I would like to fill the gaps between my teeth – what are my options?
This is a very common question and we get many requests to explain the options available.
I will start by saying that not all gaps need to be filled or missing teeth need to be replaced. Many people have missing teeth and have no desire to replace them or fill the gaps.
The two main purposes of teeth are aesthetic and functional (i.e mastication), and if either of these is compromised, that is when the patient might seek treatment. There are other reasons why teeth are replaced, but the above two are the most important from a patient’s perspective.
Very small spaces can sometimes be filled restoratively with careful use of composite (white) fillings, porcelain crowns and veneers. It is important to achieve a balanced look without making individual teeth look too wide.
Small gaps are often a result of teeth that have been lost and the adjacent teeth tilt or move together. Orthodontics, for example, braces and Invisalign®, can close these often more satisfactorily than making a narrow prosthetic tooth which never looks right. However, this type of treatment can be relatively lengthy.
Multiple spaces can be a result of the loss of several teeth either to caries or periodontal (gum) disease. Removable dentures can restore function and appearance in a short space of time and need not cost very much compared to other treatments. They can be very comfortable and for many this type of solution is all that is required. The prostheses are removable for cleaning and can be added to if other teeth are subsequently lost so that it is not necessary to start all over again.
If the patient wants a fixed option then bridges or implants may be indicated. Bridges were more often prescribed prior to the advent of implants. They depend on suitable teeth adjacent to the gap to which the prosthetic tooth is fixed. Small spaces of a single tooth missing are more amenable to bridge work than multiple missing teeth due to a variety of mechanical and biological reasons.
Dental implants have revolutionised the way teeth are replaced. They are stand-alone titanium “roots” that are fixed into the jaw bones and carry a porcelain prosthetic tooth. They can be used in a wide variety of scenarios from single tooth gaps to fully edentulous cases. There are a few medical conditions in which implants would not be recommended, but a full assessment is done beforehand.
Prosthodontics is the dental speciality that addresses concerns in the areas of cosmetic dentistry, crowns and bridges, dental implants, restorations, missing teeth replacement and rehabilitation of head and neck cancer patients.
Dr. Steven Soo
Specialist Dental Group
Disclaimer: The views and opinions in the article are the writer’s own and do not necessarily reflect those of Mount Elizabeth Medical Centre (MEMC). The writer is fully responsible for the accuracy, completeness and usefulness of the information provided in the article. MEMC will not be liable for any errors, omissions or copyright issues with regard to the contents of the article.