When you lose a tooth, you usually have three choices.
1. Do Nothing
2. Have a 3-unit bridge constructed
3. A dental implant placed
The problem with option one – not replacing the tooth, is your other teeth tend to move and collapse into the space. This can cause malocclusion or periodontal problems, meaning, you may no longer bite together correctly with your teeth moved, and you can have gum and bone problems around the teeth that move.
Choice number two, getting a 3-unit bridge, entails cutting down the teeth behind and in front of the missing tooth. A 3-unit bridge is then made by a laboratory and the restoration is cemented onto the teeth in front and in back of the missing tooth, with a fake tooth now in-between. The disadvantage to a 3-unit bridge is you have now decreased the strength and integrity of the two teeth holding the bridge. The crown margins, where the crown meets the tooth, is highly susceptible to decay and it may have to be periodically replaced if decay occurs around the margins. The 3-unit bridge is more difficult to keep clean since a floss-threader is required.
The third choice, a dental implant is usually the best choice, although each case does vary. With implant placement, the adjacent teeth do not need to be cut down, and it is much easier to keep clean than a 3-unit bridge. The success rates for dental implants have improved dramatically over the last decade.
If possible, it is wise to get an implant consult with a specialist prior to the removal of the tooth. The specialist, generally a periodontist or an oral surgeon, may want to extract the tooth himself or herself and place a bone graft. Sometimes the implant can be placed at the same the tooth is extracted. This can save up to four months treatment time. If it is decided a bone graft is needed first without immediate implant placement, then you would wait four months for the bone to integrate, and the implant would be placed later.
With this said, each individual case does vary. Sometimes implants are not possible depending on the amount of bone, positioning of the nerves and the maxillary sinus, or because of various health reasons. In the end all options should be weighed and discussed between the dentist and patient, and the best healthiest choice should be chosen.