If you have lost one or more teeth and are looking to restore your smile, you will likely choose from among three options:

• dental implants, which are ideal for one or more teeth,

• removable partial dentures, which can address multiple gaps, and

• fixed bridges, which are attached to the remaining teeth using bonding techniques

Choosing between these options can be difficult for a layperson, but knowing some of the benefits of each option can help you make better decisions.

1. Traditional restorations

Typically, bridges and dentures are considered more traditional approaches to tooth replacement compared with implants. They are easier to acquire and install, and work well for most patients. They are also cheaper and are therefore covered by most dental insurers.

Bridges, in particular, utilise the existing/natural tooth structures to support the crowns, which means that you must have healthy teeth remaining to support the bridge attachment. Fixed porcelain bridges will be cemented or bonded in place, and can only be removed by a dentist. Removable bridges can be taken out for cleaning and replaced, but they offer less security because of this.  

Multiple tooth loss has often been resolved by removable full or partial dentures, especially in older patients. These are usually supported by the mouth's suction capability. They are ideal for patients for whom implants aren't an option, since they can be placed on smaller bone volumes than the former.

However, some adjustment is required when using dentures, particularly in feeding and speech. In addition, dentures do not prevent bone resorption, and one should expect regular visits to the dentist for readjustment or replacement as the jaw structure changes

2. Dental implants

Implants can be used to replace a single or multiple teeth and also to anchor partial or full dentures. Consisting of titanium posts that are screwed into the bone, implants are considered the most permanent solution to tooth loss. They offer great support to crowns, almost like natural teeth, and will have little impact on speech, feeding and oral hygiene habits (normal brushing and flossing is sufficient).

Another advantage of dental implants is that it controls bone resorption which occurs after tooth loss. The posts hold on just like natural roots and protect your bone structure. Implant installation does not affect nearby teeth, unlike bridge installation in which adjacent teeth are altered to attach the crowns.

Implant installation is considered oral surgery, and hence any patient that qualifies should be generally healthy. Also, there must be sufficient bone to hold the implant posts, which is why you shouldn't wait too long after tooth loss to install implants. Patients with diabetes, leukaemia and other chronic illnesses can expect must slower healing and should only install implants where benefits outweigh risks.

Finally, most insurers shy away from implant coverage, considering them cosmetic restorations, but mostly because they are more expensive than the above options. Nonetheless, the upfront cost is well worth it, as implants can serve trouble-free for years, decades even before replacement is required.

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