Dealing with Large Gaps After Dental Implants: Solutions and Considerations

After dental implants, if the gaps between the teeth are too large, it can lead to food trapping?

Hello Dr.
Tseng, I recently underwent dental implant surgery for three teeth, two of which have a large gap between them and the adjacent teeth, making it easy for food to get stuck.
These are located at positions 27 and 47.
Both of my wisdom teeth are still present, but the opposing molars are no longer there.
Most of my teeth have significant gum recession, so after the implants, the distance between the crowns of the implants and the adjacent wisdom teeth is too large, causing food to easily get trapped in that space and resulting in considerable discomfort.
I expressed my concerns to the implant dentist, who suggested two options: 1.
Extract the wisdom teeth (which are slightly tilted and have some occlusal function with positions 17 and 37), or 2.
Widen the crowns of the implants to reduce the gap between the gums, which would minimize food impaction (however, this would require grinding down some of the adjacent teeth to facilitate crown placement, leading to potential sensitivity in the future).

Doctor, I have two questions: 1.
Is there any way to fill the gap between the teeth with resin or other materials without damaging the teeth? 2.
Is it reasonable to extract a wisdom tooth that has occlusal function? Would you recommend extraction? Thank you for your response, Doctor.

Xiao Guang, 60~69 year old female. Ask Date: 2024/06/27

Dr. Zeng Guanghui reply Dentistry

Dear Mr.
Hsiao-Kuang,
1.
Generally, dental gaps cannot be filled with resin or other materials.
Even if they can be filled, over time, the gums in the gaps are prone to infection and inflammation.
2.
If the opposing tooth of the wisdom tooth is no longer present, the opportunity for the wisdom tooth to contact the opposing arch decreases.
In this case, it may be considered to extract the wisdom tooth; otherwise, the wisdom tooth without an opposing tooth will continue to grow, causing occlusal interference.
Sincerely,
Director Tseng Kuang-Hui, Dental Department, Nantou Hospital

Reply Date: 2024/06/27

More Info

Dealing with large gaps after dental implants can be a frustrating experience, especially when food gets trapped in these spaces, leading to discomfort and potential oral health issues. Based on the situation you've described, there are several considerations and potential solutions to address the gaps between your dental implants and adjacent teeth.

Understanding the Issue
The large gaps you are experiencing between your dental implants (specifically at positions 27 and 47) and neighboring teeth can arise from several factors, including the positioning of the implants, the size and shape of the crowns placed on them, and the condition of the surrounding teeth and gums. The presence of wisdom teeth (or third molars) that are not fully erupted or are misaligned can also contribute to the overall dental alignment and spacing issues.

Potential Solutions
1. Modification of the Dental Crowns: One option your dentist suggested is to modify the crowns on your implants to make them wider. This could help reduce the gap and minimize the space where food can become trapped. However, this approach may require some alteration to the adjacent teeth, which could lead to increased sensitivity or other complications. It's essential to weigh the benefits against the potential risks.

2. Extraction of Wisdom Teeth: The second option involves the extraction of the wisdom teeth. Since you mentioned that these teeth are slightly misaligned and that their opposing teeth are missing, removing them could potentially improve the overall alignment and function of your bite. However, this decision should be made carefully, considering the role these teeth play in your occlusion (bite).

3. Use of Composite Resin or Other Materials: While you inquired about using materials like resin to fill the gaps, this is generally not a recommended solution for several reasons. First, filling the gaps with resin may not provide a long-term solution, as the material can wear down or become dislodged over time. Additionally, food particles can still become trapped around the resin, leading to potential gum irritation or infection.

4. Orthodontic Consultation: If the gaps are significant and affecting your bite, consulting with an orthodontist may be beneficial. They can assess your overall dental alignment and determine if orthodontic treatment could help close the gaps or improve your bite function.

Considerations for Wisdom Tooth Extraction
Regarding the extraction of your wisdom teeth, it is reasonable to consider this option, especially since they are not contributing positively to your dental health. If these teeth are misaligned and not functioning properly, their removal could alleviate some of the issues you are facing. However, it is crucial to discuss this with your dentist or an oral surgeon to understand the implications fully, especially concerning your existing dental structure and any potential impact on your bite.

Conclusion
In summary, addressing the large gaps after dental implants involves a careful evaluation of your specific situation. Modifying the crowns, considering wisdom tooth extraction, and exploring orthodontic options are all valid approaches. It is essential to have an open discussion with your dental care provider about the risks and benefits of each option, ensuring that you make an informed decision that prioritizes your oral health and comfort. Regular follow-ups and maintaining good oral hygiene will also be crucial in managing any discomfort associated with these gaps.

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