Few procedures in dentistry make a more dramatic difference than the closure of spaces between teeth. Spaces frequently result from a discrepancy between the size of the teeth and the size of the jaw They may also be due to the loss of a tooth or teeth, which allows the other teeth to shift and thus open up spaces.
The most common area for a gap is between the two front teeth. If this gap is no larger than 2 millimeters (1/32 of an inch), the space can be closed with composite bonding. If it is larger, orthodontics, veneers, crowns, or a combination of these approaches needs to be considered.
Another alternative is a removable bridge which does not require crowning of adjacent teeth. The removable bridge is held in place by wire clasps around the teeth on either side of the space, but is not as comfortable or as easy to care for as is the fixed bridge. If there are too many missing teeth, however, and the remaining teeth are loose, a removable bridge may have to be used.
If the gap is due to tooth loss, the tooth needs to be replaced with a fixed bridge. The space is bridged by crowning the teeth on either side of the space and connecting them with a false tooth. The bridge is cemented over the adjacent teeth and does not come out.
To maintain the overall health of the mouth, a lost tooth must be replaced. Teeth are maintained in position by each other. Therefore, if one tooth is lost, the teeth behind the space will tilt forward and the teeth in the opposite jaw will move into the space. With time, these changes affect the bite and cause the loss of other teeth as well. If numerous back teeth are missing, the bite may close down. This could contribute to the formation of wrinkles around the mouth, and thus premature aging in a younger adult.
Fixed bridges have certain advantages. They improve the bite, maintain the position of the teeth, and improve the appearance. The disadvantage of a fixed bridge is that some tooth structure must be forfeited in order for the supporting crowns to be placed on the adjacent teeth. A fixed bridge lasts anywhere from 5 to 20 years and costs between $400 and $1,200 per tooth.
