I recently consulted an orthondist who advised me that instead of a dental implant, she can actually use braces to pull my two back teeth forward, thus eliminating the gap where the extraction was. She works with Damon braces and seems to think those would help the case. Is it common to do this? What are the trade-offs betwen braces vs. an implant? I am guessing that my periodontist would vote for implant, but is that just because he makes more money that way?
Trade-off Between Dental Implant and Braces for Extracted Tooth?
Doctor Answers (8)
Closing the Space with Braces is a More Permanent Solution
Dental Implants are a great way to replace a missing tooth, but may need to have the crown attached to the top of them replaced after being in for a long time since the implants are anchored in place and don't drift with the rest of teeth. Even in our adult years we continue to grow a little and the implant tooth can appear submerged relative to adjacent teeth. However, the older you are the less you have to worry about this happening.
If you close the space using braces, you don't have to worry about maintaining an implant at all, which can be nice though it will take a long time to close the space, and you might not have the patience for that. Either way the choice is up to you and there are pros and cons to both.
Trade-off Between Dental Implant and Braces for Extracted Tooth
When one is congenitally missing a posterior tooth or has had the tooth extracted due to decay, there are new options now to be able to close the space (TADS) which stands for Temporary Anchorage device. This new technology, along with the Damon braces system, is something that we are utilizing in our office today as another option for patients who are missing teeth. Traditionally, we have set the space up to have an implant placed in the missing tooth area which is still a viable option today. When our patients come in, we go over the advantages and disadvantages of having an implant placed versus closing the space or protracting the posterior teeth forward as another treatment solution option.
The advantages of protracting or bringing the posterior teeth forward are one will have the natural tooth that was given to us in a place of this missing space, so it tends to feel more natural due to the proprioceptive fibers, so the sensory feedback is bette long term. Usually, the periodontal condition around a natural tooth tends to be a lot better than an implant over the duration of one’s life. Also the cost overall is generally less expensive when you close the space versus have and have an implant done. So, financially, the patients tend to come ahead when closing the space.
We heavily weigh both option and consult with the patient’s general dentist and ultimately the general dentist will make the final decision on which way we go from holding the space for an implant versus closing the space. Each person is different, the position of each tooth is different and ultimate final outcome for each patient will be different too.
Implant vs. Braces to Replace Missing Tooth
The decision whether to replace a tooth with an implant or close the space with orthodontics is different for every patient. There is no "right" or "wrong." There are several factors that affect which option is best for you. Is there crowding near the tooth that was removed? Are there other reasons to have braces (like an overbite)? These are questions that an orthodontist can help answer for you when you go in for a consultation. If there are no other reasons for braces, an implant is a great choice. But if there are other reasons for orthodontic treatment, you may be able to "kill two birds with one stone."
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Close Space or Place Implant?
My first thought was if the orthodontist can close up the space using braces, can't she also open up (idealize) the space with braces? With very few exceptions (e.g. wisdom teeth), it is better to replace missing teeth. I commonly use orthodontics to open up and idealize the space for the implant to replace the missing tooth.
Implant tooth replacement vs orthodontics
Replacement of missing teeth is important for various reasons including prevention of other teeth movements and protection of the bite long term. The teeth work together to protect each other. The back teeth help to support the front teeth and the front teeth protect the back teeth by providing a mechanism where by when we chew or grind our food our cusp are not broken.
That being said missing teeth should be replaced in order to maintain harmony in the mouth for longevity.
There is always more than on way to skin a cat. Masking a loss of teeth by moving another tooth in that spot may cause an imbalance and may effect your mouth in a negative way in the future. However, the use of orthodontics to help make room for a missing tooth may be necessary.
In summary, if there is a missing tooth it should be replaced. Replacement options include implant supported teeth, a traditional bridge or a resin bonded bridge. Orthodontics may only be needed to aid in the replacement, of the missing tooth or teeth.
Replace with a new dental implant if possible
The only reason I would recommend closing the space with braces is if it were a second molar that was lost and you are able to bring the wisdom tooth down into its place. I doubt this is the situation, and since I don't have all the information I would recommend the implant option. It is a large investment now, but in the long run, you will guarantee more normality with balance, function, airway, broadness and aesthetics of the arch, etc.
The Damon system is a great system, but it is not without controversy. There is still a little question whether it can do everything they claim it can, and one of those things may be broadening the arch and opening the airway, in all cases treated by it. If you can afford it, definitely plan for the implant.
Trade off between implant and braces for sure!
Well, the space certainly needs to be filled and the two best ways would be with an implant/crown or with orthodontia. Implants usually take about 6 months from start to finish. A three tooth bridge will take two weeks. Braces will take way over a year. So it's all about you the patient and how much time you want to invest in this space problem. Usually, a two week bridge is the wise choice. Usually, not always! Depends on the consults that you receive.
Missing teeth should be replaced, not shifted
When teeth are missing, replacing with implants or bridges is best. Shifting or moving teeth to fill spaces creates an imbalance to the bite and can contribute to airway issues. If the space is too small now for an implant, long term you are better off to orthodontically create space and place the implant.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.