The current form of dental implants came into being in the early 80’s. Today they are considered the standard of care.
One of the biggest dilemmas dentists and patients have, every day is when to replace a tooth with an implant. Before implants became available, dentists replaced missing teeth with cemented fixed bridges or removable partial dentures. This is still an option and sometimes the only one.
If teeth have been missing for a long time, placing implants may be difficult or impossible. And, to have a cemented bridge, one usually needs healthy teeth on both sides of the space.
While having a cemented bridge is considered more desirable than a removable appliance, one of the downsides of a cemented bridge is that the dentist has to grind down the surrounding teeth which may be perfectly healthy and attractive. The beauty of the implant treatment is that we don’t have to grind down the surrounding teeth. They remain untouched, and the implant goes into the bone where the tooth is missing.
Remember that the implant is usually a two part process. The actual implant replaces the root of the missing tooth, so it is below the gum line and then you still need a crown on top of the implant with which to chew and smile.
Consequently, if the surrounding teeth are unattractive or have old, failing restorations, then a fixed bridge may be the better choice since it will cover the surrounding teeth with new, attractive materials as well as replace the missing tooth.
Another factor to consider is whether the failing tooth requires root canal therapy because of infection in the nerve. For this to be worthwhile, the tooth in question needs to be structurally sound because root canal therapy can weaken it.
As I mentioned above, this is one of the most difficult decisions we have to make today in dentistry. Implants are not without problems and complications, and there is nothing better than your natural tooth so removing it to place an implant is something that requires careful consideration.