Treating Spaces

Loss of teeth often causes problems for those that remain, and if towards the front of the mouth can affect appearance and speech.

A full set of teeth work as a team, spreading the biting forces and supporting each other, usually prevent food trapping. When a single tooth is lost subtle changes in bite can occur causing other teeth to tilt and move out of the bone. Changes in the bite can cause new forces on other teeth, which may chip or break, even on the other side of the mouth. In the worst cases it can harm the jaw joints causing pain such as frequent headaches. Tilting and movement of teeth can leave areas of gum vulnerable to attack by harmful bacteria, eventually causing loss of more teeth.

For some people, the gradual loss of teeth results in them having no natural teeth. A very few live out their lives with no dentures, but most want improved appearance, normal speech, and better ability to chew, albeit nowhere near the same as healthy natural teeth.

Treating spaces may consist of replacing a single tooth or the whole dentition. Because dentures can't be compared to normal teeth, we often say to patients that they need to consider them as substitutes for spaces rather than teeth, so they don't have high expectatiions. Very few can eat steaks, except the minced variety, or bite into apples, unless chopped up, once they have full dentures.

Ageing and lost teeth

Bone around teeth is maintained so long as biting forces pass through it. Once a tooth is lost some bone is gradually removed as it is not needed.

As gaps increase in size and number cheeks and tongue may be drawn into the spaces and become damaged or ulcerated as chewing takes place. As we age the elasticity of tissue decreases making the situation worse.

When all teeth have been lost a great deal of bone is removed (by the body) to the point where the lower jaw may not stick up between the tongue and cheek at all. A denture made will be pushed around by cheek and tongue, but there is no particular place it fits against the gum. Surprisingly some people manage to control and eat with these, but many are constantly searching for something better and go from dentist to dentist having sets made.

Loss of teeth without proper replacement gives that sunken in appearance adding years to the actual age.

It is much better to avoid this situation, unless you are psychologically capable of coping, but you won't know until its too late to do anything else.

With advances we (dentists) thought this was a thing of the past, but recent NHS changes may encourage its return. With greater encouragement to extract rather than undertake more complex treatment, potentially saveable teeth will be lost. This will create an unacceptable divide between those who want, and can afford private treatment and those who rely on the NHS. The barrier to changing this is the number of people who want to access NHS dentistry, because they 'support the NHS' or 'they're entitled to it' or 'they've paid their stamp'. In reality there is not enough money to treat them as they should be treated, and the really poor, who have no choice, are being denied proper care, because valuable funding is being diverted to those who could choose otherwise. Politicians will not admit to this or do anything about it, because too many votes are at stake. NHS dentists can't say what is happening because they will lose their contracts and livelihoods. As a private practitioner I can say it as it is, even though it may annoy those who prefer a veil over what is happening.