tooth. Treatment has been used for many years, providing reliable and cost-effective results.

When fitting a three-unit bridge, a dentist must substantially reshape the teeth adjacent to the gap. These teeth are covered with dental crowns, so removing quite a bit of tooth structure is necessary to create enough room for these crowns, ensuring they don’t look and feel too big and bulky. The crowns are attached to the replacement tooth, called a pontic. The pontic is shaped to look like a real tooth, resting directly on the gum underneath, right over where the original tooth was once situated.

Although the results can look and feel natural, and this restoration is strong, stable, and relatively long-lasting, there are some significant drawbacks. Reshaping the adjacent teeth puts them at risk of tooth decay and infection, especially when the crowns begin to age and potentially leak.

The bone underneath the pontic gradually resorbs without the stimulation provided by a real tooth root. Over time, a gap can develop underneath the pontic, between the pontic and the gum. This can create a food trap and look unsightly. The adjacent teeth or abutment teeth must also support the pontic, increasing the stress and strain on these teeth created when you bite and chew food.

Even so, a three-unit bridge is a popular solution, especially as it can be completed in just a few weeks and requires no oral surgery. It can also be helpful if the abutment teeth are already decayed and infected and will benefit from being covered with dental crowns.

Cantilever Bridge

Unlike a three-unit bridge where the pontic is supported on either side by crowns, a cantilever bridge relies on the support of a crown on just one side. The pontic is cantilevered off the crown. A cantilever bridge is less stable compared to a three-unit bridge. Therefore, your dentist will most likely suggest this bridge in specific situations, such as replacing a missing front tooth, where you do not need to chew food, so the stress and strain on the crown is less excessive.

It can be useful when the abutment tooth on one side of the gap is not strong enough to support a dental bridge or is missing entirely. A cantilever bridge can be made quickly and economically without oral surgery.

Maryland Bridge

A Maryland bridge is another one used only in specific circumstances when replacing a missing front tooth. Instead of crowns, the pontic is supported by “wings” fitted on the inner surfaces of the abutment teeth. These wings are cemented onto the abutment teeth so they are virtually invisible.

A Maryland bridge can be a good option when replacing a small front tooth that will not come under too much stress or strain when biting into food. It also requires minimal tooth preparation, so treatment is very non-invasive.

Maryland bridges tend to be a bit more fragile, and there is a risk that the bond between the wings and the tooth will fail, allowing the bridge to pop off. If it comes loose, it must be re-cemented in place by a dentist. It is another option that is economical and can be completed in a matter of two or three weeks. It can sometimes be used as a temporary measure instead of a dental flipper during conventional dental implant treatment.

Dental Flipper

A dental flipper is usually only a temporary solution and is the cheapest form of tooth replacement. It consists of a single-tooth denture, so the denture tooth is supported on a removable acrylic base. It lacks stability and can be uncomfortable to wear, but it can be a good solution immediately after a tooth has been extracted and while the gum is healing. Dentists sometimes recommend a dental flipper while patients consider their options or must wait for implant treatment.

Dental Implant

All the above options rely on existing teeth or, in the case of a dental flipper, on the gum for support. A dental implant is different as it is self-supporting, and there is no need for a dentist to reshape the abutment teeth. Instead, a small screw is inserted into the jawbone, a process that requires a short surgery, and an abutment is fitted onto the screw, supporting the implant crown.

Another major advantage of the dental implant is that it protects the jawbone. Instead of the jawbone resorbing, the implant screw transmits the sensations created when you bite and chew food into the surrounding bone, ensuring it remains strong and healthy.

Initially, a dental implant is the most expensive option, and it can take longer to complete because your implant dentist must assess your suitability and carry out diagnostic tests to plan and place your implant. Your implant screw also needs time to Osseointegrate or bond with the bone around it. Traditional implant treatment can take several months to complete.

Same-Day Restoration May be Possible

However, nowadays, it’s possible to have a dental implant fitted and restored on the same day. After implant surgery to insert the screw, a temporary crown can be fitted onto the implant a little later. The temporary crown can be made before implant surgery and is designed not to contact the opposing teeth. It’s important that the implant doesn’t come under any pressure and cannot move during healing, allowing it to fuse with the surrounding bone successfully.

Even if you cannot have a temporary crown fitted immediately after surgery, we can still provide another temporary restoration to wear during healing, especially when restoring a front tooth. We fully understand many patients’ fear of being left with a gap in their smile and can assure you this need not happen.

In the longer term, a dental implant may be a more cost-effective solution. All dental restorations need replacing as they age, and it will be cheaper to replace a single implant crown than a three-unit bridge.

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Making the Right Decision

Understanding the various missing tooth replacement options available can help you make a more informed choice, and there is much to consider. When you see our implant dentist, we can discuss your aims, desires, and budget and review your dental and medical health to see which treatment suits you best. We always allow plenty of time for questions and want to ensure you have all the information you need to make the right decision.

Did You Know? Generally, people will lose 25% of their supporting jawbone structure within the first year after tooth loss. Dental implants are more easily placed when teeth are first extracted because bone replacement becomes more complex as time passes.