You regularly take care of your teeth, maintain good hygiene, and visit the dentist… But it happened—you had to have a tooth extracted. The reasons can vary: a tooth removed in childhood when extractions were more common than treatments; biting down on something hard or experiencing trauma to the tooth that caused it to break; or perhaps the tooth was recently treated but ultimately had to be removed. Whatever the reason, the consequence is the same: a single extracted tooth can disrupt the balance of the entire dental arch.
The dental arch in the upper and lower jaw functions as a single unit. Patients often perceive it primarily as an aesthetic unit. The decision whether to replace a missing tooth usually depends on whether the gap is visible when smiling. Fewer patients are aware of the importance of replacing missing teeth due to their functional role.
What does one missing tooth mean for the rest?
Every tooth is in contact with neighboring teeth as well as with the teeth in the opposing jaw. Teeth naturally strive to maintain this contact so that the forces generated during chewing are evenly distributed. When a tooth is lost, adjacent teeth in the same arch—and teeth in the opposing arch—begin to “search” for the missing tooth. They attempt to re-establish contact and fill the space, leading to the tilting of neighboring teeth into the gap. Teeth in the opposing jaw may “grow” into the space in an attempt to find their counterpart.
This shifting of teeth seriously disturbs oral balance. Chewing forces are no longer properly distributed and begin to negatively affect the supporting structures of the teeth. Over time, this can lead to gum recession and enamel damage.
How can you replace a missing tooth?
Today, several different methods are available for replacing a missing tooth. The treatment plan for each patient depends on the location of the extracted tooth, the size of the gap, the condition of neighboring teeth and bone, as well as the patient’s personal preferences and options.
Dental Bridge
A bridge is a prosthetic solution in which adjacent teeth support a structure that replaces the missing tooth. Depending on the location of the missing tooth, it is determined which neighboring teeth will be involved in the bridge. Typically, these are the two adjacent teeth that border the empty space on either side. In some cases, both supporting teeth may be on the same side. The bridge must match the shape and appearance of the surrounding teeth.
The supporting teeth are anesthetized and drilled (to allow room for the new material), after which impressions are taken. Finally, the entire bridge is permanently cemented to the supporting teeth.
It’s essential to maintain good hygiene around the bridge and to visit the dentist regularly for check-ups, just like with natural teeth. This solution is popular due to its relatively simple and quick procedure. A bridge is especially recommended when the neighboring teeth already have fillings, as it provides additional protection.
Maryland Bridge
The Maryland bridge is a type of bridge where adjacent teeth are not fully prepared (shaved down); instead, small grooves or slots are made to hold the wings of the bridge. These two anchoring parts connect and support the replacement tooth in between.
This solution is typically used for teeth that do not endure heavy chewing forces, as the Maryland bridge is not as strong as a traditional bridge. Still, it blends seamlessly in both form and appearance with the rest of the dental arch.
Dental Implant
Thanks to technological advancements, dental implants are now a common replacement method. An implant is a metal “screw” inserted into the jawbone where the missing tooth used to be. It serves as a replacement for the tooth’s root. After placement, a crown is fabricated on top of the implant to match the surrounding teeth.
This method is suitable for patients willing to undergo a surgical procedure to replace a tooth. A 3D scan of the jaw is first required to determine whether there is sufficient bone in the area for implant placement. Then, computer-guided planning helps identify the optimal site for the implant. A surgical guide is created to assist the surgeon in placing the implant precisely. This is currently the most accurate and safest method of implant planning and placement in modern dentistry.
Many patients are not fully informed about what can happen after the extraction of “just one tooth.” If you have already had a tooth extracted, or know you will soon, speak with your dentist about potential consequences and available solutions.
