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In modern society, missing a tooth at the front can be devastating because it is visible. A conspicuous black hole at the front makes you unattractive and diminishes your socioeconomic status unless you are a well-known NHL player. Most people would not think twice before having missing front teeth restored.

What if the missing tooth is in the back of your mouth out of the vision of other people? Because it is out of sight, some people do not see the immediate need to replace it because it is out of the mind. However, leaving a space at the back of your mouth can severely affect your health, appearance, and daily life.

A healthy tooth has many roles to play in the back of your mouth. It not only helps you chew and crush food without a problem, but it also mutually supports the teeth’ stabilities around it. Besides, a tooth stimulates the cells and maintains the jaw bone’s healthiness, keeps the cheek or lip full, prevents the lower jaw from over closure that affects the look of the face, and facilitates articulation.

Once a tooth is missing due to extraction, gum disease, gross decay or tooth fracture, there will be a space where the tooth occupies before. The teeth beside the void will gradually drift and tip into the hole, resulting in open contacts (small gaps) between the other teeth further away from that void. The small gaps form food traps that can lead to more gum disease, bone loss and cavities further out from the original space, like a domino effect.

Moreover, the opposing tooth on the opposite jaw of the space may over-erupt into the void, causing excessive and uneven wear of the enamel of the tipped teeth, interference of chewing movement of the lower jaw, and possibly loosening of the tipped or over-erupted teeth.

The jaw bone where the missing tooth’s roots were embedded shrinks in all three dimensions to make the matter worse. The gum tissues overlying the shrinking bone will follow the contour of the shrinking bone and become thinner and smaller.

There will be less support of the lips and the cheeks because of the space and diminishing bone. Hence the facial appearance will change – wrinkles, suck-in look, saggy cheeks etc.

Because of all the aforementioned adverse effects, there will be a chain reaction of unwanted consequences. Food chewing can be inefficient, with more chances of losing the other teeth because of gum disease and constant banging on the tipped or over-erupted teeth during food grinding and bruxing. Higher prevalence of cavities and bad breath, Lack of confidence because of the changed appearance, and possible damage to the temporal mandibular joints are all the sequelae of just one missing tooth.

With the technology we have, we can replace a missing tooth with a replacement tooth. The replacement tooth can be anchored to the adjacent teeth to bridge the gap literally. The material utilized for making the false tooth is natural-looking ceramics such as zirconium, acrylic, composite resin or porcelain fused on a metal substructure. The replacement tooth using the surrounding teeth for support and anchorage can be fixed like a bridge or removable like a denture. The replacement tooth can also be attached to an implant embedded in the jaw bone. An implant-supported replacement tooth will not need to rely on the adjacent teeth for any support because it does not attach to the other teeth at all, which is one of the advantages of an independently self-supporting structure. The additional advantage would be the embedded implant will maintain the quality and quantity of the surrounding jaw bone – so that the bone would not shrink.

The different options have their merits and cons. You will need to consult with your dentist to find out which one is the most suitable for you to replace your missing teeth.

01 May, 2020

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