Replacing missing teeth

Produced by Rebecca Canvin, Bupa Health Information Team, January 2012.

This factsheet is for people who are having missing teeth replaced, or who would like information about it.

Replacing missing teeth can improve appearance and dental health. Treatment options include dentures, bridges and implants.

About replacing missing teeth
Treatment options
Dentures
Bridges
Dental implants

About replacing missing teeth

When teeth are missing, it can affect the way the rest of your teeth bite together. Your remaining teeth may tilt and drift into the gaps and food can get trapped in the spaces, increasing your risk of tooth decay and gum disease. When many teeth are missing, your facial muscles can become saggy, affecting your speech and appearance.

Replacement teeth are made to match the colour of your natural teeth as closely as possible.

Treatment options

If you have missing teeth, you may choose to do nothing and leave the space empty. Alternatively, you may want to have your missing teeth replaced. There are several different treatment options available.

• Dentures (false teeth). These are removable plastic or metal frameworks carrying false teeth.
• Bridges. These are false teeth fixed onto adjacent natural teeth.
• Dental implants. These are metal 'pegs' placed in your jawbone. Dentures or bridges are clipped or screwed on top of dental implants.

The most appropriate treatment will depend on the number of teeth that are missing, where they are in your mouth and the condition of any remaining teeth. Your dentist will help you decide which option is best for you.

Availability and use of different treatments may vary from country to country. Ask your dentist for advice on your treatment options.
 

Dentures

Temporary dentures

After you have had teeth removed, it takes several months for your jawbone and gums to heal completely. During this time, your dentist may fit a temporary denture. This can even be fitted and worn the same day as your teeth are removed.

As your jaw heals, the temporary denture will become loose and may need adjusting. It can take up to six months for your jawbone and gums to become stable. Your dentist will then be able to fit your long-term denture or bridge.

Partial dentures

A partial denture can be used to replace one or more missing teeth. A partial denture is a framework (plate) with a number of false teeth on it.

There are different types of partial dentures, but they commonly include a metal and/or plastic plate with plastic or porcelain false teeth. Partial dentures often have metal clasps. Where possible, these clasps are hidden so that they can't be seen when you smile or talk. Alternatively, your dentist may recommend flexible (or soft) partial dentures. These adapt around the shape of your teeth and gums and can be used when it's difficult or impossible to fit a plastic or metal denture.

Full dentures

Full (or complete) dentures are needed when you have no teeth left in your upper or lower jaw. They are usually made of a plastic plate with plastic teeth.

Full upper dentures cover the roof of your mouth (palate). A very thin layer of saliva between your palate and the denture creates suction, which keeps it firmly in position. Your facial muscles and tongue also help to keep it in place.

Full lower dentures are often more difficult to keep in place because the floor of your mouth moves a lot, and the ridge where your teeth used to be shrinks with age.

However, good dentures should fit your mouth exactly so you shouldn't need to use denture adhesive cream (fixative).

Getting used to dentures

It's very important to have realistic expectations of dentures. Getting used to them will take time. They should help you to eat, speak and smile confidently, but even the best dentures won't feel the same as natural teeth.

Your mouth may feel a bit sore and uncomfortable to start with. Your dentures should start to feel a bit more secure as you get used to them. Your dentist will schedule a check-up appointment a week or two after fitting your new dentures. If you're having any problems, he or she can make the necessary adjustments to your dentures.

You may find some words difficult to pronounce at first, but this usually improves with time.

It takes a while to get used to eating with new dentures, so it's best to start with soft food. Try to use both sides of your mouth at the same time. This will help to keep your dentures in place.

Looking after your denture and mouth

Brush any remaining natural teeth twice a day with fluoride toothpaste. If you have a full set of dentures, it's still important to clean your gums, tongue and the roof of your mouth with a soft brush.

Clean your dentures after every meal using a soft toothbrush and soap. It's a good idea to brush them over a bowl of water to prevent damaging your dentures if you drop them. Ensure that you clean all the surfaces of your dentures, including the areas that sit against your gums.

You should take your dentures out at night and leave them in a glass of water or denture cleaning solution. If you have metal clasps or a soft lining on your denture, you must ask your dentist for advice before using any denture cleaning solutions because these are more delicate.

Don't soak your dentures in any type of bleach or very hot water, as this can weaken them and change their appearance.

If your dentures are worn or don't fit properly they can cause irritation and discomfort. Ideally you should have your dentures remade before these problems arise. Even if you have no natural teeth left, you should still have regular check-ups with your dentist so that he or she can assess the fit of your dentures, and can detect any infections or other conditions at an early stage.

Bridges

If only one or two teeth are missing, your dentist may recommend a bridge. He or she will attach a false tooth (or teeth) to your natural teeth on either side or occasionally on only one side of the gap.

Bridges are made of porcelain and/or metal. There are many bridge designs. The natural teeth on either side of the space are specially prepared for the crowns to fit on top. These crowns are permanently attached to a false tooth in the centre.

 
Bridges are cemented in place, so you can't remove them for cleaning. To keep your natural teeth healthy, you should clean the gap under a bridge with a special dental floss. Ask your dentist or hygienist to show you how to floss under your bridge. On average, bridges last between five and 10 years.

Dental implants

A dental implant is a metal rod (titanium or titanium alloy) that is placed in your jawbone to hold a false tooth (or teeth) in place. Over several months, your jawbone fuses with the metal rod. Dentures or bridges can be screwed or clipped onto the implant.

Dentures and bridges that are supported by successful implants tend to be very secure. Dental implants last at least 10 years.

Implants can be expensive and require surgery. You need to have healthy gums, and if you smoke, your dentist may not recommend implants as it can affect the success of the treatment. Your dentist will tell you if this treatment is suitable for you.