Replacing a missing tooth: your options explained

Why replacing a missing tooth matters

Many people delay replacing a missing tooth — particularly if it's not immediately visible. But leaving a gap untreated has real consequences over time:

• The teeth either side of the gap gradually drift and tilt into the space, changing your bite • The tooth above or below the gap over-erupts (grows into the space), causing wear and bite problems • The jawbone beneath the gap slowly resorbs (shrinks) due to lack of stimulation • Gaps collect food and plaque, increasing decay risk in neighbouring teeth

The longer a gap is left, the more complex — and often more expensive — the eventual treatment becomes.

Dental implants

An implant replaces the root of a missing tooth with a small titanium post placed directly into the jawbone. A crown is then fixed on top. The result looks, feels, and functions like a natural tooth — and is the only replacement option that preserves the jawbone beneath the gap.

Best suited to: Single or multiple missing teeth where bone density is adequate, in patients who want a permanent fixed solution and are willing to undergo a minor surgical procedure under local anaesthetic.

What the process involves: Treatment is typically carried out over 3–6 months in two stages: placement of the implant post, a healing period of 3–4 months while it integrates with the bone, then fitting of the final crown. A CBCT scan (3D X-ray) is used beforehand to assess bone volume precisely.

Honest limitations: • Not everyone has sufficient bone density — a bone graft may be needed first, adding cost and time • The surgical element puts some patients off, though it is carried out under local anaesthetic • Higher upfront cost than alternatives, though the long-term cost per year is often lower • Smokers and patients with certain medical conditions (e.g. bisphosphonate use) require careful assessment

Dental bridges

A bridge fills a gap by anchoring a false tooth (called a pontic) to crowns placed on the teeth either side of the space. No surgery is required, and the result is a fixed, non-removable restoration completed in two or three appointments over a few weeks.

Best suited to: Patients replacing one or two adjacent teeth who want a fixed solution without surgery, particularly where the adjacent teeth already need crowns or have existing restorations.

Honest limitations: • The teeth either side must be permanently crowned — this removes some healthy tooth structure • If one of the supporting teeth develops problems in future, the whole bridge is affected • Does not stimulate the jawbone — bone loss beneath the gap continues over time • Cleaning requires flossing beneath the bridge with a special tool or water flosser

Dentures

Dentures are removable appliances that replace one or more missing teeth. A partial denture replaces some teeth while the rest remain; a full denture replaces all teeth in an arch. They are the most affordable option and require no surgery, but they are the least natural in feel and function.

Best suited to: Patients replacing several or all teeth on a budget, or where surgery is medically inadvisable. Implant-retained dentures offer a middle ground — the security of being fixed, at a lower cost than full implants.

Honest limitations: • Must be removed for cleaning and at night • Can feel bulky or less secure than fixed options, particularly when eating • Bone loss beneath the gap continues, meaning the fit changes over time and relining is eventually needed • Some patients find the psychological adjustment to wearing a denture difficult

What about implant-retained dentures?

Implant-retained dentures (sometimes called All-on-4 or implant-supported dentures) are a fourth option worth knowing about if you are missing several or all teeth. Two to four implants are placed to anchor and stabilise a full arch of teeth. The result is far more secure than a conventional denture and significantly less expensive than replacing every tooth individually with an implant.

This is worth asking about specifically if you have multiple missing teeth and are finding conventional dentures uncomfortable.