Friday, August 23, 2013

Just Lost a Tooth? Now What?

When a tooth is lost, there are several options to replace it. You can have something that is permanent or something that is removable. There are four main options: 1. implant 2. bridge 3. partial denture and 4. nothing.


The best option is to replace it with an implant. Implants are very predictable and have a very high success rate. Once they are integrated into the bone, they can pretty much last forever. I joke around and tell my patients that it will still be in there 5,000 years from now. The disadvantage is that it is the most expensive option. Typically the implant and crown can range between $3500-4500.


The next best option is a bridge. However, I personally don't like this option for a couple reasons. First of all, if the teeth adjacent to the missing tooth are "virgin" teeth (perfectly sound teeth with no decay), then we would end up damaging them as well by cutting them down. The average lifespan of a crown or bridge is approximately eight years. That means that in eight years, we may likely have issues with the adjacent teeth. The reason this is the case is because decay can sometimes form at the junction between the tooth and the crown. Many people do not floss, so the surfaces that aren't cleaned regularly will have recurrent decay. Even if a person flosses, it is a challenge to floss under the bridge unless a floss threader is used. The cost of a bridge can range between $1000-1300 per unit. A bridge always has three or more units. The cost of a three unit bridge is comparable to an implant, so the implant to me is the only logical choice unless the adjacent teeth have significant decay and need to be restored anyway.

Partial Denture

The next best option after a bridge is a partial denture. A partial denture is the most economical choice ranging between $500-2000. It works......but I don't like this option either. As far as the patient is concerned, it is very inconvenient to always have to remove the appliance. For me, I don't like it because in many cases, the partial denture is retained by other teeth. Over time, the other teeth are damaged or compromised. It is an option though.

Do Nothing

By far this is the least expensive option. However, it is also the worst option. The remaining teeth shift and create problems. Teeth are like gears. They need to match up properly. For example, if the gears in a watch or engine don't match up, in a relatively short period of time the watch or engine will fail. In addition, the jaw bone will develop defects.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

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