One of the questions I often answer during new patient appointments is, “Do you see many patients with missing permanent teeth?” The answer is, “Yes, I do.”
Approximately sixteen percent of the population is congenitally missing a permanent tooth, meaning the tooth never forms. This figure does not take into consideration third molars or patients who have lost a tooth during their life.
Another common question I receive is, “Why do you see so many patients with missing teeth when it is a relatively small group in our population?” Because, orthodontics provides the best treatment plans to help patients solve this problem. Solving this problem orthodontically tends to be less invasive and less financially costly to the patient.
The three main orthodontic treatment plans I recommend for correcting the tooth missing issue: are: 1. preserve the primary (baby) tooth; 2. replace the missing tooth; or 3. orthodontically close the space where the permanent tooth is missing. The condition of the teeth, the fit of the teeth (occlusion), and the amount of crowding/spacing in the mouth are all factors that influence which treatment plan is ideal for a patient.
Preserving the baby tooth is my preferred plan of treatment as long as the fit of the teeth is good and there is not significant crowding. If the primary tooth fuses with the bone (ankylosis) at any stage, the primary tooth will need to be removed and a restorative treatment plan put into action. Replacing the missing tooth is usually accomplished with an implant and a crown.
An implant is a permanent structure placed into the bone, usually by an oral surgeon or periodontist. The implant will remain in the bone for the rest of the patient’s life. The crown on top of the implant is placed by the primary care dentist and usually needs to be replaced every ten to fifteen years.
If the patient has crowding, the primary tooth can be removed and the teeth can be orthodontically moved to close the space and fit the teeth together properly.
If you or your child is missing permanent teeth, please visit an orthodontist to learn more about your treatment options. An orthodontist will work with your primary care dentist to develop the best treatment plan for you, while orthodontically moving your teeth to give you the smile you have always wanted and a bite that is properly aligned. Every smile deserves the best treatment options and, when needed, a board certified orthodontist.