Dental Prosthetics: Complete Guide to Artificial Teeth

Why Might You Need Dental Prosthetics?

Dental prosthetics replace teeth that are missing due to injury, decay, gum disease, or developmental issues. They restore your ability to chew properly, speak clearly, and maintain facial structure while preventing remaining teeth from shifting out of position.

There are several common reasons why people need artificial teeth to replace their natural ones. Understanding why replacement may be necessary helps you make informed decisions about your dental care and discuss options with your dentist.

Tooth loss can happen at any age, though it becomes more common as we get older. The loss of even a single tooth can have significant effects on oral health and quality of life. When a tooth is missing, the surrounding teeth may gradually shift into the empty space, leading to bite problems and making remaining teeth harder to clean. The jawbone beneath the missing tooth also begins to deteriorate over time without the stimulation it normally receives from chewing.

Beyond functional concerns, missing teeth often affect self-confidence and social interactions. Many people feel self-conscious about gaps in their smile, which can impact professional and personal relationships. Modern dental prosthetics address both the functional and aesthetic aspects of tooth loss, providing solutions that look, feel, and function remarkably like natural teeth.

Common Causes of Tooth Loss

• Trauma or injury: Accidents during sports, falls, or other impacts can knock out or break teeth beyond repair
• Tooth wear: Grinding (bruxism), clenching, or consuming highly acidic foods and drinks can erode teeth over time
• Periodontal disease: Advanced gum disease destroys the supporting bone structure, causing teeth to become loose and eventually fall out
• Severe decay: When cavities progress too far or root canal treatment fails, extraction may be the only option
• Congenital absence: Some people are born missing certain teeth (a condition called hypodontia) or have teeth with abnormal shapes

The decision to replace missing teeth should be made in consultation with your dentist. While not every missing tooth requires immediate replacement, especially those in less visible areas of the mouth, your dentist can help you understand the potential long-term consequences of leaving gaps and the best timing for treatment.

What Are Dental Crowns and Bridges?

A dental crown is a cap that covers a damaged tooth to restore its shape, strength, and appearance. A dental bridge replaces one or more missing teeth by anchoring artificial teeth to adjacent natural teeth or implants. Both are fixed prosthetics that you cannot remove yourself.

Crowns and bridges are among the most common dental prosthetics, used for decades to restore damaged or missing teeth. They are considered "fixed" prosthetics because, once placed, they become a permanent part of your dental structure and cannot be removed for cleaning like dentures.

A dental crown, sometimes called a "cap," completely covers a tooth that has been weakened by decay, fracture, or root canal treatment. The crown restores the tooth's original shape and size while protecting it from further damage. Crowns are also used for cosmetic purposes to improve the appearance of severely discolored or misshapen teeth. The procedure involves reshaping the underlying tooth to create room for the crown, taking impressions, and having a dental laboratory create a custom crown that matches your other teeth.

A dental bridge literally "bridges" the gap created by one or more missing teeth. The bridge consists of artificial teeth (called pontics) held in place by crowns attached to the teeth on either side of the gap (called abutment teeth). Bridges restore your ability to chew and speak properly, maintain the shape of your face, and prevent remaining teeth from drifting out of position.

The Crown and Bridge Procedure

Getting a crown or bridge typically requires two dental visits. During the first appointment, your dentist prepares the tooth or teeth by removing a thin layer of enamel to make room for the restoration. Impressions are taken and sent to a dental laboratory where skilled technicians create your custom prosthetic. You and your dentist will select the shade that best matches your natural teeth.

While waiting for your permanent restoration, you'll wear a temporary crown or bridge made of plastic or composite material. This protects your prepared teeth and allows you to eat and speak normally. At your second appointment, usually two to three weeks later, your dentist removes the temporary, checks the fit and color of the permanent restoration, and cements it in place.

Caring for Crowns and Bridges

Although crowns and bridges are artificial, the natural teeth beneath and beside them are still vulnerable to decay and gum disease. Bacteria can accumulate at the junction between the crown and the natural tooth, so meticulous oral hygiene is essential. Use a soft-bristled toothbrush and fluoride toothpaste, paying special attention to the gum line.

For bridges, cleaning under the artificial tooth (pontic) is crucial. Use floss threaders, interdental brushes, or water flossers to clean beneath the bridge where a regular toothbrush cannot reach. Your dentist or hygienist can demonstrate the proper technique. Regular professional cleanings every six months help maintain your prosthetics and catch any problems early.

How Long Do Crowns and Bridges Last?

With proper care, crowns and bridges typically last 15 to 20 years or longer. However, several factors can shorten their lifespan:

• Teeth grinding or clenching: These habits place excessive force on restorations and can cause fractures. A nightguard can protect your investment
• Poor oral hygiene: Decay around crown margins or gum disease can compromise the underlying tooth structure
• Chewing hard objects: Ice, hard candy, or using teeth as tools can damage crowns and bridges

What Are Dentures and How Do They Work?

Dentures are removable prosthetics that replace multiple missing teeth. Partial dentures replace some teeth while anchoring to remaining natural teeth, while complete dentures replace all teeth in an upper or lower jaw. Modern dentures are more comfortable and natural-looking than ever before.

Dentures have been used for centuries to replace missing teeth, and modern materials and techniques have made them more comfortable, functional, and natural-looking than at any time in history. They remain an important option for people who have lost many or all of their teeth, offering a non-surgical solution to restore function and appearance.

A partial denture is used when some natural teeth remain. It consists of replacement teeth attached to a gum-colored base, which is connected by a metal framework that holds the denture in place. Clasps or other attachments anchor the denture to your remaining natural teeth. Partial dentures not only fill in the spaces created by missing teeth but also prevent other teeth from changing position.

A complete (full) denture replaces all teeth in either the upper or lower jaw, or both. Upper dentures cover the roof of your mouth (palate) and stay in place through suction against the gum tissue. Lower dentures are horseshoe-shaped to leave room for the tongue and rely more on muscle control and sometimes adhesives to stay in place.

Getting Adjusted to Dentures

Adapting to new dentures takes time and patience. Most people need 2 to 4 weeks to become comfortable with their new teeth. During this adjustment period, you may experience:

• Increased saliva production (your mouth thinks the denture is food)
• Minor soreness as your gums adapt to the new pressure points
• Difficulty pronouncing certain words, especially those with "s" and "f" sounds
• A feeling that the dentures are loose or bulky

Start by eating soft foods cut into small pieces, chewing on both sides of your mouth simultaneously to prevent the denture from tipping. Gradually introduce harder foods as you become more confident. Practice speaking by reading aloud or singing to help your tongue and cheek muscles learn to work with the dentures.

Lower dentures typically require more adjustment time than upper dentures because they have a smaller base and less suction. Implant-supported dentures, which clip onto dental implants placed in the jawbone, provide significantly more stability and eliminate many of the challenges associated with traditional lower dentures.

Caring for Removable Dentures

Proper denture care is essential for maintaining oral health and extending the life of your prosthetics. Remove dentures daily for cleaning and to give your gums a rest. Clean them with a soft denture brush and mild soap or denture cleaner - never use regular toothpaste, as it contains abrasives that scratch the acrylic surface and create places for bacteria to grow.

When not wearing your dentures, keep them in water or a denture soaking solution to prevent them from drying out and losing their shape. Handle them carefully over a folded towel or sink full of water to cushion them if they fall. Even with dentures, brush your gums, tongue, and palate with a soft brush before inserting your dentures to stimulate circulation and remove bacteria.

When Dentures Need Adjustment

Over time, the bone and gum tissue beneath dentures change shape, causing the fit to become loose. This can lead to irritation, sores, and difficulty eating and speaking. Regular dental checkups allow your dentist to assess the fit and make adjustments as needed. Dentures typically need relining (adding material to the base to improve fit) every few years.

What Are Dental Implants?

Dental implants are titanium screws surgically placed into the jawbone to serve as artificial tooth roots. After healing, a crown, bridge, or denture attaches to the implant. With a 95-98% success rate after 10 years, implants are the most durable and natural-feeling tooth replacement option available.

Dental implants represent the most significant advancement in tooth replacement technology of the past 50 years. Unlike dentures and bridges that sit on top of the gums, implants are anchored directly in the jawbone, providing unparalleled stability and preventing the bone loss that typically follows tooth extraction.

The implant itself is a small titanium post, typically 3-5 mm in diameter and 6-16 mm long. Titanium is biocompatible, meaning your body accepts it without rejection, and it has a unique ability to fuse with bone in a process called osseointegration. Once integrated, the implant functions exactly like a natural tooth root, transferring chewing forces to the jawbone and maintaining bone density.

A connector piece called an abutment attaches to the top of the implant once healing is complete. The visible artificial tooth, whether a crown, bridge, or denture, then attaches to the abutment. The result is a restoration that looks, feels, and functions almost identically to a natural tooth.

Types of Dental Implant Treatments

The type of implant treatment you receive depends on how many teeth need replacement and your overall oral health:

• Single tooth implant: One implant supports one crown, ideal for replacing a single missing tooth without affecting adjacent healthy teeth
• Implant-supported bridge: Two or more implants support a bridge replacing multiple adjacent missing teeth, without grinding down healthy neighboring teeth
• Implant-supported denture: Four to six implants in a completely toothless jaw can support a full arch of teeth, providing much more stability than traditional dentures

Who Can Get Dental Implants?

Most healthy adults with adequate jawbone are candidates for dental implants. However, certain conditions may affect your eligibility or require additional treatment before implant placement:

• Insufficient bone: If you've been missing teeth for a long time, bone may have deteriorated. Bone grafting procedures can rebuild lost bone to support implants
• Uncontrolled diabetes: High blood sugar impairs healing and increases infection risk. Diabetes must be well-managed before implant surgery
• Active gum disease: Periodontal disease must be treated and controlled before implant placement
• Certain medications: Bisphosphonates (used for osteoporosis) and some cancer treatments can affect bone healing
• Smoking: Significantly increases implant failure rates. Patients are strongly advised to quit before and after surgery

The Dental Implant Procedure

Implant treatment is typically completed in several stages over 3 to 6 months, though newer techniques sometimes allow for same-day tooth placement in suitable cases.

Planning: Your dentist takes detailed X-rays or CT scans to assess bone quality and plan the precise implant position. This planning phase is crucial for long-term success.

Surgery: Under local anesthesia, the dentist makes a small incision in the gum and creates a precisely sized hole in the jawbone. The implant is placed and the gum is closed over it. Some patients receive a temporary tooth during healing; others may wait with a gap or wear a temporary denture.

Osseointegration: Over 2 to 6 months, the bone grows around and fuses with the implant surface. This integration is what makes implants so stable and long-lasting.

Restoration: Once healed, a minor procedure exposes the implant and attaches the abutment. Impressions are taken, and your final crown, bridge, or denture is fabricated and attached.

Recovery After Implant Surgery

Most patients are surprised by how manageable implant surgery recovery is. You can expect some swelling, bruising, and discomfort for 1-2 weeks, typically well-controlled with over-the-counter pain medication. Many patients return to work the day after surgery.

During healing, follow your dentist's instructions carefully:

• Avoid chewing on the implant site
• Eat soft foods for the first week
• Don't smoke - it dramatically increases failure risk
• Rinse gently with salt water or prescribed mouthwash
• Take antibiotics if prescribed to prevent infection

What Are the Possible Complications?

While dental prosthetics are generally safe and successful, potential complications include infection around implants, loosening of restorations, damage to prosthetics from grinding or hard foods, and bone loss. Most complications can be prevented or treated with proper care and regular dental visits.

Understanding potential complications helps you recognize warning signs early and take steps to prevent problems. Most issues with dental prosthetics are preventable with good oral hygiene and regular professional care.

Implant Complications

Dental implants have very high success rates, but problems can occur:

Peri-implantitis: Similar to gum disease around natural teeth, this infection causes inflammation and bone loss around implants. It's caused by bacterial buildup and is more common in smokers and those with poor oral hygiene. Early treatment can save the implant; advanced cases may require removal.

Implant failure: About 2-5% of implants fail to integrate with the bone. Early failure (within months) is usually due to infection, poor bone quality, or surgical complications. Late failure (after years of function) is typically caused by peri-implantitis or excessive biting forces.

Mechanical complications: The crown or abutment can sometimes loosen, break, or chip. While frustrating, these are usually easily repaired without affecting the implant itself.

Crown and Bridge Complications

The most common problem with crowns and bridges is decay of the natural tooth beneath the restoration. This occurs when bacteria penetrate the junction between the crown and tooth. Sensitivity to hot and cold temperatures may indicate decay or a compromised seal.

Crowns and bridges can also fracture or come loose. This is more common with teeth grinding, biting on hard objects, or inadequate tooth structure supporting the restoration. If a crown comes off, keep it safe and see your dentist promptly - it can often be re-cemented.

Denture Complications

Ill-fitting dentures can cause sore spots, difficulty eating, and impaired speech. The underlying bone and soft tissue continue to change shape throughout life, so dentures that fit well initially will eventually need adjustment or replacement.

Some people develop allergic reactions or fungal infections (thrush) related to denture wear. Proper cleaning and removing dentures at night help prevent these issues.

How Do You Care for Dental Prosthetics?

Care for fixed prosthetics (implants, crowns, bridges) by brushing twice daily with fluoride toothpaste, flossing with special tools for bridges, and attending regular dental checkups. For removable dentures, clean daily with a denture brush and soap, soak overnight, and rinse before wearing.

Proper care of dental prosthetics is essential for their longevity and your oral health. While artificial teeth cannot decay, the surrounding gum tissue and any remaining natural teeth are still vulnerable to disease. Bacterial plaque accumulates on prosthetics just as it does on natural teeth, potentially causing gum disease and bad breath.

Daily Care for Fixed Prosthetics

Implants, crowns, and bridges require care similar to natural teeth:

• Brush twice daily: Use a soft-bristled toothbrush and fluoride toothpaste. Electric toothbrushes can be especially effective around implants
• Floss daily: Regular floss works for crowns on single teeth. For bridges, use floss threaders, interdental brushes, or water flossers to clean under the pontic (artificial tooth)
• Rinse with antimicrobial mouthwash: Helps reduce bacteria around prosthetics
• Avoid damaging habits: Don't chew ice, hard candy, or non-food objects. Don't use teeth as tools to open packages

Daily Care for Removable Dentures

Dentures require specific cleaning routines:

• Remove and rinse after eating: Rinse dentures under running water to remove food particles
• Clean daily with a denture brush: Use a soft brush designed for dentures and mild soap, dish detergent, or denture cleaner. Avoid regular toothpaste - it's too abrasive
• Soak overnight: Most dentures need moisture to maintain their shape. Use water or a denture soaking solution
• Rinse before wearing: If using a soaking solution, rinse dentures thoroughly before putting them back in your mouth
• Clean your mouth too: Brush your gums, tongue, and palate with a soft brush before inserting dentures

Regular Dental Visits

Even with excellent home care, professional maintenance is essential. Your dentist can identify developing problems before they become serious, professionally clean areas you may miss, and adjust prosthetics as needed. Most patients with dental prosthetics should visit their dentist every 6 months.

Frequently Asked Questions