We’ve come a long way in our ability to restore missing teeth. Today’s top choice is dental implants, prized not only for their close resemblance to real teeth but also their durability.
The rise of implants, though, hasn’t put older restorative methods out to pasture—many continue to offer patients a viable and affordable choice for tooth replacement. One example is the removable partial denture (RPD).
Once quite common, RPDs’ popularity has only slightly diminished with the advent of implants. They’re a fair option in terms of dental function and appearance, and much less expensive than implants or fixed bridges.
Similar to a full denture—a removable appliance that replaces all the teeth on a dental arch—a RPD can replace multiple missing teeth in a variety of configurations. A traditional RPD is usually constructed of vitallium, a lightweight but strong metal alloy, which allows for a very thin and comfortable frame. It’s covered in a gum-colored resin or plastic with prosthetic (false) teeth precisely set at the missing teeth’s locations. The appliance stays in place through a series of clasps that attach to the remaining teeth.
Each RPD is custom-made to fit a patient’s mouth contours and the locations and patterns of the missing teeth. The top design goal for each individual RPD is to minimize any rocking movement during chewing; achieving that goal will depend not only on how many teeth are missing and where, but also what type of teeth are being replaced. For example, teeth missing from the back would require a different support design than teeth missing from the side or front.
RPDs’ biggest benefits are comfortable fit, effective dental function and good appearance. However, their means of attachment can create difficulties keeping remaining teeth clean of disease-causing bacterial plaque. Furthermore, an ill-fitting or unstable RPD could damage or even loosen natural teeth. It’s therefore essential for wearers to diligently practice daily hygiene (including cleaning the RPD) and undergo regular fit monitoring with their dentist.
Even with these constraints, a RPD can do an acceptable job providing dental function. What’s more, it can definitely improve your smile.
If you would like more information on options for dental restoration, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
Besides reduced biting and chewing function, a missing tooth can cause an embarrassing inhibition to healthy social interaction. This can be especially so for teens who greatly value peer relationships and acceptance.
Be that as it may, we typically discourage a permanent replacement for teens with a missing tooth, particularly dental implants. While we value a patient’s psychological needs, the long-term effect on dental health may be too great to advise otherwise.
The effect we’re concerned with involves jaw growth and development. Although a person’s permanent teeth have usually all erupted by early adolescence, the jaws continue to grow until the late teens or early twenties. Natural teeth can adapt to this growth because the periodontal ligament that holds them in place allows for incremental tooth movement. The teeth move in response to jaw growth and are thus able to maintain their proper relationship and alignment in the jaw as growth occurs.
Dental implants, on the other hand, are imbedded into the jaw bone: they, therefore, can’t move like natural teeth and thus can’t adjust their position with jaw growth, particularly the upper jaw as it grows forward and down. This can result in the implants appearing as though they are left behind or retreat into the jaw. It can also affect the position of the gums and inhibit their growth around the implants.
It’s best then to hold off implants and other permanent restorations until the jaw has finished developing. That, however, isn’t always easy to determine: specialized x-ray diagnostics may help, but it’s not an exact science. Your input as a parent will also be helpful, such as whether you’ve noticed the end of growth spurts (not changing clothes or shoe sizes as often) or your child’s recent similarity in appearance to other adult members of your family. It thus becomes a judgment call, based on examination and experience, as to whether it’s safe to proceed with implants — and may require erring on the side of caution.
In the meantime, there are temporary restorations that can improve appearance while you wait for the appropriate time to undertake a permanent restoration. Two of the most useful are removable partial dentures (RPDs) or a bonded bridge, a less invasive form of the traditional bridge. With a proper assessment we can advise you on which option is your best choice.
If you would like more information on tooth restorations for teenagers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teenagers & Dental Implants.”