A few thousand years ago, if you needed some new teeth, it was a whole lot easier than it is today. The tribal healer simply sifted through a pile of human and animal teeth for some good matches, drilled little holes through them, looped them together like beads and tied them off to the adjacent teeth. It wasn’t a bad bargain for a basket of figs and nuts, and maybe a few barbecued squirrels.

However, recycled teeth didn’t last. They rotted. Eventually, artisans began sculpting teeth from ivory using elephant, walrus and hippopotamus tusks. Tusks are teeth after all, made of the same stuff. But ivory teeth fared little better than borrowed natural ones. After a while, no amount of mouthwash or breath mints could mask the pungent smell. Not so romantic. But if they could afford it, most people preferred ivory to potentially ill-gotten choppers from humans or chimps.

And speaking of romantic, Japanese technicians tooled remarkable dentures from fine-grain wood. Wooden teeth worked well enough from the late 1500s into the nineteenth century, when something new came along. It was famous artist, inventor, politician, soldier, scientist, naturalist, three-time husband and father of 16 children, Renaissance man Charles Peale who, in his spare time, first made teeth from porcelain. With its superior hardness and resilience, its realistic colour and texture and its excellent longevity, porcelain ceramics still fill the gaps and make the veneers and the caps that are commonplace today.

Since Peale’s time, the process has evolved to today’s advanced state. With innovations in the materials sciences, and with 3D X-ray imaging and 3D printing, tooth replacements that are indistinguishable from the real thing, and in some ways superior as well, are the norm. So why not just lose those bothersome natural teeth and replace them with something better?

For one thing, a new set of dentures, bridges or implants will set you back more than just some figs, nuts and barbecued squirrels. So it’s important to consider all the pros and cons.

Implants cost more but can actually save money in the long term. Implanted teeth mimic natural teeth. They focus chewing compression into the bone, keeping it healthy. Dentures and bridges, resting on the surface of the gums, dissipate chewing pressures away from the soft porous bone of the jaws, which can alter the shape of the bone and encourage shrinkage. Also, dentures and bridges come with their own hygiene challenges, which eventually may cost far more than opting for implants today.

From the 3D X-ray to a new tooth can take about six to eight months. 3D X-ray imaging allows the surgeon to perform precision work. After determining the optimum approach, the surgeon has a guide template printed in a 3D printer. The guide fits over the gum and takes all the guesswork out of aiming the drill.

Same-day implant services do exist for when you’ve lost a front tooth and your wedding is tomorrow, but same-day might not be the wisest choice. It takes time for the implant post to fuse properly with the jawbone before fitting the tooth. And for added durability, the patient may need a bone graft, which requires more time, patience and good oral hygiene to take effect. Except for some mild post-surgery discomfort, the whole procedure is virtually painless.

The best option of all, of course, is to avoid dentures, bridges and implants in the first place and take good care of the teeth mom gave you.

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