Healthy Smile: They Told Me That I Need a Denture Because I Lost My I-Tooth

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

I can see all the letters and phone calls coming in. “Dr. Gross, is that a typo or didn’t you proofread?” The Apple Corporation makes so many products that begin with the letter “I,” such as the iPhone, iPad, etc. that we expect to see words start with “I.” I took a little license, had some fun, and deliberately misspelled the term. The correct spelling is “eye tooth.” It derives its name because that tooth is lined up right under our eyes. It is the end of the front teeth section and often corresponds to the corner of the mouth.

The tooth has a very long root and is more prominent than the other front teeth. Many patients lose their back teeth as they get older. Typically, there are eight back teeth if we don’t count our wisdom teeth. These back teeth do a lot of chewing and have a lot of grooves and ridges to help chew. These nooks and crannies are great spots to catch food and bacteria. Because of this unique anatomy of these teeth, they often decay early. Many times this occurs during our extensive candy indulgence years as a child. The back teeth also get the brunt of the chewing. As such, they break down and could be lost early on. This loss of back teeth leaves us with our only front teeth.

In the past, the most common solution to replace missing teeth was a partial denture. A partial denture is a set of teeth that come in and out of the mouth. This device replaces only some missing teeth, unlike a full denture that replaces all of one’s missing teeth. For a partial denture to achieve stability, some anchorage is needed. The anchorage occurs via attachments or small wires that wrap around other teeth.

In our case, where all of the back teeth are missing, the anchorage will occur at the end of the front teeth. We have come full circle to our eye-tooth. The eye-tooth is a strong and stable tooth is surrounded by the wire that keeps all of the back teeth functional. We established that the eye tooth is an ideal place to provide anchorage for the back teeth. Aside from its shape and long root, it is right next to the missing tooth area. What happens if we lose the idea tooth as my patient vocalized to me?

The natural answer would be to move the wire connection to the next tooth forward. Although this sounds logical, the next tooth in line is a horrible candidate for this job. Whereas the eye tooth has a prominent bulge and long root thick root, the next tooth over has no prominence and has a short root. The lateral incisor, which is next to the eye-tooth is a horrible choice to attach and anchor a partial denture. First of all, it’s shape doesn’t lend itself to grab well. Secondly, the roots are so weak that attaching a partial denture to this will call this tooth to fail.

The poor choices for anchorage are the reason why patients who come to me with a missing eye tooth are moving to a denture. A denture may be appropriate if the rest of the front teeth are really on their last legs. However, if the remaining teeth are okay, then using a dental implant to help with anchorage or stability is the way to go. Dentures are a choice but not the only one. A simple, single implant is a great choice to make the rest of the teeth last for many years.

If your front teeth are looking good, but the back of your mouth is struggling, find out what you can do to preserve your front teeth. Call Joyce at 440-892-1810 and set up an appointment to have a discussion. Let’s see what we can figure out together.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile – Bay Village Dentist, 27239 Wolf Road Bay Village, (440) 892-1810,

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