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Do you have a missing tooth (or teeth) that need to be replaced? Throughout our lives, teeth can be lost for a variety reasons. They can be lost from tooth decay, periodontal disease, nutritional neglect, and accidents. Missing teeth can compromise your eating habits, speech, health, and appearance. The loss of a front tooth can negatively affect the appearance of your smile, your speech, and your self confidence. Losing a tooth in the back of your mouth can lead to a number of issues affecting your ability to chew, your ability to properly clean your teeth, jaw collapse, teeth shifting, and the health of your remaining teeth. Replacing a lost tooth will prevent further destruction and help save your remaining teeth. Replacing lost teeth can save you time, money, keep you healthier,and prevent many other oral difficulties in the future.

The loss of a single tooth can start a devastating chain reaction of events. After a back molar tooth is lost, a series of destructive events occurs including the displacement and tilting of other teeth around it including a supra eruption (when a tooth continues to grow into the mouth because it is not being kept in place by it’s opposing tooth) of the tooth above it, decay, drifting and formation of periodontal pockets. Eventually, bone loss and periodontal disease, to the teeth surrounding the lost tooth, tend to cause further destruction. If you fail to replace a lost back tooth, you may cause the loss of other teeth.

What Can Happen If Lost Teeth Are Not Replaced?

-Shifting of Teeth - When a tooth is lost, for whatever reason, the surrounding teeth will begin to drift into the open space. This includes both adjacent teeth as well as teeth in the other arch. A once straight smile can quickly turn into a crooked one. Replacing a lost tooth sooner, rather than later, can prevent this from happening As the number of lost teeth increases, the further the damage to the overall eveness of the bite  and, making it harder to replace later on. The altered position of teeth causes the forces to be applied incorrectly while chewing, making fractures and bone loss much more likely. The incorrect forces also cause wear which can result in loss of tooth height and subsequent facial changes.

-Temperomandibular Joint Issues (TMJ Disorder) - As your teeth shift out of their normal alignment, bite issues usually develop. When the upper and lower teeth do not meet properly, it can strain and eventually damge the TMJ. This can lead to head, jaw, and ear pain, headaches, dislocations, clicking and popping, as well as permanent damage to the joint.

-Periodontal Disease - When teeth begin to shift, it makes it that much harder to keep your teeth clean. It will be harder to brush and floss certain areas which have, essentially, created a trap for plaque and food debris to build up. When plaque and bacteria are not removed and allowed to build up the result can be tooth decay and periodontal disease. When teeth shift and drift, they oftentimes create a root exposure problem, and allow forces to move them in unnatural ways. This can loosen teeth, and make them very sensitive. Periodontal disease can lead to further tooth loss.

Options For Replacing Missing Teeth

Patients have multiple options when teeth are lost. They can include fixed ( permanent and not removable) or removable options. These procedures can include:

-Removable Dentures - This option has been the longstanding traditional option when multiple teeth are missing. Removable dentures are often the fastest and least expensive alternative in the short term. There are some disadvantages to removable dentures. Removable dentures work by attaching to exisiting teeth. This often leads to these “anchor” teeth becoming loose, worn, decayed, or broken. There can also be bone loss under the denture, which over time will make the denture more and more mobile and uncomfortable. Removable dentures can also be inconvenient to clean after eating especially if out at a restaurant. Lastly, removable dentures have about 1/3 the chewing power and efficiency of natural teeth. This can lead to poor chewing and lack of good nutrition in one’s diet.

-Fixed Bridge - This entails cutting down surrounding teeth, and fitting them with fused crowns to replace any missing teeth. The most popular type of fixed bridge is called a 3 unit bridge. This means that the two natural teeth adjacent to the missing tooth serve as anchors. This is a very stable option but does also have disadvantages. Disadvantages include:

-Removal of good tooth structure from adjacent teeth.

-Difficulty maintaining good dental hygiene under bridges as normal flossing is not possible

-Long term prognosis of most dental bridges in between 8-10 years before it needs replacing. This is an average. Some bridges can and will last longer.

-Dental Implants – Dental implants are the largest initial investment, but most cost effective long term solution for replacement of missing teeth available today. The main disadvantage to dental implants is the time it takes to be completed. Following placement of the dental implant a 4-6 month healing time is generally needed before the tooth can be restored. Dental implants are the ideal solution for many tooth replacements in dentistry today.

-All on Four Dentures - When many or all  teeth are lost, or if you are rapidly progressing to full mouth breakdown, This dental implant/denture option is an excellent choice. The best thing about this procedure is that you have your entire procedure done and walk out with teeth the same day. There are usually 4 dental implants placed and a titanium bar supported denture placed. It is screwed down, but can be removed if needed. The biggest negatives here are price, and post operative possibility of bruising and discomfort while healing.

Tooth Replacement Conclusion

Tooth loss can happen at any time to anyone. Losing a tooth due to a trauma, disease, habits, etc. can be a big problem for a variety of reasons. If not replaced, they can cause issues for you including bone loss, periodontal disease, and more tooth loss. Replacing lost teeth as soon as possible will save you discomfort and greater expense in the future. Knowing your options, and being informed can help you and your dentist come up with the best treatment options for you. Remember, sooner is better than later, but know that whenever you are ready to move forward with tooth replacements there will always be options!

Tooth eruption is a process in tooth development in which the teeth erupt into the mouth and becomes visible.

The arrival of a new tooth, or tooth eruption is a big event for most of us! As a baby, tooth eruption allows for introduction of new foods with more substance. Later on, many parents and kids look forward to a visit from the tooth fairy, and for their new “grown up” teeth to come in. It is an exciting time for parents and children alike and losing baby teeth is an important milestone in most kids and parents lives. It means they are growing up, getting bigger, and taking on more responsibility for themselves at home and school.

Tooth Eruption Facts

Humans have two sets of teeth, primary (or baby) teeth and then permanent teeth. These teeth develop in stages. The schedule is different but the development and tooth eruption of each of these sets of teeth is very much the same. Following are a few facts about tooth eruption:

-Tooth eruption tends to happen in parallel. This means that the bottom molar tooth on your left side should erupt into your mouth at about the same time as the bottom molar tooth on the right side.

-Primary tooth development begins during the 2nd trimester of a woman’s pregnancy. Primary teeth are place holders for permanent teeth.

-Loss of primary teeth due to extraction or loss of space due to breakdown of baby teeth, makes a child susceptible to malocclusion and more likely to need orthodontic treatment.

-The crown of a tooth is the first to begin forming. The roots continue to develop and lengthen even after the teeth have come through the gums.

-There are 20 primary teeth. These are usually fully erupted by age 3, and remain until around 6 years of age when they begin to fall out to make room for your permanent teeth.

-Adult teeth usually begin to erupt into the mouth between 6 and 12 years of age. Most adults have 32 permanent teeth.

-Permanent teeth are larger and take longer to erupt than primary teeth.

Tooth Eruption – Types of Teeth

A person’s teeth will vary in size, shape, and their location. Each tooth in your mouth has a job to do and that is why it is shaped the way it is and where it is located. Tooth eruption follows a definite pattern.  There are 5 types of teeth:

1) Incisors. Incisors are the eight teeth in the front of your mouth (four on top and four on bottom). These teeth are used to take bites of your food. Incisors are usually the first teeth to erupt. Primary incisors erupt at around 6 months of age.Permanent incisors should come in at  6 and 8 years of age.

2) Canines. We have four canines in our mouths. These are the next type of teeth to erupt. Canines are your sharpest teeth and are used for ripping and tearing food apart. Teeth eruption for primary canines usually occurs between 16 and 20 months of age, with the upper canines coming in just before  the lower canines. The order is reversed for permanent teeth. Lower canines erupt around age 9, with the uppers erupting at about 11-12 years of age.

3) Premolars. Primary molars are replaced by premolars. Premolars (also called bicuspids) are used for chewing and grinding of food. You have four premolars on each side of your mouth, two on the upper and two on the lower jaw. The first premolars appear around age 10 and the second premolars arrive about a year later. Premolars are generally the teeth that may need to be removed during orthodontic treatment to create space.

4) Molars. Primary molars (replaced by the permanent premolars) are also used for chewing and grinding food. Teeth eruption for these happens between 12 and 15 months of age. The first permanent molars erupt around 6 years of age while the second molars come in around 11-13 years old.

5) Third Molars. These are also referred to as “wisdom” teeth. These are the last teeth to erupt into the mouth and do not typically erupt until age 18-21 years of age. Some

Tooth Eruption Issues - Peg Laterals - Marielaina Perrone DDS

Tooth Eruption Issues – Peg Laterals

people never develop third molars at all. These molars may cause crowding and need to be removed. Other times they develop in the jaw but never erupt into the mouth. When this happens it is referred to as impacted.

Tooth Eruption Issues

-Supernumerary teeth.  Extra teeth may form and make normal tooth eruption more difficult, delayed or impacted. This happens most often in the wisdom tooth area. Another type of extra tooth is called a mesiodens. This is an extra small tooth growing right between the two upper front teeth and needs to be removed surgically. There is also Gemination, or twinning of a tooth, wherein, a double tooth forms.

-Malformed  Teeth. Tooth eruption is not always perfect. Sometimes genetics, medications etc. can cause malformed teeth. Examples are peg laterals (very small lateral incisors), mulberry molars (a molar

Fused Tooth - Marielaina Perrone DDS

Tooth Eruption Issues – Fused Tooth

that has a raspberry like appearance), Fused teeth (two different teeth which form conjoined into one tooth such as a lateral and canine),  Dens in dente (a tooth growing completely inside of another tooth).

If a tooth does not form in the primary dentition (for example a child never forms a front baby tooth), there will never be a permanent tooth to replace it. Also, tooth eruption in the lower arch in front can sometimes erupt behind the primary teeth. This is quite normal but may necessitate the need of removal of the primary teeth to aid tooth eruption.

If teeth are not erupting properly, have your dentist take an x ray. Sometimes there are developmental or genetic issues causing malformed teeth, extra teeth or lack of tooth development. It is important to monitor tooth eruption as it happens. The earlier these issues are detected, the better you can prepare for future treatment needs.

 

Primary Tooth Eruption Chart

Tooth Eruption Chart - Marielaina Perrone DDS

Tooth Eruption Chart