The eternal quest to replace missing teeth

By From page A9 | June 23, 2013

Replacing missing teeth has been a human quest from even earlier than you would believe. “The Phoenician Dental Bridge” made of four natural teeth and two carved ivory teeth bound with a gold wire dates back to 2,500 years ago. Teeth carved out of shells and implanted in jaws by the Mayans date back to about 1,500 years ago.

Modern concepts of replacing missing teeth are an extension of this ancient quest; but today we are much better equipped and far more sophisticated.

There are many other benefits to having teeth besides chewing. Teeth maintain smiles, aid in speech, and help define the shape of the face. Teeth, when fit properly, also maintain the harmony in which the jaw joint, nerves, bones and muscles of the face function together.

Dentures are probably the most commonly known, yet dreaded option for replacing missing teeth. It will not be surprising if someday scientists prove that George Washington’s grim-faced portrait on the dollar bill is mostly due to him wearing dentures. Although modern denture materials are more natural-looking, lighter and less bulky, most studies concur that dentures provide only 20 percent of the bite strength of natural teeth.

Until the advent of modern tooth implants, dental bridges have been the most popular option. A patient is guaranteed to have a temporary plastic bridge that can provide immediate function and aesthetics in one visit, while the final bridge is being made at a laboratory within a couple of weeks.

But this is at the expense of removing healthy tooth structure from neighboring teeth to anchor the bridge. These supporting natural teeth will then further suffer from excessive load, future inevitable dental work, and even the risk of tooth loss, turning one tooth problem into multiple issues.

Dental implants are currently the best available solution. A titanium root is placed in the jaw bone and supports a natural looking tooth without any damage to neighboring teeth. Dental implants do not decay and have an overall success rate of about 95 percent; however, they can still develop gum and bone disease and thus require maintenance similar to that of natural teeth. They also require a longer healing time of up to four months before they can be fully functional, when compared to bridges.

So what is next? Recently, scientists were able to re-grow a tooth from mouse stem cells and transplanted it into an adult mouse. It would be wonderful if we could witness re-growing teeth in humans in our life time!

— Dr. Alassaad is in private dental practice in Davis. Contact him at [email protected]

Samer Alassaad

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