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Tooth Replacement

Tooth Loss

When you are missing a tooth, there are generally 4 options.

1.  Do nothing.  May not be a great choice aesthetically, especially if it is a front tooth, but missing a back tooth can also affect your bite and overload the remaining teeth.  Then, the other teeth can start drifting into the open space by tipping and erupting.  These other teeth can become more susceptible to gum disease and the 'new' bite can cause problems with your jaw joints.  It is recommended by many dentists to replace your missing tooth as soon as possible before the bone shrinks away causing a cosmetic deformity and increasing the likelihood for a bone graft in your future if you want an implant.

2.  Removable denture.  A denture can be used to replace the missing tooth.  It is recommended you remove it each night when you sleep to prevent damage to your remaining teeth.  It can prevent the drifting of your teeth and keep your bite stable.  In most cases, it will NOT prevent the loss of bone should you decide to get an implant later.  A small amount of tooth structure needs to be permanently removed from surrounding teeth in most cases to make the removable denture fit properly in your bite.  Another artificial tooth can be added to a removable denture should you lose another natural tooth.  

A removable denture that replaces ONE or SOME of your missing teeth is called a partial denture.  A removable denture that replaces ALL of your missing teeth is called a complete denture.

3.  Fixed denture (bridge).  A bridge is similar to a removable denture in that it can replace a missing tooth only you cannot take it out.  You need a floss threader to clean under your bridge.  Your bite can be stable and it is less likely your teeth will drift.  You can still lose bone under the bridge where the natural tooth is missing and you might require a bone graft should you decide on an implant later.  Bone loss can also cause a bony defect in the gums which might be a problem cosmetically in the future.  This is especially true for the front upper teeth if your gums show when you smile.

The average lifespan of a bridge is approximately 15 years.  I have seen a bridge fail after 1 year and also seen one 30 years old.  To get a bridge made, the dentist must permanently remove tooth structure from at least 2 remaining teeth (abutments).  The amount of tooth structure removed varies and the event can cause the need for a future root canal or eventual loss of the abutment tooth.

4.  Implants.  An implant is a stable metal post placed right in your bone that acts as the root of your replacement tooth.  No tooth structure is removed from any other teeth in your mouth.  You need enough bone to fully house the implant.  If you don't have enough bone, a bone graft can usually be done.  It takes approximately 6 months for the implant root to integrate with your natural bone before a final tooth can be placed on the implant.  Once an implant has integrated with your bone, a tooth can be placed over top. One can floss between the teeth like a natural tooth. In many cases, the dentist can make an inexpensive removable denture to wear in the meantime to hold your bite and maintain your aesthetics.

Although success rates of implants on average are fairly high, if you are a smoker, the documented evidence suggests that successful integration is lower. Other medical conditions such as diabetes affects the integration of the implant.  Your individual case needs to be carefully assessed so you can make an informed decision prior to your investment.  Once an implant 'takes', it can last the rest of your life if you are healthy. 

Both general dentists and specialists place implants. Dr. Heit is a general dentist that places implants but will be pleased to refer you to a specialist for your implant if you prefer or if your case is difficult.

Since an implant can be used to support one tooth, be part of a bridge or help support a denture, it is important to look at the overall condition of your health and teeth to optimise the position of your implant.  For example, the same implant can be used to support 1 tooth today and a denture in the future.

A complete exam and time to discuss your personal options with Dr. Heit will help you make an informed choice regarding your dental treatment.


Reasons for dental implants:

  • Replace one or more missing teeth without affecting adjacent teeth.
  • Resolve joint pain or bite problems caused by teeth shifting into missing tooth space.
  • Restore a patient’s confident smile.
  • Restore chewing, speech, and digestion.
  • Restore or enhance facial tissues.
  • Support a bridge or denture, making them more secure and comfortable.

What does getting dental implants at Scotia Square Dentistry involve?

 You are usually done in 3 or 4 appointments:


  1. Scan appointment to make a surgical guide (minutes)
  2. Surgery (1/2 hr to 2 hrs) depending on the amount of implants and the complexity of your individual case with a post op appointment  
  3. After 4-6 months of healing, an impression is taken of the integrated implant (this means your own bone has secured the implant).  The porcelain teeth are made and securely attached to the implant.

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