Missing Permanent Teeth: Braces or Implants?

Hi, I am 20 years old and I have a spacer in my right upper jaw because I am missing a permanent tooth. I have a baby tooth in my lower left jaw (I believe my lower left 2nd bicuspid) and a baby tooth in my upper left 2nd bicuspid. My lower right 2nd bicuspid is slightly turned. To get braces my baby teeth would be pulled out and my teeth would be moved forward. Would braces or implants be better?

Doctor Answers 6

Missing permanent teeth

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If the permanent teeth are missing in their place there are temporary teeth - they`re able to hold the space. If the space is not adequate, the braces can be recommended. In any way, after braces the implants will be more predictable long-term option.

Missing Permanent Teeth: Braces or Implants?

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Many patients have been through the same problem and it is not hard at all. It just planning and time what takes in place, from your dentist, the orthodontist, the surgeon and yourself. The long-term option will be to pull the baby teeth and have braces done. The orthodontist will stay in touch with the surgeon when its ready to have the implants placed, and by the time your are done with braces your implants will be ready for crowns. The end result will give you a broader, healthier and stable bite. Because implants needs time to heal and braces takes some time, everything is planned well.

Pamela Marzban, DDS
Fairfax Dentist

Missing Permanent Teeth: Braces or Implants?

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Many patients have the situation you describe where a permanent tooth does not develop. In some circumstances the baby tooth never falls out. The issue is that the baby tooth and the permanent tooth are different sizes and that can throw the whole alignment off.


I would meet with an orthodontist first. I would ALSO meet with a great cosmetic dentist at the beginning as well. 

II almost always see these baby teeth begin to give problem when patients reach their late 40's. If you don't deal with it now, you'll be doing it then.


With a good plan right from the beginning, you will know what to expect, have a good idea what your smile will turn out like, and have a good understanding of the pros and cons of each approach.



Implants or braces for missing teeth

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It sounds like you have several missing permanent teeth, with a number of baby teeth retained.  Usually we plan to either replace the baby teeth with implants or, in particular cases, close some of the spaces with braces.  Closing the spaces is appropriate only in cases where doing so will not overly retract your front teeth, and when it is orthodontically possible to do so.  For most cases, NOT closing the spaces is best.  Sometimes it is best to LEAVE the baby teeth for a number of years and replace them later; because doing so preserves the bone for eventual implants.  Some people can retain healthy baby teeth for years with no ill effects, but in other cases, they need to be removed right away.  The only way you will know which approach is best for you is to visit an orthodontist or cosmetic dentist and get a thorough diagnosis.

Brian Povolny, DDS, PhD
Seattle Orthodontist

Braces VS dental Implants to close space

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Not having a photo is hard to tell, but here is the rule of thumb:

If you have not discrepancy in the anatomical structure, meaning that your arch is not in need of improvement, and you jaw  is not collapsed and small , then Orthodontics is OK, but if you have a small arch, and short height when you put your upper and lower teeth together, then implants preserve more bone and you should go that  route.

Almost always the combination is better. implants save bone and fill the space, and braces put the jaw in order. 

Soheyla Marzvaan, DDS
Orange County Dentist

Braces or Implants to Replace Missing Teeth or Retained Baby Teeth

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Often a case like this is best treated using both orthodontics AND implants. Missing baby teeth often requires more tooth movement than is appropriate to fill the spaces. One thing you want to be very careful about is that front teeth are not overly retracted orthodontically to fill spaces as this could lead to jaw joint problems and unexpected and unwanted changes in lip support and facial appearance.

Great question and good luck!

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.