Replacing Missing Teeth

Broadly speaking, if you have a missing tooth, and you feel it needs to be replaced – either for appearance or for improved function – you could consider one of three options

A denture

Dentures have most benefit where there are several missing teeth. It can be the most cost effective way, they can look good and require little or no work on the remaining teeth. But they are designed to be removable, cover other parts of the mouth beyond the missing teeth and some people can have difficulty adapting to them.

They can be all acrylic or on a metal framework with clasps to provide additional stability.

A bridge

Often the choice selected. This is where a laboratory made porcelain tooth is fixed to one or more adjacent teeth. It is therefore dependent of the condition of the adjacent teeth (and gums). Larger spaces or multiple spaces can be less suitable for bridges.

Conventional/traditional bridges can be very reliable but involve shaping the adjacent teeth which is not ideal if it can be avoided.

For this reason, in the last 30 years or so, adhesive (sometimes called Maryland) bridges have become more common for small spaces.

Adhesive bridges use a ‘wing’ (largely hidden from sight) to attach with sophisticated cements and so involve minimal preparation of adjacent teeth. It can be a great option and they cost less as well. However, they tend to be less suitable at the back of the mouth.

An Implant

An implant is perhaps the next nearest thing to a real tooth, and is most likely to be the choice, when a patient cannot tolerate a denture or when a bridge is not a good option – for example a bigger space, adjacent teeth not strong enough or at the back of the mouth. They have very good success rates but it is a surgical process and is the most expensive option.