20 Sep 2021

What do I do if I have a missing tooth?

What do I do if I have a missing tooth? When a tooth is lost, patients often only go to the dentist for aesthetic reasons without taking into account the functional problems of chewing that this loss entails.

This loss can have consequences, which is why we must act quickly. These problems are above all the extrusion of the antagonist tooth (the tooth with which it was in contact moves up or down) and the mesialisation (the posterior teeth move forward). Another complication that could occur is the irreversible enlargement of the tongue towards the edentulous or toothless area.

What is the ideal treatment for a missing tooth?

All these problems will create difficulties in finding a solution and that is why it is necessary to act quickly. The best solution to a missing tooth would be to place a crown supported by a dental implant.

This treatment allows for excellent oral hygiene, as the area between the tooth and the implant or between the teeth (interproximal) can be cleaned well with dental floss and prevents caries and gum problems (periodontal).

In addition, with this treatment it is not necessary to prepare the neighbouring teeth and they can be kept as they are in the mouth.

What is the advantage of this treatment?

What happens when an implant is placed in the mouth is that the gum, bone and teeth around the implant are stabilised. In other words, the neighbouring teeth will no longer move and the implant will remain “fixed” in the bone.

Another advantage of placing an implant-supported crown is that the dentist can, at any time, unscrew the crown in case of a fracture or if any repairs have to be made.

It is a long-term solution and has a high success rate and generates a lot of patient satisfaction. In fact, 98% of patients at Nart Clínica Dental Barcelona recommend dental implant treatment to their friends and family (statistics from 2016-2018).

what factors must be taken into account in order to have an implant?

In order to carry out this treatment, several factors must be taken into account, such as the amount of bone in the area, the patient’s health and their commitment to lifelong care and hygiene.

If there has been bone loss in the toothless area and there is not enough bone to place an implant, a bone regeneration treatment could be carried out to gain bone in the desired area and then the implant could be placed.

Another option would be the placement of a narrower implant that allows us today to avoid bone regeneration in most cases.

What if I can’t get an implant?

If it is not possible to place an implant for medical or economic reasons, there are other treatment options. An alternative would be the placement of a bridge or a fixed denture.

If this option is chosen, it must be taken into account that the neighbouring teeth must be in good condition to be able to withstand the forces of the bridge.

Advantages of a dental bridge

An advantage of this treatment is that it is quicker, as with the placement of an implant it will be necessary to wait two months for proper healing and good aesthetic results before the crown can be placed.

Alternative treatments to bridging

Maryland type adhesive prosthesis

Another treatment that could be carried out would be a Maryland type adhesive prosthesis (fixed prosthesis that replaces a single tooth using the neighbouring teeth as support), where it is not necessary to grind the neighbouring teeth, as it will be cemented to the inside of the neighbouring teeth.

Removable prosthesis

This treatment is usually temporary. Finally, there is also the option of a removable prosthesis, which is usually the least comfortable for the patient.

Regardless of the treatment chosen, its success will be determined, in part, by the patient’s oral hygiene and maintenance visits. The importance of maintaining good oral hygiene should be explained to the patient and they should be shown in detail how to achieve this.



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    Dr. José Nart Molina

    Dr. Jose Nart received his dental degree in 2001 from Universitat Internacional de Catalunya (UIC), Barcelona, Spain, and his Advanced Certificate in Periodontics and Implant Surgery from Tufts University in 2007. Dr. Nart was awarded Diplomate status by the American Board of Periodontology on May 2008, and he obtained his PhD in Dentistry in 2010 with the highest degree. Currently, he is Professor, Chairman and Program Director at the Department of Periodontology at UIC-Barcelona, and President for the Spanish Society of Periodontology and Osseointegration (SEPA). He maintains, with his family, a well-known multispecialty private practice in Barcelona, Nart Dental Clinic, as medical director. Dr. Nart is author of many international high-impact JCR publications (+110), worldwide speaker and reviewer of the highest impact factor Periodontology and Implant Dentistry journals.


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