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Dental Aesthetics – Losing a Tooth by Dr. BreeAnn

“Hello! I’m Dr. BreeAnn Christiansen, holistic dentist at Brighton Dental in San Diego.

And today I’m going to talk about a very common issue, a very scary issue, and something that a lot of people have to go through.

So here’s the situation. You just found out that one of your front teeth has to be pulled. Losing a tooth at any place in your mouth is scary, let alone one of the teeth right in front. So what now? How do you go through this experience without losing some pride and feeling humiliated?

We take for granted how much our teeth contribute to our looks. Good or bad, they’re a dominant part of your face when you smile, when you speak, when you laugh. Now that you have to lose one, what are the options?

This is what I’m here to discuss. I’m here to give you some confidence that this is a problem many people have to deal with and I guarantee most of us wouldn’t even know what’s going on to someone we know. I’m going to tell you what the process for every option is, when each option is recommended, and how you will survive the treatment without missing your front tooth the whole time.

Some vanity is healthy and I understand that. At Brighton dental, I know we’ll put your oral health first, but do so in a way you’re comfortable. So remember, each case is different and some treatments listed here aren’t always suitable, but I will try to generalize them.

Let’s start with the first case.
You have a front tooth that you need to come out, either you broke the tooth, the tooth had a root canal that failed, or there’s some other reason the tooth cannot be saved, it has to be pulled. How do we replace it?

The most ideal way to replace a single missing tooth is with an implant. When the adjacent teeth are healthy, an implant is always my number one recommendation. If the tooth has not yet been pulled, it’s more likely that the bone present is sufficient enough to support the implant. Now it’s just up to your dentist to judge if it is appropriate to place the implant right after the extraction.

If the implant is placed immediately, it is most likely that the implant will need some time to heal before it can be restored. If we decide to wait to place the implant, it is usually because the amount of bone available is not ideal or the infection present is more than we are comfortable with placing an implant into the same area. So in that case, we place the bone graft, close the area and give it a couple of months to heal before reopening it and placing the implant.

So what replaces the missing tooth in the meantime?
We call it a flipper. The flipper is an acrylic prosthetic that replaces your single tooth and it’s made by the lab before you come in to have the tooth pulled. This way, when the tooth is gone and the space is empty and you have to go through one to three to four months of healing time, you have something temporary to wear while you’re waiting for everything to finish.

Implants are traditionally a three-step process. First, the implant is placed and you give it at least three months to heal. In some cases, the implant can be immediately loaded with a crown. In that case, at the appointment when the implant is placed, an abutment, which is the part that the crown cements on to is placed on to the implant and a temporary crown is also placed on this abutment. And then an impression is taken eventually and sent to the lab and your new crown comes back to be cemented.

If the abutment is not placed at the same appointment as stated, the implant usually takes one to three months to have the abutment placed, an impression taken sent to the lab and then your crown comes back two weeks after that to be cemented. Again, once the abutment is placed, a temporary crown is placed for that two weeks while you’re waiting for the permanent crown.

One other point I would like to make is that for ideal aesthetics, it is extremely difficult to match a single crown to the rest of your teeth perfectly. In some cases, if a lot of staining is present or a difficult shade is on the adjacent teeth, I recommend veneers to achieve a beautifully uniform smile.

Option number two is a bridge. A bridge requires the adjacent teeth to be crowned. And the crown called the ‘Pontic’ connects those two crowns to replace the missing tooth. This is also a great option when the teeth on either side of the missing tooth have large fillings or crowns already.

So here’s how the appointment goes. The teeth next door are prepared for crowns. After this is done, the tooth that needs to be pulled is pulled and a temporary bridge is then made. The temporary bridge is cemented on and replaces the missing tooth, so you leave the office as if nothing changed.

In six weeks, and that healing has taken place for us to take the final impression, this final impression is then sent to the lab and in two weeks you have a permanent bridge that is cemented in place and yours to keep for the life of your teeth.

Bridges can be a little trickier to clean. You have to make sure that you are able to floss through and under the pontic, but as long as you take good care of the bridge, it will last just like any of your crowns.

So another option is the removable partial denture. This is typically my least favorite option because it does not have the same function nor the best aesthetics. It similar to the flipper I talked about earlier but a little bit sturdier. I rarely recommend this option when we’re replacing a single tooth, but it may be a decent option when you already have missing teeth in that same arch.

Remember, this partial is removable. That means you have to take it out at night to allow your tissues to rest. It can sometimes move while you’re chewing your food, laughing or speaking. When this option is selected, we take impressions and the partials are made at the lab so it is ready for you the day your tooth is extracted. You leave the office with the tooth.

Again, the options I gave you are very generalized. Dentistry is great because we can get creative and have a little fun with every option, so don’t feel like you’re limited to just these three situations.

So now that I have gone over these, I hope that you’re a little less afraid of what’s to come. I hope you feel that we, at Brighton dental care about your situation and want you to be comfortable and confident that we are going to restore your smile to what it was or even make it a little better.

If you think you have to lose a front tooth or already have, please call our office for a consultation to see what we can do for you. Believe it or not, losing your front teeth is not the end of the world. There’s so many ways we can make it unnoticeable. No one would even have any idea what’s going on.

Thank you and I look forward to see you in our office.”

Book an appointment with Dr. BreeAnnn Christiansen at Brighton Dental San Diego by calling (619) 640-5100

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