If you have chosen to have your root canal removed, then this is the follow-up article for you. Of course, this article also applies to anyone who is missing teeth for whatever reason.
The principle we want to bring to light here is called: ‘Use it or lose it.’ Like all principles, ‘use it or lose it’ has far-reaching applications.
For example, we lose our cognitive ability if it is not used properly. Perhaps this is why many elderly find enjoyment in exercising their mental faculties through crossword puzzles.
If we do not use our muscles, they will deteriorate. If we do not maintain the range of motion of our joints, the body will calcify around the joint to accommodate only the range of motion we regularly use.
Our ability to focus our eyesight diminishes unless we exercise our ability to focus our vision at various ranges.This principle of ‘use it or lose it’ is also directly applicable to the jaw bone. If we do not stress the jaw bone, the density of the jaw can diminish. Chewing on teeth anchored in and around the jaw provides the optimal way to stress and exercise the density of the jaw bones.
The first option we see is to do nothing. As Robert Gammal (one of the experts we interviewed in the HealThy Mouth World Summit) put it so eloquently in his Aussie accent, “There’s nothing wrong with going ‘gappy’.”
While we appreciate Dr. Gammal’s willingness to make light of such a situation, having a missing tooth over time may cause some trouble. That’s because teeth are placeholders for one another. If a tooth is missing for a prolonged time, other teeth that are adjacent to or opposite from it (think top to bottom) may shift and change the bite.
More proof that we can’t address one part of the body without affecting the whole system! When we have a missing tooth, then our other teeth can move, thus impacting the bite of that whole side of the mouth.
Another drawback of doing nothing is that you will no longer be able to stress the jaw bone at the location of the missing tooth. This results in an increased risk of losing bone density at that site. Depending on what tooth is missing, doing nothing can compromise one’s ability to effectively use that side of the mouth for chewing.
On a positive note, doing nothing means that you aren’t introducing any crazy, potentially toxic materials into your system. Another positive to doing nothing is that the area will be easy to clean around, something that can become an issue with the following options.
For years, conventional dentistry has encouraged traditional bridgework as the ‘go-to’ answer for a missing tooth. Despite the fact that bridgework has been a common solution for years, we are not particularly keen on this for several reasons:
In traditional bridgework, the teeth on either side of the gap are ground down to ‘posts’ in order to attach the fixed bridge. One main issue we have with traditional fixed bridges is that if either of the two anchor teeth become compromised, you don’t lose one tooth – you lose the whole bridge.
What’s more, the anchor teeth must be compromised by radically stripping away much of the outer tooth structure to prep for the bridge. It should be no surprise then that we’ve heard numerous stories from our community about this exact situation occurring.
Once one of the two anchor teeth become compromised, the person is faced with the situation of losing three teeth–or essentially their entire chewing capability on that side.
Another challenge of traditional fixed bridges is the ability to clean under the bridge.
You can’t easily floss the area around a bridge. So how is someone expected to be able to disrupt and disorganize the bad bugs in the gum pockets all the way around the two anchor teeth?
Finally, you are essentially asking two anchor teeth to do the work of three teeth with a traditional bridge. Asking an already challenged tooth (from the stress of being prepped to carry the bridge) to do half the work of another tooth is a lot to expect.
What are the upsides to traditional bridgework?
You have a full chewing surface! Though not perfect, that’s plenty to celebrate! If you have a traditional bridge now, do everything you can to maintain healthy gum tissue around those anchor teeth.
With an implant, the dental specialist places a post (most commonly titanium) into the jawbone at the site of the missing tooth. After they determine that the post ‘was accepted’ by the body, then a crown is placed on the post.
Dental metals in the wonderfully microbially diverse ‘perfect petri dish’ of the mouth tend to compel the bad bugs to adapt–and thus produce atypical toxins. This is big trouble as the body is forced to combat new toxins that can add increased stress to our immune system. (While titanium does oxidize more slowly than other dental metals, it is still a metal, and as such could be problematic.)
There is a lesser-used material for the implant screw which does offer more promise. Zirconia, the crystal created by superheating the metal zirconium, is no longer a metal; that means it is not going to activate with the bad bugs to produce atypical toxins.
This is an interesting alternative to traditional fixed bridgework.
Many dentists can now build a ‘bridge’ out of composite resin materials (the same materials the tooth-colored fillings are often made from).
The main upside to composite bridge work is that the two anchor teeth won’t ground to posts. The dentist simply builds off of the adjacent teeth with composite materials to fill the gap.
While not the perfect solution, a composite bridge does offer substantial benefits when compared to the other options so far:
~ It’s not metal, so there are no ‘metals and microbes’ issues.
~ The anchor teeth are kept in good condition and not compromised by grinding them to posts.
~ Unlike traditional fixed bridges, if one of the anchor teeth becomes compromised, you can still remove the bridge and keep at least one of the teeth.
Yet a composite bridge still isn’t the perfect solution, and here’s why:
You still have to address the issue of cleaning around and under the bridge, and you are still asking two teeth to do the work of three. I also wonder how strong these composite bridges are over time. Finally, you are not able to exercise the bone under the bridge.
The last option we see to span the gap of a missing tooth is with some form of a removable bridge. There are several styles of removable bridges, and they have many names. A few of these ‘out of style’ options are removable partials, a flipper, and Nesbit.
As their names suggest, each of these options can be removed from the gap. So, it’s easy to clean around them.
Each of these solutions would also help to maintain the space to avoid any changes in bite and teeth shifting. As they do sit directly on the gum tissue of the missing tooth, they may also put some demand on the jaw bone, thus working with our ‘use it or lose it’ principle.
There are some possible downsides to removable options. First, they may not fit well and can be uncomfortable. They would require that you be conscious when eating (which isn’t such a bad habit) as they are not cemented into place and could come loose while chewing. You would also have to be diligent about removing it after eating to clean around the space.
Perhaps the biggest challenge with removable options is finding a dentist who is comfortable helping you fit one.