Interesting Green: Don’t grin and bear it

Today, Tuesday, December 13, 2011, Page T8 - T9, Health
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Source Website: http://www.todayonline.com/Health/EDC111213-0000018/Dont-grin-and-bear-it
By Eveline Gan, eveline@mediacorp,.com.sg, 04:45 AM Dec 13, 2011

PHOTO: Mind the gap -- or it might be too late.
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Today, Tuesday, December 13, 2011, Page T8 - T9, Health

What can you do if you have missing teeth?

SHE was only in her early 50s but when she put on dentures to replace seven of her missing and damaged teeth, Agnes Fong felt like she had aged decades.

"I didn't dare tell anyone that I was wearing dentures. They would laugh at me. I felt like I was becoming my grandmother, who wore a mouthful of dentures and couldn't chew anything properly," said Agnes, a businesswoman, candidly.

She put up with the "embarrassment" for half a year, before switching to bridging and crowning after being advised by her new dentist.

PHOTO: Put up with the "Embarrassment"
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http://www.diabetesmine.com/2011/09/laughing-over-diabetes-beats-the-alternative.html

Although the procedure cost her "an arm and a leg" - the S$7,000 bill was 14 times the price of her set of dentures - Agnes said it was all worth it as she can now eat normally. Plus, she no longer has to worry about her dentures falling out of her mouth.

Eager for a more long-term solution for his missing front tooth after a sports injury, 48-year-old architect CK Lim decided to fork out S$5,000 for a high grade titanium dental implant last year.

Despite the high price, CK feels the implant is a "sound investment".

He said: "It meant that I could have a perfect smile again, that looked natural and was long lasting."

PHOTO: A perfect smile that looked natural and is long lasting.
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A toothless grin may look cute on a preschooler, but for adults like Agnes and CK, missing teeth are a source of embarrassment.

Although tooth loss is mostly associated with the elderly, Dr Choy Keen Meng, clinical director of Toof Doctor Dental Surgeons, said research shows that about one in five people lose their first tooth between the ages of 21 and 30.

PHOTO: There are health reasons why missing teeth should be replaced. Chew better and teeth may drift.

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Why you should fill that gap
Apart from aesthetic and self-esteem reasons, Dr Marlene Teo, periodontist of TP Dental Surgeons, said there are other health reasons why missing teeth should be replaced.

"It allows the person to chew better. If missing teeth are not replaced in the long run, the adjacent teeth may drift into the spaces. This may affect the person's bite," she explained.

Dr Choy advised that one should also get those gaps filled as soon as possible - preferably within three months - instead of waiting indefinitely.

When you lose a tooth and do not replace it, the jaw bone starts to dissolve and shrink, becoming thinner. Dr Choy explained this makes it difficult to have dental implants or even wear dentures in the future.

While missing teeth were treated more conservatively in the past, today's teeth replacement options have become more varied.

According to the experts, there are three ways to replace missing teeth: Using dentures, bridges and implants.

What best suits you will depend on your preference, health, jawbone quality and how much you are willing to pay.

"There is no one-size-fits-all type of teeth replacement option. However, in general, for a younger adult, I would recommend a dental implant to replace a missing tooth," said Dr Teo.

Weighing your options:
Dentures

PHOTO: Some people may feel ashamed to be subjected to wearing dentures.

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Today, Tuesday, December 13, 2011, Page T8 - T9, Health

What: We've all seen them in our grandparents' mouths, and left overnight on the bathroom counter. These removable device anchor plastic teeth with a plastic or metal base, secured using clasps.

The Good: Dentures are relatively inexpensive compared to bridges and implants. For instance, to replace several missing teeth, Agnes' set of partial dentures cost only about S$500. No surgery is involved.

The Bad: According to Dr Choy of Toof Doctor, dentures are becoming less popular nowadays as they are the least stable and aesthetically-pleasing of all the treatment options.

Compared to the other options, dentures have the shortest "shelf life".

Said Dr Choy: "On average, they only last about five years. You also have to take them out at night. Partial dentures require two healthy teeth on either side for support. This is a challenge for older adults with weakened teeth."

Even for people with stronger teeth, denture clasps can damage the teeth they hook onto, added Dr Teo of TP Dental Surgeons.

"Loose dentures can even drop out while you're talking or eating (yikes!), creating potentially embarrassing social situations," said Dr Choy.

Bridges

What: As its name suggests, dental bridges quite literally bridge the gaps between your teeth. It is typically made of two crowns on either side of the missing tooth, and a false tooth/teeth in between. It is then fitted over the surrounding teeth and cemented permanently.

The Good: Bridges are a long-term fix and do not need to be removed at night. Unlike dentures, they also look and feel more natural. According to Dr Teo, bridges are a good option for people who are not good candidates for surgery, or are afraid of undergoing surgery.

Compared to dentures, studies show that with proper care, bridges can last for more than 10 years.

The Bad: With bridging, two (healthy) adjacent teeth will have to be ground down to support the missing tooth or teeth in between them.

"Teeth that are ground down may develop problems and may need root canal treatment in the future," explained Dr Teo.

She added that bridging links several teeth together (to form the bridge). Should one tooth fail, the rest of the teeth will eventually suffer.

Bridging is not suitable for people who have too many missing teeth in a row, and do not have strong enough teeth on either side for support.

PHOTO: Model of dental implant.
Dental implants are most favoured, but they are costly and time-consuming.
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Today, Tuesday, December 13, 2011, Page T8 - T9, Health

Implants
What: The most favoured option among many dental specialists to replace missing teeth, implants are artificial tooth roots (small titanium screws) that are surgically inserted into the jawbone. A crown is then attached to the implant.

The Good: According to the dental experts, implants look and feel the closest to natural teeth as they are integrated into the jawbone.

Your neighbouring teeth are spared as implants do not rely on them for support, and your dentist only needs to work on the missing bits.

Dr Teo recommends dental implants for younger adults. She said the new generation dental implant systems available now have well-documented studies to support its success rates, some of which are as high as 98.8 per cent after five years.

In fact, Dr Choy added that for people with good oral health, an implant should be able to last 20 years or more.

Although dental implants are the most costly of all three options, it can be claimed via Medisave as it is considered a surgical dental procedure.

The Bad: On the downside, you will have to undergo minor surgery to place the titanium root into the bone. Sometimes, you may require a bone graft to enhance bone volume, added Dr Teo.

The process of having dental implants is also relatively time-consuming. You will need to wait up to 12 weeks for the implant fixture to integrate with your bone, before a crown can be placed.

If you are suffering from poor health, you may not be suitable for an implant procedure. Implants may also be too expensive an option for people with many missing teeth.

By Eveline Gan, eveline@mediacorp,.com.sg, 04:45 AM Dec 13, 2011