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Implants - All the other choices

  • Implants
  • Bridges
  • Dentures
  • Dentures
  • No Treatment

In today’s post, we discuss the alternatives to implants and their differences.

What are bridges

Bridges are done when there are missing teeth between two adjacent teeth.

In the above case, the patient has one missing tooth. For a bridge to work, the adjacent teeth have to be ‘shaved down’ so that they can act as anchors for the bridge.

The bridge is made up of 3 crowns splinted together. It is attached to the 2 adjacent teeth and cemented down.

                                                              Advantages
This option is great when the two adjacent teeth require treatment.

In this example, the two adjacent teeth are discoloured and require root canal treatment and crowns. Bridges offer an option to ‘kill two birds with one stone’ by also replacing the missing tooth in the middle.

Avoids implant surgery

Patients may be unwilling or unable to undergo implant surgery for multiple reasons. This is especially so for those with medical conditions for which implant surgery is not recommended. Check out my article here to know if you should not do implants.

Comparable aesthetics to implants in simple cases

                                                            Disadvantages
The main disadvantage of bridges is that it requires shaving down the two adjacent teeth in order to fit the bridge.

If the 2 adjacent teeth are free of decay and fillings (as in the above case), we will be unnecessarily cutting down good tooth structure. Also, this cutting down of tooth structure may lead to tooth sensitivity in future.

Difficult to clean

Dirt and food tend to collect underneath bridges. However, because bridges are made up of 3 crowns splinted together, you cannot floss through them like normal teeth. You will have to use a special floss (Superfloss) or a floss threader in order to clean your bridge.

Watch this video to see how a floss threader works:https://www.youtube.com/watch?v=RwHyUbVwr0E

This is a hassle compared to cleaning implants.

How long does it last

95% success rate at 10 years

Dentures

Dentures are removable appliances. They usually come as a single piece and have the ability to replace multiple missing teeth. They can either be made entirely out of resin (a derivative of plastic), or they can have a metal base as shown below.

                                                                 Advantages

Much cheaper than implants and bridges

They are the most cost effective out of the 3 options. While implants and bridges can only replace a limited number of teeth, a single denture can replace multiple teeth at one go.

A 3 unit bridge has an average cost of 2500 while a single implant costs at least 3000. A single denture, however, usually costs anywhere from $300-$800.

Easier to repair and replace

Bridges and implants are difficult and time consuming to replace. Because bridges are permanently cemented to the anchor teeth, they cannot be removed easily. To remove bridges, they have to be sectioned into multiple pieces. When that happens, it cannot be reused and a new bridge has to be fabricated.

Similarly, implants are made up of multiple parts either cemented or screwed together. A defective crown on the implant can usually be replaced. However, if the implant screw is loose and problematic, the entire implant has to be taken out and replaced.

Dentures, on the other hand, can usually be repaired. If a patient loses another tooth when wearing a denture, an extra tooth can usually be added onto the denture.

If the denture breaks, it can usually be pieced back together by the addition of new resin.

The cost of repairing a denture is very much lower than replacing an implant or a new bridge.

For this reason, we usually recommend dentures to patients who are at a high risk of losing additional teeth in future. Patients with poor oral hygiene, who are smokers, diabetics or with poorly controlled gum disease have a high risk of tooth loss.

Implants and bridges should only be placed when the patient has otherwise stable dentition. If not, these costly appliances may fail.

Able to replace the soft tissue contour

Bone loss happens as age advances. In the elderly, especially those who have lost their teeth for a long time, it is common to see these ‘collapsed profiles’.Dentures have the ability to prop up tissues and create a fuller look

                                                          Disadvantages

Less comfortable

First time users often find them uncomfortable. They definitely feel more ‘foreign’ compared to implants and crowns.

It takes some time getting used to a piece of plastic on your mouth, and it will initially affect your speech and how you eat.

Inconvenient

While implants and bridges are fixed on permanently, dentures have to be cleaned and removed every night.

Not as aesthetic

While implants and bridges have excellent ability to replace the shape, contour and colour of natural teeth, dentures tend not to do so as well.

This is because of the material they are made of, which comes of as looking slightly unnatural.

Less stable

Partial dentures are retained by using metal clasps to hook around the neighbouring teeth for support.

These definitely not as stable as implants and bridges. In addition, these clasps may loosen over time, causing the denture to rock and become loose. You will have to see your dentist regularly to tighten the clasps or make a new set of dentures.

Social stigma associated with dentures

https://tenor.com/view/teeth-dentures-blowing-out-candles-uh-oh-grandma-fail-gif-5232659
People tend to associate dentures with old people. While dentures can be used for a multitude of purposes across all ages, it is sometimes difficult to shake off that image.



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