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Q: Doc, I lost one of my teeth in a car accident, what are my options for replacing it?

A: In the second part of this article, I’ll offer some of the options available to replace a tooth as well as some of the benefits and drawbacks of each. In a previous article I discussed some of the factors that are important in choosing the correct replacement.

This is not a “one size fits all” solution. By this I mean that we must consider the remaining bone, the area where the tooth is missing, the financial situation of the patient as well as esthetic and functional concerns.

One option available would be to place a bridge. This is an option if there are healthy teeth adjacent to the tooth that is missing. The reason the teeth must be healthy is that they will serve as the support for the missing tooth. If there is inadequate bone, either where the tooth is missing, or surrounding the adjacent teeth this would not be a good option. The lack of bone lowers the prognosis for longevity and severely compromises any esthetic concerns the patient may have.

Another option would be a removable partial denture. This would only be an option if there are multiple teeth missing. A partial denture has a metal framework with metal clasps that hook onto the adjacent teeth and help to hold it in place. One drawback is that the clasps are visible and show when you talk or smile. Another is that with a partial over time the teeth and bone are subjected to additional forces they were not designed to take. This causes the bone to erode and the teeth to shift making the partial loose and uncomfortable.

Another type of removable appliance is called a “flipper” and is a temporary solution. These are generally made when esthetics is a concern and the tooth is located in the front. This type of temporary can be used until a more permanent treatment option is chosen. The drawback is that this type of appliance is not very strong is easily broken and Crazy glue won’t fix it. The benefit is that in an emergency situation a ‘flipper” can be made quickly and easily without compromising the patient’s lifestyle. Most typically, it is used as a transitional appliance before and during implant treatment.

More and more dental implants are being chosen as replacements for missing teeth. This technology has been proven to be superior over the last thirty years of use. They are chosen for their superior strength and esthetics. An implant looks and functions the same as a natural tooth. The implant itself is placed in the area of the missing tooth where it integrates into the bone over about a six month period. During this time the patient may choose to leave the site alone or may decide to wear a temporary such as a “flipper” while healing takes place. After the implant has integrated it is uncovered and the tooth portion (called a crown) is fabricated out of porcelain and cemented in place.

As you can see there are almost as many factors to consider as there are options to choose from when selecting a replacement for a missing tooth.

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Questions can be sent to Fred Eck, D.D.S. at Marco Dental Care, 950 N. Collier Blvd., Suite 305, Marco Island, or call 389-9400. Web site: marcodentalcare.com. He received his Doctor of Dental Surgery at the University of Detroit Mercy and is licensed by the Florida State Board of Dentistry.