Artificial Teeth

Artificial teeth are the ones which are carefully customized by a dental team in order to fill the gaps which are formed in the mouth after losing the natural teeth. Some artificial teeth are commonly used to provide support to a root canal treated tooth. These teeth are made to best resemble your natural teeth in shape, color, and size.

Artificial teeth are of various types. Here is a list of the ones which are commonly used:

• Fixed (which are placed in your mouth to stay there permanently) or removable (which are supposed to be removed for cleaning purpose every day).
• Single (which cover or replace a single tooth) or multiple (which cover or replace multiple teeth)
• Porcelain, acrylic, metal, or a fusion of these. These are the materials with which artificial teeth are made.
• Complete (which replace all the teeth when you do not have a single natural tooth remaining in your mouth) or partial (which replace one or more lost natural teeth).
• Temporary (which are supposed to be worn by you till permanent teeth are ready) or permanent (completely processed final set of artificial teeth)
• Restorative (those which are fixed on natural teeth to improve their appearance) or replacing (those which take the place of lost natural teeth)

Fixed artificial teeth

These teeth are placed in your mouth to be there as long as possible. These include crowns, crowns and bridges which replace one or more teeth (fixed partial dentures), and overdentures (complete set of 28 artificial teeth).

• Crowns
  Crowns are cap-like structures which fit on a ground tooth or implant (artificial tooth root made of titanium metal) just like how a pen cap fits the pen. They can be given to partially or fully cover your healthy or root canal treated tooth. Those which are given on a healthy tooth are usually for cosmetic purposes to improve the shape and appearance of your teeth or to hide discoloured teeth. In babies, stainless steel crowns are given to provide support to an extensively damaged tooth or in children who do not or cannot maintain oral hygiene to prevent damage due to cavities. They can be also made with porcelain, acrylic, ceramic, stainless steel, metal alloys, or a fusion of these.
• Crowns and Bridges
  Artificial teeth can also be attached between two crowns and the whole set is known as a bridge. The natural teeth and screws (implants) which are used as pillars on either side are known as abutments. Crowns and bridges can be made with metal, tooth-coloured resin material (acrylic), ceramic, porcelain or in a combination of these.
  In the middle, the bridge has a single or a span of multiple artificial teeth (called pontic) between the abutments. The pontic covers the toothless gap which is present between natural teeth or implants.
• Overdentures (fixed complete set of artificial teeth)
  These are a set of 28 artificial teeth (14 teeth for each jaw bone) which are placed and fixed on the screws (dental implants) permanently. These are also known as implant-supported dentures. After every 2-3 teeth, a crown or cap is present which is supposed to fit on the screws.

Removable artificial teeth

Removable artificial teeth are those which you can take out of your mouth anytime. These are worn during the day and are taken out at night. These teeth can be made of acrylic, porcelain, metal, or a fusion of these. These teeth are usually used with a pink plastic base (denture base) which covers the gum area. The artificial teeth are attached to this denture base and the set is worn as a whole. These may take support from the tooth (intracoronal) or from soft tissue (extracoronal) or both. They are of following types:

• Removable partial dentures
  These are the artificial teeth which are provided to you if you have lost a few teeth and still have other natural teeth remaining in your mouth.  
• Complete dentures
  These are traditional dentures which are most commonly made for people who do not have a single natural tooth left in their mouth.
• Immediate dentures
  These are a type of removable dentures which are fabricated before the surgical removal of the natural teeth is done. These are placed in the mouth right after the natural teeth are removed. They prevent the loss of bone height and also fit well in the mouth.

Depending on the procedure, it is either done by a general dentist or a prosthodontist (an expert dentist who specializes in replacing the lost teeth). Before starting the procedure, you will be required to give a detailed history of your physical and dental health to the doctor. Any medical condition that might affect or hinder the treatment outcome will be noted by your dentist. These include the current condition of your gums, your remaining natural teeth, the amount of loss of jaw bone, stability of the abutment teeth, the extent of mouth opening, any disorder of the joints especially the joint of your jaw bone with your head which is present near your ears, the condition of your facial muscles, any past dental treatment that you have received, the status of the root canal treatment of the abutment teeth, any infections in the body or in the mouth, etc. Your dentist will also conduct a detailed examination of the outer and inner aspects of your mouth. After all this, your dentist will tell you in detail about the best option for you and the reasons for choosing it. Various procedures for getting artificial teeth are as follows:

Fixed artificial teeth
Fixed artificial teeth are usually given on a natural tooth, a root canal treated tooth, and on implants. If your dentist finds you suitable for this procedure, you will undergo the following steps to get your fixed artificial teeth:

• Crowns
  For placing the crowns, your dentist will first examine the status of your tooth. If there are chances of sensitivity or damage to the pulp after the treatment, your dentist will advise you to undergo root canal treatment (RCT) of that tooth. After the RCT, your dentist will check whether it is successful or not. For this, you will be required to get an X-ray done. If the X-ray shows healthy and healing areas, your dentist will proceed with the grinding of your teeth.
  Before starting the grinding process, your dentist will do a quick check-up of your gums and teeth in your mouth. If there is no pain, pus, swelling, or bleeding, the dentist will start shaping and preparing your teeth. A powered instrument with water spray is used for this. Your dentist will take a negative replica (tooth impression) of your teeth before and after grinding. This is important to use the details of your natural crowns to be transferred to your artificial crowns. Depending on the type of crown needed, the dentist will grind one or two sides (for a partial crown) or all the surfaces of your crown (for a full crown). Usually, in partial crowns, the new crown is placed on the same visit using an adhesive material. In full crowns, after the tooth impression, your dentist will temporarily put an easily removable crown on your tooth until your new artificial crown is ready. It might take a week or two before your new crown is ready. It depends on the dental lab where your crown is being made. In your next visit, your dentist will remove your temporary crown and place the new crown with a cementing material which will strongly seal your teeth with the new caps. A cap can also be placed on a screw (dental implant) in case the chances that the implant treatment will be successful are high.
• Crowns and Bridges
  The procedure is similar to that of placing a crown. The only difference is that here, two natural teeth are ground and crowns are placed on them with attached artificial teeth between the two caps. When you have a short gap between your teeth, the teeth on either side of the gap can be used as pillars (abutments). Your dentist will check these teeth to see if they are stable and strongly placed in the bone, and your skills and keenness towards maintaining oral hygiene are good. If screws (implants) are used as abutments, the condition of your jaw bone, your health status, and your oral hygiene will also be assessed. Implants can also be used as abutments and the crown and bridge set is placed on them.
• Overdentures (fixed complete artificial teeth)
  In this procedure, your customized set of artificial teeth is made just like how a removable complete denture is made. After the examination, your dentist will put a few screws in your mouth in both upper and lower jaw bones. After putting the screws, their position will be determined on the previously made teeth set. This is important to make sure that the teeth set fits well on your screws. Your bone will take a few months to heal and after that, your dentist will call you for your next appointment to fit the teeth on the screws.  

Crowns and dentures are also made using computers which design your denture after getting the details of your face structures by taking various X-rays. These are called CAD-CAM dentures.

Removable artificial teeth
If your dentist finds you unsuitable for a fixed denture procedure because of your health condition, the condition of your jaw bones or due to financial reasons, you may be advised to get removable artificial teeth. The procedure that you can expect is as follows:

• Removable partial dentures
  These are given when a few of your natural teeth are lost. In the first appointment, following a complete mouth checkup, your dentist will take an impression of your teeth to make a mold on which teeth will be placed using wax. This pattern will be tried in your mouth in the next appointment to see if your natural teeth are aligned well with the other adjacent as well as the opposite natural teeth. Once the trial is done, your teeth will be processed to replace the wax with a strong and durable material. In your final appointment, your dentist will place these teeth in your mouth and make adjustments if necessary.
• Removable complete dentures
  The procedure for complete dentures is similar to that of partial dentures, except for a few additional steps. The dentist will use a rubbery paste to take a negative replica (impression) of your toothless jaw bones and the soft tissue in the first appointment. In the second appointment, your dentist will again take a detailed impression (final impression) of your jaws and the soft tissues. This is a very important step because if it is not done properly, your dentures will not fit in your mouth. Since these are removable, it is important to take great precautions while taking impressions to record fine details. This will help your dentures to stick to the underlying soft tissues and the bone.
  In the next appointment, your dentist will put wax-made strips with a base to check various aspects of your mouth and face such as the expected level of your artificial teeth, your ability to speak if you wear a similar final denture, tension in your muscles after wearing the wax-pattern, the way you open and close your mouth, etc. Once this is done, your dentist will set artificial teeth in that wax and a trial will be done in your next appointment to check whether the teeth are placed according to your face structure. Your dentist will also check if you are comfortable while opening and closing your mouth, speaking and swallowing. These teeth are then processed in a dental laboratory to replace the wax with a strong plastic or metal base in which the teeth are firmly fixed. In your final appointment, after making the necessary adjustments, your dentures will be given to you.   

One of the most important factors which decide how long your artificial teeth will last is the precautions and care taken by you in maintaining them. Here are a few things to be kept in mind after getting your artificial teeth:

• Maintain oral hygiene
  You should maintain good oral hygiene. Brush twice a day and rinse your mouth after every meal. If you have fixed artificial teeth, make sure that area is not lodged with food. If you have removable teeth, it is important that they are taken out after every meal, washed and worn again.
• Limit alcohol consumption and smoking
  Smoking usually makes your gums recede or move away from your teeth. This will result in the loss of bone surrounding your teeth. Once enough amount of bone is lost, your teeth will become unstable and they will start moving. If the teeth start moving, it will also cause movement of your artificial teeth which are attached to them and may eventually lead to the loss of your natural teeth, falling out of your fixed teeth, and failure of the implants.
• Take a balanced diet
  A good diet will not only maintain your overall health but will also prevent the loss of jaw bone, dehydration and irritation of your soft tissues, adequate flow of saliva not only helps in removing food particles but also helps in retention of your removable partial or complete dentures.

Read more: Balanced diet chart

• Cleaning of artificial teeth
  The removable partial dentures should be cleaned in the morning with cotton or brush and soapy water. They should not be cleaned with a toothpaste. Once they are cleaned, they should be worn throughout the day. At night, they should be taken out, washed, and stored in water in a capped jar (to protect them from rodents and insects). Replace the water with clean water every night.
• Visit your dentist to make sure your denture, teeth and soft tissues are in good condition
• Do not chew tobacco. This will not only discolour your denture, but will also irritate your soft tissues, cause bone loss, reduce your mouth opening, and may also cause mouth cancer.

There are various benefits of getting your lost teeth replaced by artificial teeth:

• Full crowns restore the strength of your teeth and give them a look similar to your natural teeth.
• Partial crowns improve the appearance of your teeth and make them look brighter and in good shape.
• After replacing your lost teeth with artificial teeth, you will be able to chew and speak in a better way.
• Artificial teeth restore the fullness of your face and improve your appearance.
• Fixed teeth which are placed on implants also prevent loss of jaw bone.
• Artificial teeth also improve the tone of your facial muscles.  
• Having your teeth back also improves your self-esteem and boosts your confidence.

Artificial teeth have a very few side effects. However, you can expect the following problems on wearing artificial teeth

• Some crowns made of porcelain cause wearing of the opposite natural tooth. They also make clicking sounds when the teeth are clenched.
• Initially, you may face difficulty in adjusting them in your mouth. It may cause slurred speech, increased salivation, and increased self-consciousness about how your teeth make you look.
• Removable artificial teeth cause slow resorption of your jaw bones, eventually making them loose and ill-fitted.
• Removable teeth also move a lot in the mouth and may also come out or fall down while coughing, talking, and laughing. This can cause embarrassment in public places.
• Removable dentures become loose over a period of time and need to be made again as the condition of your jaw bones and soft tissues changes.
• Fixed dentures are mostly expensive.
• You may be allergic to the materials used in denture making. This may irritate your soft tissues and your dentist may advise you to stop wearing them for a while.
• If the denture is ill-fitted, it may cause stressing or sagging of your facial muscles, your face may either appear shorter or longer and may also cause pain in your jaw joint (joint between your lower jaw and head).

Cost of artificial teeth vary greatly depending upon the type of material used, the number of teeth to be replaced, whether the crown is full or partial, fixed or removable, charges and expertise of your dentist, the quality and warranty of your artificial teeth, and whether you are going to a government or a private clinic.

This is a list of the estimated costs of various artificial teeth, however, charges may vary depending on the factors mentioned above:

• Metal crowns: 1500-3000 INR
• Partial ceramic crowns: 2500-5000 INR
• Porcelain fused to metal crowns: 3500-5500 INR
• Full ceramic crowns: 6000-15000 INR
• Zirconia crowns: 6000-18000
• Removable complete dentures: 5000-30000 INR
• Removable partial dentures: 5000- 15000 INR
• Implant abutment: 5000-35000 INR
• Overdentures: up to 100,000 INR