When tooth is lost the individual faces many choices. The first choice is should I replace the missing tooth? The second is what is the best way to replace it? In making these decisions there are many factors to consider and research data to be evaluated.
There are three basic ways to replace missing teeth.
These include:
1) Removable partial dentures
2) Tooth supported bridges and
3) Implant supported teeth.
Removable partial dentures have metal clasps that clip onto teeth to hold the device in the mouth. Patients need to take these in and out for cleaning after eating.
Tooth supported bridges rely on the adjacent teeth for support. The teeth next to the missing tooth space are ground down and the bridge is cemented onto them. This bridge does not come in and out and relies on the integrity of the adjacent teeth for support.
Dental implants. The final method of tooth replacement is the dental implant, which is a replacement for the root of a tooth. The implant is placed where the root of the missing tooth used to be. The replacement root is then used to attach a replacement tooth.
Should I Replace a Missing Tooth?
There are a number of studies reporting on survival of teeth next to missing tooth spaces. These studies look at the survival of the teeth next to the missing tooth space in cases where the missing tooth is replaced and the missing tooth is not replaced. Studies show that there is a significant loss of adjacent teeth if the missing tooth is not replaced. Tooth replacements with fixed bridges attached to teeth improves the survival of the teeth compared to no replacement.
When removable partial dentures are used to replace missing teeth, the failure of the adjacent teeth is much higher than if there was no replacement, or if the replacement was with a tooth supported bridge. Patients who do not replace missing teeth may experience shifting of teeth, spaces opening between teeth (resulting in food impaction), collapse of the bite, alterations in their chewing ability, TMJ pain, and trauma to the remaining teeth. People sometimes don’t replace teeth that are “in the back” of the mouth because no one sees them. The back teeth are needed to support the bite and grind up food. We can all swallow food that is not chewed thoroughly, but this compromises the nutrition we extract from our diet. When enough back teeth are lost the front teeth can start to flare or become “buck teeth” as they carry forces in excess of what they were designed for.
Let’s look at some of the data from scientific studies that look at replacing missing teeth.

VA Medical Center Longitudinal Study Shugars JADA 1998
19% of adjacent teeth failed if the space was untreated
10% failed if the space was treated with a tooth supported bridge
30% failed if the space was treated with a removable partial denture
Permanente Dental Associates looked at 317 patients who wore tooth supported fixed bridges for an average of 6.7 years and removable partial dentures for an average of 4.2 years. Their findings:
13% of adjacent teeth failed if the space was untreated
7% failed if treated with a tooth supported bridge
17% failed if treated with a removable partial denture
Truman Medical Center, 8.6 years tooth supported bridge and 7 years observation for removable partial dentures
12% of adjacent teeth failed if untreated
7% failed if treated with a tooth supported bridge
22% failed if treated with a removable partial denture
In conclusion, we can see the following:
• There is significant loss of adjacent teeth (ranging from 12%-19%) if the missing tooth is not replaced.
• Tooth supported bridges improve the survival rate, with abutment tooth loss from 7%-10% at 6.7 and 8.6 years.
• Removable partial dentures increase abutment tooth failure rate ranging from 17% to 30% at 4.2 to 7 years.
• There is no significant difference in the statistics of the various studies.
When an individual loses a tooth there are important decisions to be made. To learn more about tooth replacement options including using dental implants to replace a missing tooth visit http://www.drscharf.com

Author's Bio: 

Dr. Scharf is a board Certified Periodontist specializing in placing dental implants and treating periodontal disease. To learn more about Dr. Scharf’s qualifications follow this link drscharf.com/perioscopy/html/meet.html
To see Dr. Scharf be interviewed on “The Wellness Hour” on the topic “Who is a Candidate for Dental Implants” follow this link wellnesshour.com/features/dental_implants/scharf_david.html