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Replacing missing teeth

Published by Bupa's health information team, February 2008.

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.

About replacing missing teeth
Treatment options
Dentures
Bridges
Implants
Further information
Questions and answers
Related topics
Sources

About replacing missing teeth

When teeth are missing, it can affect the way the rest of your teeth bite together. The remaining teeth may tilt and drift into the gaps and food can be trapped in the spaces, which can increase your risk of tooth decay and gum disease. When many teeth are missing, the muscles of the face can become saggy, making it difficult to speak and chew.

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

Treatment options

There are a number of options after you have teeth removed including the following.

Do nothing - accept the space and leave it empty.
Have dentures (false teeth) fitted. These are removable plastic or metal frameworks carrying artificial teeth.
Bridges can replace missing teeth. These are artificial teeth fixed onto adjacent natural teeth.
Implants are another option. These are metal "pegs" which attach to the jawbone and either dentures or bridges are clipped or screwed on top (see Related topics).

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.

Dentures

Temporary dentures

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

As the tissues of your jaw heal, the temporary denture will start to 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 artificial teeth on it.

There are different types of dentures, but they commonly include a metal and/or acrylic (plastic) base with plastic or porcelain artificial teeth. Metal clasps are usually used to attach the denture to adjacent teeth and keep it in position (see illustration). Where possible, these clasps are hidden so that they can't be seen when you smile or talk.

If you have this type of denture, you will need to remove it for cleaning and it should be taken out at night.

Illustration showing teeth on the upper jaw with dentures
Teeth on the upper jaw with dentures

Full dentures

Full dentures are needed when there are no teeth left in the upper or lower jaw. They are usually made of an acrylic base with plastic or porcelain teeth. Occasionally a metal base is used.

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

There are tiny taste buds on your palate so if you wear an upper denture, it can affect how you sense the temperature and taste of food.

Full lower dentures are held in place by the tongue and cheek muscles. As you get older, your cheek muscles may become weaker, so your lower dentures can be slightly more difficult to keep in place than your upper dentures.

However, dentures should fit the mouth exactly so denture adhesive cream (fixative) shouldn't be necessary.

If you have full dentures, you will need to remove them for cleaning and take them out at night.

Getting used to dentures

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

It's usual to produce more saliva for the first few hours after having your denture fitted. Also, your mouth may feel a bit sore and your dentures may feel uncomfortable for the first few weeks.

Your dentures should start to feel a bit more comfortable as you get used to them. If they continue to feel uncomfortable, you may wish to see your dentist so that he or she can make adjustments to your dentures.

During the first days and weeks, your tongue and cheek muscles will adapt to the new dentures. At first, some words may be difficult to pronounce. Reading out loud and practising tricky words can help.

It takes a while to get used to eating with new dentures, so it's best to start with soft food. Chewing slowly, using both sides of your mouth at once, will help to keep the denture in place.

Looking after your dentures and mouth

Good dental hygiene is necessary to keep your dentures and your mouth in a healthy condition.

You should 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.

Like natural teeth, dentures must be kept as clean as possible. You should clean them twice a day, and after you eat if necessary.

Your dentures are fragile and likely to break if you drop them. It's best to clean them over a folded towel or basin of water so if you do drop them they will fall on to a soft surface. Use a soft toothbrush and ordinary soap or toothpaste to remove any food that has stuck to the dentures. Ensure that you clean all the surfaces of your dentures, including the areas that attach to your gums. Soaking solutions, available from your dentist or a pharmacy, may help remove bacteria or stubborn stains. Ask your dentist to recommend a solution that is suitable for your design of dentures.

When you aren't wearing your dentures, keep them in a container so that they don't get broken. At night, leave them in clean water. Don't soak them in bleach or boiling water as it can weaken the dentures and break them.

If your dentures are worn or ill-fitting they can cause irritation and discomfort. Ideally, you should replace dentures every five years or so, before these problems arise. If you have dentures you should have regular check-ups with your dentist so any infections or other conditions can be detected at an early stage.

Bridges

If only one or two teeth are missing, your dentist may fit a bridge to replace them. Replacement teeth are attached to natural teeth on either side of the gap.

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

Illustration showing teeth with a bridge
Teeth with a bridge

Bridges are cemented in place, so they can't be removed for cleaning. To keep the teeth healthy, you should clean the gap under a bridge with a special dental floss - an ordinary toothbrush will not do the job. Your dentist or hygienist will show you how to floss under your bridge. On average, bridges last between five to ten years.

Implants

A dental implant is a metal rod that is placed in the jawbone to hold an artificial tooth in place. Over several months, the bone fuses with the metal implant. A small attachment is left poking through the gum, and dentures or bridges can be screwed or clipped onto this attachment.

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

Implants are not suitable for everyone. You need to be in good general health, have healthy gums and your jawbone must be thick enough for the implant. There are however, surgical procedures to increase the amount of bone in your jaw. Your dentist will tell you if this treatment is suitable for you.

If you have dental implants, you must be prepared to maintain good oral hygiene and make regular visits to your dentist.

For more detailed information on dental implants, see Related topics.

Further information

British Dental Health Foundation
0845 063 1188
www.dentalhealth.org.uk
British Dental Association - Smile
www.bda.org/smile