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Replacing lost or damaged teeth?

Find what’s best for you!

by Dr. Mehrdad Ezzati

www.olympicvillagedental.com Phone: 604-629-8440 Email: info@olympicvillagedental.com

Replacing lost or damaged teeth?

Find what’s best for you!

Losing a tooth is always quite a traumatic and emotional experience to my patients.

No one likes the idea of losing a tooth and it makes some people feel like they are getting old. Others are disappointed in themselves about letting their oral health deteriorate to the point of losing a tooth. Your first thought will be to wonder what you can do to correct the situation. Whether you have lost your tooth due to accident, poor oral hygiene or decay, the result is the same.

Unfortunately, this can and does happen to many of us, but you don’t need to worry; there are great solutions available with today’s modern dentistry.

Do you fall into the ‘missing tooth’ category?

Unbelievably, research shows that more than 50% of us are missing a tooth. The causes of tooth loss are many, but the leading causes are: broken teeth; cracked teeth (especially previously root canaled teeth that did not have a crown placed after treatment); large cavities that are beyond repair; failed root canal treatment; trauma from accidents; gum disease; and cysts and abscesses in the mouth.

www.olympicvillagedental.com Phone: 604-629-8440 Email: info@olympicvillagedental.com

“50% of us are missing a tooth.”

Leading causes of tooth loss Broken Teeth Cracked Teeth Large Cavities Failed Root Canal Treatment Trauma Gum Disease Cysts Abscesses

Do you really want to remain toothless?

Once people come to grips with the fact that their tooth cannot be restored and needs to be extracted, they are faced with some choices about what to do following their extraction. One option after losing a tooth is to do nothing and not replace the missing tooth. Unfortunately this decision can have some bad consequences. These include: tipping of neighboring teeth into the missing tooth space; shifting of all the teeth in the affected jaw toward the missing tooth space; and the tooth opposing the missing tooth erupting further out of the gums looking for something to bite on.

However the most common and worst consequence of not replacing a lost tooth is the resulting bone loss in the missing tooth space. This is why I usually recommend that extracted teeth should be replaced in some way unless there are factors that make treatment not possible or advisable.

Consequences of not replacing lost teeth Tipping Teeth Shifting Teeth Erupting Teeth Bone Loss

www.olympicvillagedental.com Phone: 604-629-8440 Email: info@olympicvillagedental.com

Your tooth replacement options Once patients decide that they would like to replace their missing tooth, they are presented with some options on treatment modalities each of which has both positive and negative aspects. Let’s help you to look at some solutions that best suit you and your circumstances.

Figure 1: Examples of partial dentures

Partial denture One option that I always present to my patients is a partial denture. Partial dentures are removable appliances which attach to other teeth in the arch of the missing teeth. The partial denture can be made from all acrylic material or more commonly has a metal substructure with acrylic on top to simulate teeth and gums. The advantage of a partial denture is that it does not require any significant alteration of adjacent teeth for its manufacture and the cost of treatment is relatively low - usually being $500-$1500 depending on size and type The major draw-back of partial dentures is that they are big and bulky and can be annoying to eat with. They can also increase the likelihood of cavities around the teeth that they attach to. Consequently, I usually prescribe partial dentures for patients who are missing several teeth in the back of the mouth or are missing a single front tooth. I also make sure that my patients are aware that a significant number of partial dentures made to replace back teeth are actually not tolerated by patients, and consequently are not worn. .

www.olympicvillagedental.com Phone: 604-629-8440 Email: info@olympicvillagedental.com

However, there are also many of my patients who wear partial dentures long term and enjoy the benefits of increased chewing area and maintenance of the position of adjacent teeth.

Importantly though, partial dentures do not stop the bone loss in the extracted tooth area and usually have to be re-lined or re-made to fill in the extraction site as the bone is resorbed (reduced) over time.

Advantages and Disadvantages of Partial Dentures

Advantages Fills gaps between teeth Cosmetically enhancing Prevents the mouth ‘sagging’ Relatively inexpensive

Disadvantages Makes eating/drinking/ speaking difficult Feels bulky Can cause cavities Does not prevent bone loss

Fixed bridge Another option to replace an extracted tooth is a fixed bridge. A fixed bridge is made from the same material as dental crowns, namely porcelain or porcelain-metal combinations. The bridge is cemented in permanently to adjacent teeth after these teeth are prepared for a crown. The advantage of a fixed bridge is that the missing tooth is replaced in a relatively short time with a prosthesis. In fact the process can take as little as 10-14 days.

This is not a big issue if the adjacent teeth are already heavily filled or have large cavities and would benefit from having a crown anyway, but if the teeth are relatively healthy and have not been damaged in the past, I feel very hesitant to remove healthy tooth structure to allow for the fabrication of a bridge. This preparation of the adjacent teeth may even cause damage to the nerves of the teeth being prepared, resulting in the need for root canal treatment.

Advantages and Disadvantages of Fixed Bridges

Advantages Fills gaps between teeth Cosmetically enhancing Prevents the mouth ‘sagging’ Comfortable and not bulky

Disadvantages Surrounding teeth will be drilled down Does not prevent bone loss More expensive than a denture Adjacent teeth may suffer as a result of prep work Being fixed and not removable makes living with a bridge a lot more comfortable than a partial denture. The bridge also does not add any additional bulk or extra material to the mouth. Bridges are also about 30% cheaper in cost than having a dental implant. However, I am prescribing bridges less and less commonly because of the major drawback – the need to reduce the size of the adjacent teeth to make room for the required crowns.

www.olympicvillagedental.com Phone: 604-629-8440 Email: info@olympicvillagedental.com

Figure 2: Fixed Bridge

Furthermore, patients have to be aware of the fact that even the best made bridge will only last 10-15 years at the end of which most patients will experience more decay, damage and deterioration to these prepared teeth which could lead to these teeth needing to be extracted as well. Because of these draw-backs I am not sure if the side-effects of having a bridge to replace a missing tooth outweigh the benefits the bridge provides – if the adjacent teeth are healthy and minimally restored.

Dental implant - Finally the last and most advanced option for replacing a missing tooth is a dental implant.

A dental implant is made up of 3 components: 1. A titanium component that integrates into the bone and provides the support for the tooth, 2. A connection piece that attaches to the implant, 3. A crown that attaches to, or is cemented to, the connection piece.

When compared to the other methods of tooth replacement, this may be the most expensive but it also gives fantastic results.

We will take a more in-depth look at the whole dental implant process in a separate document, which we have available now for you to study.

For now, please contact us if you would like to discuss dental implants or any other restorative process for your missing teeth.

We’ll be happy to provide you with more details and helpful advice.

www.olympicvillagedental.com Phone: 604-629-8440 Email: info@olympicvillagedental.com

Dr. Ezzati “tomorrow’s dentistry, today”, Dr. Ezzati began practicing dentistry in 1997 at Atlantis Dental in Vancouver’s Yaletown.

The slogan at Atlantis was “tomorrow’s dentistry, today”, and 16 years later that tomorrow is very much here. Dr. Ezzati is eager to make the all of the impressive advancements in dental technology available to his patients as needed.

His aim is to establish Olympic Village Dental as Vancouver’s premiere high-tech dental office, where technology is paired with expertise and a genuinely caring approach for each individual.

This aim is a smart one, as increasing numbers of your professionals now reside Olympic Village and nearby neighbourhoods.

These individuals value their time very much, and trust technology more so than older generations. Olympic Village Dental has designed their practice with this in mind and intends to put themselves at the forefront for this type of clientele.

www.olympicvillagedental.com Phone: 604-629-8440 Email: info@olympicvillagedental.com

“These younger men and women want to get in, get the work done, and resume their daily lives” says Dr. Ezzati, “and our technology and expertise allows us to provide that for them.”

Last but not least, every patient can expect open, direct, and honest communication from Dr. Ezzati and his staff regarding prognosis, expectations, time requirements and costs. He practices as if every patient is a family member, taking their best interests to heart on a personal level. That’s the mark of a good dentist in Vancouver or anywhere else for that matter, and it’s a big part of the exceptional service and dentistry excellence you’ll enjoy at Olympic Village Dental.

www.olympicvillagedental.com Phone: 604-629-8440 Email: info@olympicvillagedental.com