Find out more about our Academic Medical Centre and efforts in Academic Medicine
Find out more about what JOAM do to support AM initiatives.
Academic Medicine Executive Committee (AM EXCO) and ACP Organisation Charts
Guidelines, forms, and templates for Academic Medicine.
Teeth can be lost when they are irreversibly damaged due to dental decay or trauma. Gum disease can also affect the supporting bone and gum, leading to the loosening of teeth and eventual loss.
When teeth are lost, there are several methods that can be used to replace them. These include dental implants, bridges and dentures. When the infected tooth cannot be saved and has to be removed, prosthesis replaces the missing tooth to restore speech, function and aesthetics.
TYPES OF TOOTH REPLACEMENTS
Dental implants are a substitute for a missing tooth root. Due to its durability and strength, they are ideal as tooth substitutes.
Implants can be used to replace a single tooth, multiple missing teeth or to replace teeth in cases with complete tooth loss. Therefore, in almost any situation, a missing tooth can potentially be treated with this method.
Almost all dental implants used today are made from titanium alloy. It is commonly cylinder- or screw-shaped.
Each implant is carefully and precisely drilled into the location of the intended tooth and provides a firm and stable foundation for long-term support of the replacement teeth. These materials have been shown to be well-tolerated by the body and are used as supports in the fabrication of prosthesis to restore function and aesthetics.
The treatment is carried out by a team of restorative specialists and surgeons working in close collaboration.
Your dental surgeon will assess your suitability for treatment with these implants, taking into account various considerations such as your bone volume and quality, tooth and jaw relationship, oral habits and general medical health. This may include a detailed analysis using different X-rays and scans.
Normally it takes about four months to a year to complete the entire treatment. This would depend on case complexity as well as the need for additional procedures like bone grafting.
Phase 1: Treatment Planning
A thorough assessment of your medical health, oral health, the way your teeth fit together and bone volume will be done to produce an individualised treatment plan.
Phase 2: Surgical Treatment
A minor surgical procedure is carried out to place titanium fixtures into the bone. If bone and/or soft tissue are insufficient, there may also be a need for additional grafting procedures before the implants can be placed.
Phase 3: Restorative Treatment
After the integration of the implant fixtures to the bone, ‘new permanent teeth’ will be designed and fabricated.
A bridge is a fixed prosthesis that replaces missing teeth by using neighbouring teeth as support. Healthy neighbouring teeth are trimmed and the bridge unit is fixed on them. A small number of missing teeth can also be replaced if the neighbouring teeth are sufficiently strong.
A bridge can be made of ceramic or a combination of metal alloys and ceramics to maximise strength and simulate a natural appearance.
TYPES OF BRIDGES
This consists of two crowns joined to an artificial tooth that is meant to replace the missing tooth. The healthy neighbouring teeth are trimmed and the bridge unit is fixed onto them.
This requires minimal trimming of neighbouring teeth on their back surfaces. Cement is used to bond the bridge structure to the back of these teeth. Although this method conserves more of the neighbouring teeth’s structure, not all patients are suited for it. Your prosthodontist will advise you on the technique most suited for your condition.
Your dentist will need to assess important factors such as the number of missing teeth, the condition of the neighbouring teeth and as well as those of the supporting gums and bone prior to advising you on making a bridge. Your dentist will also be able to advise on alternative ways of replacing missing teeth after a clinical examination.
The procedure itself requires at least two visits on an outpatient basis to complete.
The first visit usually involves trimming the teeth under local anaesthetic, making an accurate mould for the dental laboratory to fabricate your prosthesis and placement of a temporary bridge for you to function in the interim period.
At the second appointment, your dentist will remove the temporary bridge and check for the fit, bite and look of the final bridge before cementing it in place.
Maintenance care for bridges is similar to that for crowns. The focus is on regular flossing, brushing as well as regular check-ups.
A denture is a removable prosthesis used to replace missing teeth. Commonly referred to as ‘false teeth’, it is usually made of acrylic or a combination of acrylic and metal. A partial denture is fitted to replace some missing teeth whilst a complete denture is indicated when all natural teeth are missing. A good set of dentures helps you to eat, speak, function and often makes the person look better.
Depending on the complexity of each case, the duration of the treatment will take about two to six visits. After the initial visit for examination and diagnosis, the subsequent visits will include making impressions of the mouth (getting the shape of your gums and soft tissues), bite registration (checking how your upper and lower jaw relate to each other), try-in of the denture (to check for how the final denture will look like), issue and review.
In certain cases, especially when all natural teeth are absent, dental implants may be used to aid in anchoring the dentures so that they do not move during function. Your dentist will advise you if you are suitable for the use of dental implants to retain your dentures.