July 14, 2023

By Dr. Stuart Fass

To start, let’s agree that the best dental option is to keep your own teeth. Nothing functions as well or as predictably as what nature provides for us.  When our own teeth fail, for one reason or another, dentistry can provide solutions to the problem. In simple cases of a tooth fracturing, a crown will often be the answer to return the tooth to full function. But if teeth are lost, the solutions become more extensive and also more varied.

When many teeth are lost, we have some decisions to make. Do we want to have the replacement teeth removable or fixed?  Fixed bridges may be anchored by remaining teeth if they are healthy and there are enough to support the bite.  Some gaps might be filled in with dental implants which can function as a single tooth with a crown on it, or can anchor a fixed bridge with additional implants as indicated. It’s important to understand that natural teeth and implants cannon be used together in a single bridge since teeth have some natural movement within the bony socket and implants don’t. Mixing them leads to implant failure.

When we think of removable replacements, dentures come to mind. They may be complete dentures when all the teeth are lost, or partial dentures held by remaining teeth. But with more tooth loss comes less support, so we need to keep as many teeth as possible.

But there’s an additional option to support dentures. Teeth that are badly broken may be left and filed down to near the gum line.  The denture can then be made to go over this root which acts as a support when biting down.  If the remaining root has had root canal treatment, an attachment device can be added that has the denture snap into place and be incredibly stable. And if more teeth are missing, then implants can be added with more attachments leading to more retention and better force distribution. And with overdentures, since they are removable and have some give in the fit, you can combine natural teeth and implants under the same appliance.

Of course, once you have made the decision to maintain some teeth or to place implants under an overdenture, hygiene becomes of paramount importance. Just because implants are titanium and won’t decay doesn’t mean you can’t get periodontal infections around them.  Brushing is as important as ever!

Talk to your dental team about your problems. Let them plan a course for you that fits your needs for proper function and appearance.

This article was published on 07-14-2023 in The Altamont Enterprise.