When we see a patient who we're asked to see either on referral or who’s been recommended to see us who has missing teeth, there are always several options possible that should be explored.
So, often patients will come in and say “can I have a dental implant to replace this missing tooth or teeth” but we should always explore different options.
Option one when a patient has a space or a gap is to do nothing and that is always an option that should be considered or discussed, it is the easiest and it's the cheapest, but it doesn't necessarily fulfil the requirements of why people come in the first place but it should always be explored.
Option two is a denture option and there are different types of dentures that can be constructed. A denture is a removable replacement, often with a plastic element which is usually taken out at night but it's an inexpensive way to replace teeth. It doesn't always function the best and it depends on the circumstances for the patient. A denture can be metal based, it can have clasps on it to hold it in place so, that's an option that's always explored where at all possible for patients.
Option three is bridge work of some sort which is a construction that's fixed into the mouth to replace the teeth; held in place by adjacent teeth. Sometimes that can be stuck onto the teeth without damaging them and this is called an adhesive bridge and in other cases it's fixed in and involves the preparation and damage of the teeth, but the teeth are then crowned to hold the bridge in place. If possible, that's always an option that's discussed and the pros and cons, the disadvantages and advantages of that treatment are outlined to the patient.
Option four tends to be the dental implant option and that's the pyramid of treatment, do nothing, investigate denture options, investigate bridge options (either adhesive or fixed), and then investigate possible dental implant options and to run through those options with patients and to see how they apply to the individual circumstances of the patient.
