Missing Teeth - Implants or Bridges?

Santa Monica • Beverly Hills • Los Angeles

Medically Reviewed by Sam Muslin, DDS, MAGD | Last Updated on 04/25/2023

Many patients have missing teeth that result in cosmetic and functional problems. The ability to chew properly deals with normal day-to-day functions and the cosmetic elements become an issue even if the patient’s back teeth (molar teeth) are missing. Tooth loss causes the bite to slowly collapse. The patient is not aware of this gradual process but as the bite collapses, the face and lips also show signs of deterioration.

Some patients loose teeth because of gum disease and the slow gradual loss of bone. Teeth are lost because there is not enough bone to support the teeth. Missing teeth cause cosmetic problems and health problems. Patients cannot chew their food properly with tooth loss, which contributes to digestive problems.

Missing teeth create a chain of health problems that affect the entire body. Today, patients are living longer and the health of their mouth will determine the quality of their lives for the last 30 years of life. Dr. Sam Muslin's vast experience in mouth reconstruction dentistry can help make this possible.

Replacing Missing Teeth

Implants vs. a fixed bridge for treatment - Before and After

Before and After Missing Teeth Replacement: This patient has missing teeth and bite collapse as her front teeth are angled forward and her lip is pushed up. Tooth loss can be solved with a variety of high tech dental treatment options.

There are several ways to replace missing teeth. If the patient is only missing one tooth, a dental implant or a dental bridge are good choices. If the patient is missing multiple teeth, several dental implants or more than one dental bridges are good choices. If the patient wants to have teeth that stay in their mouth all of the time both dental implants and dental bridges work well. However, removable teeth are also a good choice.

A removable partial denture or a full denture if the patient is on a limited budget can be a great choice if the dentist has the necessary skills. Sometimes dental implants can be used in combination with a dental bridge or with removable partial or full dentures. The combination of treatments were the best cosmetic dentistry solution for this patient.

Dental Bridges

A fixed dental bridge stays in the patients mouth all of the time and this patient has a dental bridge and dental implants that replaced her missing teeth. The dental bridge was made in order to reduce the amount of surgery and expense. Second, because of the forward angle of her teeth, placing dental implants would be a mistake. A dental bridge was used to replace her two front teeth that were missing and at the same time, provide natural looking porcelain crowns over her natural teeth. Her natural teeth had extensive dental decay so the porcelain crowns combined with the dental bridge gave her the following benefits:

When a patient is missing a tooth and has good teeth on each side of the space, it is possible to replace the missing tooth or teeth with a fixed bridge. The dental bridge will be cemented to the teeth on each side of the space and stays in place permanently. The patient can chew normally and powerfully without any discomfort and can clean under the bridge with floss and a water pik. Had dental implants been chosen, the patient would have spent a lot more money and exposed to a surgical risk and possible bone grafting without significant gain in value.

With over 30 years of experience, Dr. Sam Muslin his been guiding his patients into making the best treatment plan choices. This patient received dental implants to replace her missing back teeth because she did not have any remaining teeth to support a fixed porcelain bridge. In this case, he used dental implants and dental bridges to replace missing teeth.

Buck Teeth

The missing tooth on the right and the missing lateral incisor on the left was replaced with a pontic (a fake tooth) that fits into the gum and looks completely natural. No surgery was necessary and the dental bridge is durable, esthetically pleasing and easy to maintain.

This patient has a fixed bridge on her front teeth, which enabled Dr. Sam Muslin to angle the teeth into a balanced and stable position. Using a dental implant instead of a fixed bridge would replace the missing tooth but the patient would still have buck teeth unless the other teeth were treated with dental crowns. The teeth were sticking out so far that they even pushed her lip too far forward. This patient has the “buck teeth” appearance.

By re-shaping the teeth, the lip dropped back to a natural position and her teeth fit her face proportionately. The bucktooth appearance was eliminated and her lip position is also improved. In the before photo, her lips nearly touched her nose and in the after photo, buck teeth correction treatment allowed her lip to move down from her nose. Dental bridges can be made of the new space age all porcelain systems as: Procera, Empress, G3, Zirconium, E Max and dental bridges are also made of a metal substructure with porcelain baked over the top for a very natural look.

Dental Implants

Dental implants can replace missing teeth by adding a dental implant that is surgically inserted inside the jawbone. A porcelain crown is placed on top of the implant and the patient has a complete replacement of the missing tooth. Some patients can have a dental implant bridge to replace more than one tooth. A dental implant bridge replaces three or more teeth with two implants.

The best dental implant treatment evolves around the engineering by the dentist. The patient needs to have enough bone for a dental implant to be serviceable. Without sufficient jawbone, dental implants can fail. Failed dental implants require bone grafting and months of healing before a replacement implant can be placed. It is very important when a dentist is considering dental implant treatment, that the amount and quality of the dental bone be accurately evaluated before the final restorations are placed.

Dr. Muslin has been engineering his dental implant treatment plans for many years and has been asked to testify as an expert witness in dental implant malpractice cases due to his experience and expertise. He recommends to his patients to get the best dental implant treatment with the best type of dental implant for their particular bone, health and bite. There is not a “best dental implant” that would work for everyone. Each patient has individual needs and trying to use one implant on every patient would not be in the best interest of the patient.

Partial Dentures

Partial dentures are removable teeth that are much less expensive than dental implants or dental bridges. The partial denture replaces many missing teeth with a one piece partial denture. Partial denture gets retention from healthy teeth. Generally, a clasp or an attachment system is used to get the partial denture to seat firmly for better chewing power.

Partial dentures generally cause the jawbone to wear down over time. Most patients are happy for 10 or more years but as the bone resorbs the comfort level and the retention level decrease. The problem with partial dentures is that the patient’s are living much longer lives and in the last 30 years of life, chewing efficiency can determine the level of over all health. It becomes more important than every, with increased life expectancy, that dental implants be utilized to combine with partial dentures and dental bridges.

Hybrid Partial Dentures

Most patients want teeth that stay in their mouth all of the time. Dental implants and dental bridges are the best solutions to accomplish this treatment goal. However, there is a treatment called the dental hybrid implant bridge that is removable, yet snaps on to dental implants in order to gain a solid retention and replace many missing teeth.

The dental implant hybrid bridge is essentially a more expensive partial denture that has the feeling of teeth that fit solid inside the mouth. Typically, removable partial dentures replace many teeth but need to be removed after every meal for cleaning and some patients have lived with partial dentures for decades. But, today, the partial denture can be supported with a dental implant that has a snap type attachment.

The hybrid partial denture is stronger, chews much like natural teeth, looks esthetically undetectable and fits securely inside the patient’s mouth. There are many choices and variations of choices that are available for patients today. The complexity of dental implants, fixed dental bridges, partial dentures and hybrid dentures and hybrid partial dentures has revolutionized the comfort level for patients with missing teeth. The dentist is the key element in designing the engineering and the success of the treatment. Do not be tricked by financing and sleep dentistry. When you wake up, you may be in for a very unpleasant surprise.

Dental Implants

The side teeth or bicuspid teeth were replaced with implants giving her a fuller look and stronger occlusion. The advantage of dental implants which are made by many companies as Astra, Nobel Biocare, Nobel Pharma, Straumman, ITI, etc. is that dental implants add additional root structure. The dental implants can stand by themselves and do not need abutment or teeth on either side to support them.

The big advantage of implants is that the addition of a tooth rather than using neighboring teeth (as a dental bridge or a partial denture) is actually stronger. But the disadvantage to dental implants is that a surgery is required and sometimes there are cosmetic complications with implants.

Dental implants can fail and it can be an expensive effort of time and money to try to get teeth that stay in the patient’s mouth. Some patients want to have teeth that stay in their mouth and want to have dental implants but do not have enough jawbone. These patients may undergo extensive bone grafting surgery by taking bone from the side of their jaw or hip in order to get enough bone to support a dental implant. The patients need to understand that dental implants are not superior to dental bridges and are not the best care for everyone.

Dental Implants Vs. Fixed Dental Bridge

Both had advantages and disadvantages but the bottom line is that both work very well and provide many years of service. The dentist has to be part engineer in order to develop the best plan for the patient, which may involve implants and fixed bridges on the very same patient.

The high tech dentist now has to understand the engineering of dental implants and dental bridges in order to develop the best usages of both systems and apply them to the advantage of the patient. Many patients have a limited budget and the combination of dental implants and fixed bridges can be the best treatment possible.

Finding the Best Cosmetic Dentist

Today’s high tech dentist needs to be knowledgeable of all of the technologies so he or she can make the ultimate recommendations. Cosmetic dentists can sometimes be good at bleaching teeth but terrible at porcelain veneers. Other cosmetic dentists only use one type of porcelain veneer to treat all of their patients.

Some cosmetic dentists can only treat gaps between teeth with one type of porcelain veneer. This doesn't work well if someone has tetracycline stain while another patient does not. There are various types of porcelain veneers that work much better on some patients and not well on other patients. Another critical factor is the thickness of the patient’s lips that can cause porcelain veneers to look grey.

The best cosmetic dentist has experience in lip positions, speech patterns and teeth reconstruction treatments. Additionally, there are many combinations of porcelain veneer treatments and the best cosmetic dentist has years of experience to know what is the best type of porcelain veneer for each patient.

Experience with complex dentistry is why patients should choose the experienced dentist. Dr. Sam Muslin will use two different types of porcelain veneers, porcelain crowns, porcelain bridges and dental implants on the same patient in order to get the best cosmetic dentistry results. This patient received his unique and exclusive Face Lift Dentistry® treatment.

When all available technologies are used in one patient and the cosmetic results are undetectable from natural teeth, the service to the patient can be a life changing and a dental health transformation event.

For those patients with complex problems with missing teeth, with over 30 years of experience and one of the country’s most extensive before and after photo galleries of some of the best cosmetic dentistry available today, please contact Sam Muslin DDS and schedule an appointment.

Sam Muslin DDS, MAGD

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