If you have missing teeth, you may choose to do nothing and leave the space empty. Alternatively, you may want to replace them. Treatment options include the following.
- Dentures (false teeth) – removable plastic or metal frameworks that carry false teeth.
- Bridges – false teeth that are fixed onto adjacent natural teeth.
- Dental implants – metal 'pegs' are placed in your jawbone, and dentures, crowns or bridges are clipped or screwed on top of them.
The most appropriate treatment for you will depend on the number of teeth you have missing. It will also depend on where teeth are missing in your mouth and the condition of any remaining teeth. Your dentist will help you decide which option is best for you.
After you have teeth removed, it can take several months for your jawbone and gums to heal completely. During this time, your dentist may fit a temporary denture. Your dentist can usually fit this on the same day that your teeth are removed so you can wear it straight away.
As your jaw heals, the temporary denture may become loose and 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.
A partial denture can 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 often include a metal and/or plastic plate with plastic or porcelain false teeth.
Partial dentures often have metal clasps to keep them in place. Where possible, your dentist will hide these so you can't see them when you smile or talk. Alternatively, your dentist may recommend flexible partial dentures that are entirely made of plastic. These stay in place by flexing against your other teeth.
You will need full (or complete) dentures if you have no teeth left in your upper or lower jaw. They are usually made of a plastic plate with plastic or porcelain 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 there is less support from your gums. It can be difficult to balance the denture against your cheeks and tongue. However, this should improve with time as you get used to it.
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 may schedule a check-up appointment a week after fitting your new dentures to check the fit. If you're having problems, he or she can make any necessary adjustments.
You may find some words difficult to pronounce at first, but this usually improves with time.
It can take 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.
Brush any of your remaining natural teeth twice a day with fluoride toothpaste. If you have dentures, it's 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 or a towel 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 can then soak them in a denture cleaning solution if you wish as this may help to remove any stains. Then brush your dentures again.
If you have metal clasps or a soft lining on your denture, ask your dentist for advice before you use a denture cleaning solution. These are more delicate and can be damaged by cleaning solutions. Don't soak your dentures in any type of bleach or very hot water, as this can weaken them and change their appearance.
It's important to take your dentures out at night to allow your mouth to rest. It can also help to prevent infections, such as fungal infections. Leave them in a glass of water overnight.
If your dentures become worn or don’t fit properly, they can cause irritation and discomfort. Ideally you should have your dentures re-made before these problems arise. Even if you have no natural teeth left, it's still important to have regular check-ups with your dentist. Your dentist will assess the fit of your dentures, and check for any problems or health issues.
If only one or two of your teeth are missing, your dentist may recommend a bridge. This consists of two crowns, which are placed on your natural teeth either side of the space, with a false tooth in the middle.
Bridges are made of porcelain and/or metal and there are many designs. Your dentist will prepare your natural teeth on either side of the space for the crowns to fit on top. These crowns are permanently attached to a false tooth in the centre.
Your dentist will cement the bridge in place, so you can’t remove it for cleaning. To keep your natural teeth healthy, 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.
Another type of bridge called an adhesive bridge has wings that your dentist bonds to the back of your supporting teeth. Ask your dentist which type is the best option for you.
Bridges can last anything from seven to 15 years.
A dental implant is a metal rod (titanium or titanium alloy) that your dentist will place in your jawbone. It holds a false tooth (or teeth) in place. Over several months, your jawbone will fuse 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 usually last at least 20 years (if you don't smoke).
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.
Ask your dentist if implants are a suitable treatment for you.
Do missing teeth always need to be replaced?
No, missing teeth don't always need to be replaced.
If you have teeth missing, you may prefer to have them replaced to improve your appearance, or to make it easier to eat. If you have a back tooth missing for example, it can affect the way your upper and lower teeth bite together. Your teeth either side may also start to lean into the gap. If your dentist thinks this could happen, he or she may recommend that you have the tooth replaced. You may need to replace it even if it's not visible when you talk and smile.
If you have a number of back teeth missing on one side of your mouth, this can cause muscle and joint pain in your jaw. This is because you will only use one side to chew. Replacing the missing teeth may help to treat these symptoms.
Everything tastes different. Is it my new upper denture?
Taste buds are found on the surface of your tongue. Therefore, wearing a denture plate that covers the roof of your mouth (palate) doesn't physically block your taste buds. However, dentures can affect your sense of taste in other ways.
Although dentures don't physically block your taste buds, dentures and other dental treatments (such as fillings) can change the taste in your mouth.
Your sense of taste may change if you have an infection in your mouth such as candidiasis (thrush or denture-induced stomatitis). Thrush is very common in people who wear complete upper and lower dentures. You may not realise you have it, but if you don’t treat it, thrush can cause mouth sores and lead to poorly fitting dentures. This is one of the reasons why it's important to attend your regular dental check-ups, even if you don't have natural teeth.
Other things that commonly affect taste include having a dry mouth and certain medicines. It's important to see your dentist or GP to identify what is affecting your taste. Less common causes include diabetes and thyroid problems.
Will having my missing teeth replaced hurt?
You may find having dentures fitted slightly uncomfortable, but it shouldn’t hurt. If you have a bridge or dental implant fitted, your dentist may give you local anaesthetic to ease any pain during the procedure. This completely blocks pain from your gums and you will stay awake during the procedure. You may also have a sedative, which relieves anxiety and helps you to relax.
Different types of tooth replacement involve different procedures.
Generally, having dentures fitted doesn't cause any pain, but you may feel some discomfort for the first few weeks while you get used to them. Occasionally, a pressure point on new dentures can cause a sore spot. If this happens, make an appointment to see your dentist.
Bridges and dental implants are usually fitted under local anaesthesia. After having dental implants fitted, you can expect some bruising and minor swelling. You may need pain relief to help with any discomfort as the anaesthetic wears off – especially during the first few days. You can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
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