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Replacing missing teeth


Expert reviewer, Dr Steve Preddy, Interim Clinical Director, Bupa Dental Care
Next review due October 2021

If you have missing teeth, you may be thinking about replacing them to improve the way you look. Replacing missing teeth can also help to keep your other teeth healthy, as well as helping you to eat more comfortably and speak more clearly.


Image showing teeth on the upper jaw with dentures

Why replace missing teeth?

If you have teeth missing, it can change the way the rest of your teeth bite together. This is because your remaining teeth may lean over or drift into the gaps. Food can also get trapped in the spaces, increasing your risk of tooth decay and gum disease.

If lots of your teeth are missing, your facial muscles may start to sag. This may affect the way you look and make your speech less clear. You might also worry about people noticing the gaps in your teeth, which can affect your confidence and how you feel about yourself.

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

Treatment options to replace missing teeth

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.

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:

  • full or partial dentures (false teeth) – removable plastic or metal frameworks that have false teeth attached
  • bridges – false teeth that are fixed onto existing natural teeth
  • dental implants – false teeth fitted on top of a titanium implant that is fixed directly into your jawbone

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 and gums. Your dentist will help you decide which option is best for you and how much it will cost. Dentures and bridges are generally available on the NHS (although you do have to pay a set fee) but dental implants usually aren’t.

Find out more about each treatment option below.

Dentures

Depending on how many teeth you have missing, you may have a full or partial denture. You may also have a temporary partial denture while you’re waiting to have a bridge fitted. Your denture will be designed just for you. Your dentist will take an impression of the area with dental putty before the denture is made to make sure it fits well.

Partial dentures may have a base plate made of plastic or metal. Those made with metal are stronger and lighter, but are more expensive.

Before having your denture fitted, you may have to have more teeth removed. This might be to allow for a full set of dentures to be fitted or because your other teeth are already too decayed or loose to save. You may be able to have full dentures fitted straight afterwards or your dentist may recommend that your gums are left to heal for up to a couple of months. This may mean that they fit better. Ask your dentist which option they recommend for you when you’re planning your treatment. If you have your dentures fitted straightaway, they may need adjusting later to improve the fit.

Keeping your dentures in place

Partial dentures often have clasps that clip on to the teeth next to your denture and help to keep it in place.

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. With a little practice, you will learn to balance the denture between your cheeks and tongue.

If you find your dentures slip at first when you laugh or cough, try biting down gently and swallowing and that should put them back in place.

You can use denture adhesive cream (fixative), although most people don’t need to. Some people find it helps with their confidence while they’re getting used to new dentures. Poorly fitting dentures can make your mouth very sore, so if you are concerned about the fit, see your dentist.

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.

Generally, dentists advise against wearing dentures at night. But your dentist may suggest that you wear them night and day for the first week or two, to help you get used to them.

You may find some words difficult to pronounce at first, but this usually improves with time. Try reading out loud to practice.

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 your remaining natural teeth twice a day with fluoride toothpaste and use dental floss or tape to clean between them. 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 or toothpaste. It's a good idea to brush them over a bowl of water or a towel to prevent damage if you drop them. Make sure you clean all the surfaces of your dentures, including the areas that sit against your gums and the roof of your mouth. You can soak them in a denture cleaning solution if you wish, as this may help to remove stains. Then brush your dentures again.

Some dentures have a soft lining. Ask your dentist for advice before you use a denture cleaning solution on this type of denture. The linings are delicate and can be damaged by cleaning solutions.

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 plastic denture box or glass of water overnight so they don’t dry out.

Your dentures should last several years if you look after them. But if they 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 check the fit of your dentures, and look for any problem areas on your gums and soft tissue.

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. There are two main types of bridges.

The most common type consists of two crowns, which are permanently bonded to your natural teeth either side of the space, with the false tooth (or teeth) in the middle.

If the teeth either side of your missing teeth are strong and healthy, you may have the other type of bridge. This is a false tooth with ‘wings’ either side of it. These wings are bonded to the inner surfaces of the teeth. With both these types of bridges, your new false tooth is held firmly in place by your own teeth.

Your bridge will be permanently fixed in place, so you don’t remove it for cleaning. To keep your natural teeth healthy, you need to clean the gap under a bridge with a special dental floss. Your dentist or hygienist will show you how to floss under your bridge.


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. Individual teeth, dentures or bridges can be screwed or clipped onto the implant. You may have to wait up to six months before false teeth can be screwed onto the implanted metal rod. This is to allow healing and for the rod to fuse securely to your jawbone.

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, usually done under local anaesthetic. 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. It’s also very important that you look after your implant, cleaning and flossing as you would with your natural teeth.

Ask your dentist if implants might be a suitable treatment option for you, or see our dedicated topic page on dental implants.


Image showing a dental implant

Frequently asked questions

  • You don’t have to have missing teeth replaced, unless you have so many missing that it’s making day-to-day life difficult. Dentists say that you need at least 21 teeth for them to function properly. But even if you have more than the minimum, there are lots of good reasons why your dentist may recommend you have teeth replaced.

    Teeth help to provide shape to your face, so your cheeks can look sunken if you have some missing – this may make you appear older than you are, and you may feel self-conscious about how you look.

    Replacing teeth can make eating more comfortable and can also help you to speak more clearly. It also helps to keep your mouth and other teeth healthy. If you have gaps, your other teeth can move and tilt, making eating more difficult. Food can get stuck in the gaps, increasing your risk of tooth decay. Talk to your dentist about how replacing missing teeth might help you.

  • It’s possible that having an upper denture can affect how some things taste. Researchers have looked into this but haven’t been able to prove it one way or the other. It may take slightly longer for denture wearers to recognise particular tastes while they’re getting used to their new teeth. This may be because the dentures are covering their palate.

    Having a denture is a new sensation in your mouth and will take a bit of getting used to. So this might explain why things taste different to you. When you have new dentures, ask your dentist how long any taste changes might last.

    There are a lot of other reasons why you may have taste changes. You’re less able to taste well as you get older. Taste can also be affected by mouth infections, such as oral thrush (candidiasis), which is common in people who wear dentures. It’s very important to keep your mouth and dentures clean and this will help your sense of taste. It will also help to reduce your risk of infections. Changes in taste can also happen with 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 how they will make sure your procedure isn’t painful.

    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’re asleep. But this is usually only for complicated cases; for example, if you need to have a bone graft from another part of your body.


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Related information

    • A dentist’s guide to implantology. Association of Dental Implantology. www.adi.org.uk, published 2012
    • Bridges and partial dentures. Oral Health Foundation. www.dentalhealth.org, accessed May 2018
    • Dentures. Oral Health Foundation. www.dentalhealth.org, accessed May 2018
    • Implants. Oral Health Foundation. www.dentalhealth.org, accessed May 2018
    • Dental treatments. NHS Choices. www.nhs.uk, last updated November 2015
    • NHS dental services explained. NHS Choices. www.nhs.uk, last updated January 2017
    • Oxford Handbook of Clinical Dentistry. Oxford Medicine Online. www.oxfordmedicine.com, published online August 2014
    • Complete dentures. Medscape. www.emedicine.medscape.com, last updated April 2016
    • Dental care for older people. Oral Health Foundation. www.dentalhealth.org, accessed May 2018
    • Dental bridges. British Academy of Cosmetic Dentistry. www.bacd.com, accessed May 2018
    • Implants. American Dental Association. www.mouthhealthy.org, accessed May 2018
    • Srinath HP, Akula R, Maroli S, et al. Altered taste perception among complete denture patients. Indian J Oral Sci 2014; 5(2):78–82
    • Ghaffari T, Rad FH, Kahnamoee SM. Evaluation of the effect of upper complete denture on gustatory and olfactory senses. J Dent Res Dent Clin Dental Prospects 2009; 3(4):132–35
    • Disorders of taste and smell. Medscape. www.emedicine.medscape.com, last updated January 2016

  • Reviewed by Alice Rossiter, Specialist Health Editor, October 2018
    Expert reviewer, Dr Steve Preddy, Interim Clinical Director, Bupa Dental Care
    Next review due October 2021



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