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Replacing missing teeth


Expert reviewer, Dr Steve Preddy, Dental Clinical Director, Bupa Dental Services, Bupa UK
Next review due March 2019

If you have missing teeth, you may be thinking about replacing them to improve the way you look. But replacing missing teeth may also let you eat more comfortably, speak more clearly and help to keep your mouth healthy.

About replacing missing teeth

If you have teeth 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. This can increase your risk of tooth decay and gum disease. If lots of your teeth are missing, your facial muscles can become saggy. This may affect the way you look, and make it harder for you to speak clearly.

There are different ways to replace missing teeth involving dentures, bridges and implants. Your dentist will help you decide which option is best for you.

“Replacing missing teeth can help you smile with confidence, eat more comfortably and keep your mouth and teeth healthy.” Dr Steve Preddy, Dental Clinical Director, Bupa Dental Services.

Treatment options

If you have missing teeth, you may choose to do nothing and leave the space empty. Or you may want to replace them. Replacement teeth are made to match the colour of your natural teeth as closely as possible. Your options for treatment may include:

  • dentures (false teeth) – removable plastic or metal frameworks that carry false teeth
  • bridges – false teeth that are fixed onto adjacent natural teeth
  • dental implants – false teeth fitted on top of a titanium implant that is fixed directly into your jawbone (the bone of your jaw then fuses to the titanium)

What’s best for you depends on the number of teeth you have missing. It also depends on which teeth are missing and the condition of your remaining teeth. Your dentist will help you decide which option is best for you and how much it will cost. Dentures and bridges are sometimes available on the NHS, dental implants usually aren’t.

Dentures

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 the denture 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.

Most people won’t need to use denture adhesive cream (fixative). However, some people may choose to use it because they find it helps with confidence while getting used to the new dentures.

Image showing teeth on the upper jaw with dentures

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, they can make any necessary adjustments. You may need more than one appointment for adjustments but your dentist will let you know.

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.

Looking after your dentures and mouth

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.

With dentures it’s best to brush, soak, then brush again. 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 a soft lining on your denture, ask your dentist for advice before you use a denture cleaning solution. These linings are 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. Doing this can also help to prevent infections, such as fungal infections. Leave them in a glass of water overnight so they don’t dry out.

If your dentures become worn or don’t fit properly, they can be irritating and uncomfortable. 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.

Bridges

If only one or two of your teeth are missing, and an implant isn’t suitable for you, 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. In this way, your new false tooth is held firmly in place by your own teeth on either side.

Bridges are made of porcelain and/or metal and there are many designs. Your dentist will discuss with you which is the best one for you. This will depend on the location of your missing tooth and the condition of your mouth, teeth and gums. Your dentist will cement the bridge in place, so you don’t remove it for cleaning. To keep your natural teeth healthy, clean the gap under a bridge with a special dental floss. Your dentist or hygienist will 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.
An image showing teeth with a bridge

Dental implants

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, the bone of your jaw 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. If you look after your dental implants they can last a long time.

Having an implant is a surgical procedure. You need to have healthy gums, and if you smoke, your dentist may not recommend implants as it can affect the success of your treatment.

Ask your dentist if implants might be a suitable treatment option for you.

Find out more from our specialist topic on dental implants.

Image showing a dental implant

Frequently asked questions

  • No, missing teeth don't always need to be replaced but there are lots of good reasons why your dentist may recommend you have them replaced. Reasons include improving your appearance, making eating more comfortable and keeping your mouth and other teeth healthy. Replacing missing teeth may also help you speak more clearly. Talk to your dentist about how replacing missing teeth might help you.

  • It’s possible that having an upper denture can affect your perception of how some things taste. Sour and bitter tastes seem to be particularly affected. But having a denture is a new sensation in your mouth and will take a bit of getting used to. It’s possible this might also affect how things taste to you. When you have new dentures, ask your dentist about how long any taste changes might last.

    Taste changes can also happen if you get the mouth infection candidiasis (thrush), which is common in people who wear dentures. This infection does need to be treated because it might eventually lead to mouth sores or poorly fitting dentures. Changes in taste can also happen in certain other medical conditions, so it’s a good idea to see your dentist if you notice your sense of taste has changed.

  • Different types of tooth replacement involve different procedures. You may find having dentures fitted slightly uncomfortable, but it shouldn’t hurt. If you have a bridge or dental implant fitted, your dentist will give you a local anaesthetic injection. This completely blocks pain from your gums and you will stay awake during the procedure. You may also be able to have a sedative, which helps to keep you calm and relaxed. Ask your dentist to explain to you how they will make sure you don’t feel pain during your procedure.

    Bridges and dental implants are usually fitted under local anaesthesia. It’s normal to feel a little anxious when having a surgical procedure such as dental implants. Speak to your dentist about this. They may be able to arrange for you to have sedation, which involves taking a medicine or breathing a gas to help you stay calm. Very occasionally, dental implants are put in under general anaesthesia, while you are asleep. But this is usually only in complicated cases – for example, if you need to have a bone graft from another part of your body.


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Related information

    • Complete dentures. Medscape. www.emedicine.medscape.com, published 8 March 2013
    • Disorders of taste and smell. Medscape. www.emedicine.medscape.com, published 11 April 2014
    • Abt E, Carr AB, Worthington HV. Interventions for replacing missing teeth: partially absent dentition. Cochrane Database of Systematic Reviews 2012, Issue 2. doi:10.1002/14651858.CD003814.pub2.
    • Dentures. British Dental Health Foundation. www.dentalhealth.org, accessed 10 January 2016
    • Implants. British Dental Health Foundation. www.dentalhealth.org, accessed 10 January 2016
    • Bridges and partial dentures. British Dental Health Foundation. www.dentalhealth.org, accessed 10 January 2016
    • Denture cleaning. British Dental Health Foundation. www.dentalhealth.org, accessed 10 January 2016
    • Dental stomatitis (thrush). British Dental Health Foundation. www.dentalhealth.org, accessed 10 January 2016
    • Dental implant surgery. American Association of Oral and Maxillofacial Surgeons (AAOMS). www.aaoms.org, accessed 12 January 2016 
    • Dentures. Canadian Dental Association. www.cda-adc.ca, accessed 12 January 2016
    • Bridges. Canadian Dental Association. www.cda-adc.ca, accessed 12 January 2016
    • Dentures. Mouth Healthy – American Dental Association. www.mouthhealthy.org, accessed 12 January 2016
    • A dentist’s guide to implantology. Association of Dental Implantology. www.adi.org.uk, published 2012
    • Considering dental implants? Association of Dental Implantology. www.adi.org.uk, published 2015
    • Candidiasis. PatientPlus. www.patient.info/patientplus, reviewed 12 March 2014
  • Reviewed by Natalie Heaton, Specialist Editor – User Experience, Bupa Health Content Team, March 2016.
    Expert reviewer, Dr Steve Preddy, Dental Clinical Director, Bupa Dental Services, Bupa UK
    Next review due March 2019



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