What if I’m just missing one or two teeth? Generally if someone’s missing one or two teeth, we’re not going to make a denture that goes on top. We’re just going to put a single, permanent crown that goes in place, or a bridge, and if someone’s missing two or three teeth, you don’t necessarily need to have an implant for every single tooth but you do need to have enough implants to support the number of teeth that’s missing in that area and also the force and function that’s being put on it. So if you’re missing one tooth, yes you do need one implant, but if you’re missing three teeth, you could actually do two implants and just do a bridge in between. You’ll see some of the examples of this.
Ken—Missing Four Teeth
This is a situation, this is going back to back to 1994. This is almost 20 years ago today, and this is Ken, and actually, I just saw him the other day, so this is 19 years ago today. He was missing four teeth. We put in three implants to support the four teeth that were missing, and this has held well for the last 19 years. This is how it looks in the mouth, and there it is, that was at the 11 year mark, but I can tell you I just saw him last week and 19 years later it’s still holding well.
Missing both Molars
This person is missing both molars. There it is there in the mouth. These are the implants with the crowns in place 12 years after we had done the treatment. And there it is there, it’s a kind of a funny configuration because of the tilt of that one tooth, but it’s holding very well
Seven Teeth Replaced
Another situation done 13 years ago today. There was an upper bridge, some teeth failing, the other teeth were salvageable and we could fix. We had to replace seven teeth and there’s five implants holding that seven-tooth bridge in place. And here it is in the mouth and on the x-rays, and the before and after that you can see.
Different Combinations of Missing Teeth
These next pictures I’m going to show you we’re going to go through quickly. It’s going to show you a number of different combinations of one, two, three, four teeth missing in various quadrants. This was done well over 15 years ago showing the back molars that are now missing. Here’s one with the upper left. There’s a three-tooth bridge holding that in place with two implants. That’s the same one there. Here are four teeth supported by two implants. Another one there, 12 years after we had done the treatment, and here’s another one with a single tooth.
Problem with Bonded Bridges
Now this one’s a little bit of a different situation. This person already came in with the tooth being replaced with one of these bridges that’s cemented or glued in onto the teeth on either side, and it kept coming unglued and that’s been quite typical of these types of bonded bridges. And as you can see, there the gum is quite concave there. She had lost a lot of bone, now wanted to have an implant. I said, “No problem, we can do that, but we got to build up the bone first,” and that’s exactly what we had done. So, here is the before, and here is the after. And what we had to do simply was to build up the bone first, and then we can place an implant and put the crown in place, and this is now 11 years after we had done the treatment. That implant and that crown is still in place and functioning very well.
Another one showing a single tooth missing. Here we did not only some implant work but we did some cosmetic work. I did some porcelain veneers on the natural teeth.
Another one, this is Jerry who came in to see us. He had a front tooth that was fractured, and we checked to see how it had healed. Took the temporary off. Made him the final tooth and that is his final tooth now that you see there on your screen.
Another one with a tooth that had failed with a vertical fracture that’s what you see on the upper left, the dark coloured tooth there. This is 10 years later. We’d taken that tooth out, placed an implant, placed the final tooth. Ten years later, it’s still looking very good.
Upper right tooth, baby tooth that was still in place because the permanent tooth never formed. This tooth had finally turned black, was decayed, and was failing. Took the tooth out, placed an implant, and placed a temporary tooth right away. Four months later came back and placed the final tooth that you see there.
Single molar, replaced with a single implant. Another single molar placed with a single implant, placed 10 years ago today. Lower left tooth placed six years ago. Another one with a lower bicuspid. So all these teeth as you’re seeing right now are looking more and more like natural teeth, and well if you don’t have a discerning eye, you may not be able to tell which is the natural tooth and which is the implant. And that’s the marriage that we’ve seen today with implants and cosmetic dentistry.
Gum-line Tooth Fracture—Life Changing Fix
Another situation, this is Jean, came in, she was eating dinner at a downtown restaurant and bit into something, fractured her tooth right at the gum line. She was quite beside herself as far as what could be done. We’re able to take the tooth out, took the broken root out, placed the implant on the same day, placed the temporary tooth, and she was able to function and carry on with a temporary tooth in place, and then three months later we’re able to come back and put the permanent teeth in place. We replaced a couple of the other older crowns that were there and just by doing those other three teeth, totally transformed and changed her smile, just by changing the colour, size and shape of those other teeth. Her comment to us was, “Thank you, so much. It’s life changing, and I won’t stop smiling.”
New Life, New Teeth
This last case I’m going to show you is Inga. Although most of what I’ve been talking about in these videos is implants. Just to show you that there are other types of dentistry that we still do, and are equally viable, and it depends on the individual situation.
Inga came in. She had very few teeth, and the ones that she did have were quite sensitive and broken down. As you can see, they’re all worn down. They are very sensitive. She went through a very traumatic time in her life where she literally lived in a war-torn country and a lot of stress, lack of care. She literally ground her teeth away. She had lost many teeth, because there was no way to fix them and restore them, so the teeth were removed when they broke down, and this is what she was left with.
She moved to this country trying to restart a new life having real difficulty because she couldn’t chew and eat comfortably. Teeth were sensitive to cold. She was very self-conscious whenever she went to try to get jobs and conduct interviews. She didn’t like to smile. And as you can see, her teeth are quite worn down. She has worn right through the enamel on these teeth. This is how her teeth look on an x-ray. She is already missing most of her back teeth. What she’s left with is her upper and lower front teeth. As bad as these teeth look, we were able to fix and salvage what she did have. Her teeth were quite worn down, but we were able to repair them, rebuild them with crowns.
So that’s how things looked at the beginning of her treatment before we started, and this is how it looks afterwards when we’re all done. And the close-up of her teeth, that’s the beginning, and that’s the final treatment there. And once again, there’s her top teeth before and after, and her lower teeth before and after. And of course, her close-up smile, and the head and neck shot really reveals it. Not only do you see the difference in her teeth, but if you take a close look at her eyes how that you can see there’s a total difference in her self-esteem, and something that she said how she feels inside about how confident and how comfortable she feels now with her new smile and her new teeth.
And it’s really exciting and fun, and just thrilling to do this type of work. Not only because as dentists, we see the difference in the person’s teeth, but people can really sense and appreciate how different they feel, and it’s so wonderful to see people transform, not only with their smile, but also with their overall appearance and their personality and their self-esteem. People come in smiling like this and when they’re done, they’re just beaming from ear-to-ear and even their eyes are beaming with their new teeth. It’s just really, really exciting and wonderful. It’s an exciting time to be doing dentistry.