Replacing a Missing Tooth — Your Options

You can lose a tooth through decay, gum disease, an accident or having it taken out. A gap affects more than how you look.

Over time, the bone under the gap starts to shrink. This is because there is no tooth root to keep the bone active. The teeth next to the gap can tilt into the space. The tooth above or below may start to move too.

Replacing a missing tooth helps to:

• Stop the jawbone from shrinking
• Stop the teeth next to the gap from drifting or tilting
• Help you chew in comfort again
• Keep the shape of your face and jaw
• Help you feel confident when you smile or speak

There are three main ways to replace a tooth: a dental implant, a bridge or a denture. You can also choose to leave the gap. Each choice has real good points and real downsides. This leaflet explains all four. It can help you talk them through with your dental team.

A dental implant is a small titanium screw. It is placed in your jawbone and acts like a false tooth root. It takes about 3–6 months to join firmly to the bone (osseointegration). Then a crown made just for you is fitted on top.

What usually happens:

• A full check, with X-rays or a 3D scan (cone beam CT)
• A surgical procedure under local anaesthetic to place the implant
• A healing time of 3–6 months before the crown is fitted
• The whole treatment usually takes 6–12 months from start to finish

Good points:

• Looks, feels and works the most like a natural tooth
• Keeps the jawbone and stops it from shrinking
• The healthy teeth next to the gap do not need to be cut or crowned
• With good care, it can last 15–25 years or more, and sometimes for life
• Cleaned like natural teeth, plus careful cleaning around the implant to prevent gum disease

Downsides and risks:

• It costs more at the start. It is usually £2,500–£4,000 per tooth at a private practice. Your treatment plan will confirm your exact cost. Fees vary between practices and depend on how complex your case is.
• Not usually available on the NHS for a simple tooth replacement
• You need surgery and time to heal, so the whole treatment is slow
• Not suitable if you have a lot of bone loss (you may need a bone graft first), diabetes that is not under control, or some other medical conditions
• Smoking greatly lowers the chance that an implant will work
• The implant can fail. In studies, about 5–10% of implants fail over 10 years.
• Gum disease around the implant (peri-implantitis) can happen if you do not keep it clean

How long it lasts: The implant itself could last many decades. This needs good cleaning at home and regular checks and cleaning by your dental team. The crown on top may need replacing after 10–15 years.

A bridge uses the teeth on each side of the gap as anchors (abutment teeth). These teeth are usually shaped by removing some enamel, so that crowns can fit over them. The false tooth (pontic) is held between them and fills the gap.

Another type is a resin-bonded bridge (Maryland bridge). It has metal or ceramic wings that stick to the back of the teeth next to the gap. It needs much less drilling, or none. It is often used for front teeth.

Good points:

• Fixed in place, so you cannot take it out
• No surgery needed
• Quicker than an implant. It usually takes 2–4 visits over a few weeks.
• Costs less than an implant. It is usually £800–£1,500 per unit at a private practice (NHS Band 3 in England: £332.10 where available). Your treatment plan will confirm your exact cost. Fees vary between practices and depend on how complex your case is.
• Can look natural with good results, especially for front teeth

Downsides and risks:

• Healthy teeth next to the gap must be drilled. This changes them for good and cannot be undone.
• Does not stop bone loss under the gap, because there is no root to keep the bone active
• Can be harder to clean underneath. You need special floss threaders or small brushes for between the teeth (interdental brushes).
• On average it lasts 10–15 years before it may need replacing
• If one anchor tooth fails, the whole bridge is affected
• A resin-bonded bridge may come unstuck and need gluing back on

How long it lasts: 10–15 years on average. Many last longer with very good care.

A denture is a plate that you can take out. It replaces one or more missing teeth. A partial denture fills gaps when you still have some of your own teeth. A full (complete) denture replaces all the teeth in your upper jaw, your lower jaw or both.

Partial dentures can be made of acrylic (plastic). They can also be made of cobalt-chrome, which is a stronger metal frame with plastic teeth. Chrome dentures are usually more comfortable and last better.

Good points:

• Does the least to your mouth. There is no surgery and no drilling of other teeth.
• Costs the least. A partial denture is usually £500–£1,500 privately. A full denture is usually £800–£2,500 (NHS Band 3 in England: £332.10 where available). Your treatment plan will confirm your exact cost. Fees vary between practices and depend on how complex your case is.
• Can replace several missing teeth at once
• Fairly quick to make. It usually takes 3–5 visits.
• Can be changed or added to if you lose more teeth later

Downsides and risks:

• You must take it out at night and clean it separately
• Can feel bulky or less natural than a fixed option
• Does not stop bone loss under the gap
• As your jaw changes shape over time, it may need a new fitting surface (reline) or a new denture
• Some people find hard or sticky foods less comfortable to eat with a denture
• The clips (clasps) on a partial denture can put some strain on nearby teeth
• If the fit gets worse over time, it can cause sore spots on the gum

How long it lasts: Usually 5–10 years before it needs a reline or a new denture. This is because the jawbone and gum change shape naturally.

You can choose not to replace the tooth. This is a valid choice. Your dentist should talk it through with you along with the other options. It may suit a gap that does not affect how you chew, speak or look.

Good points:

• No cost and no treatment
• No surgery and no drilling of other teeth
• You can still choose an implant, bridge or denture later. But the bone shrinks over time, and this can make an implant harder to place.

Downsides and risks:

• The teeth next to the gap can drift or tilt into the space. The tooth above or below may move too.
• Chewing may be harder, depending on where the gap is
• The bone under the gap slowly shrinks
• A gap that shows may affect your confidence when you smile

This list gives a rough side-by-side summary. Everyone is different. Your dental team will tell you what suits you best.

• Implant: Most natural feel. Keeps the bone. No drilling of nearby teeth. Slowest (6–12 months). Costs the most (£2,500–£4,000 private). Lasts longest (15–25+ years).
• Bridge: Fixed and looks natural. No surgery. Nearby teeth must be drilled. Medium speed (weeks). Mid-range cost (£800–£1,500 private / NHS Band 3 in England: £332.10). Lasts 10–15 years on average.
• Denture: Does the least to your mouth. No surgery or drilling. You can take it out. Quickest. Costs the least (£500–£1,500 partial / £800–£2,500 full private / NHS Band 3 in England: £332.10). Lasts 5–10 years before a reline or a new denture.
• Leaving the gap: No cost. No treatment. Nearby teeth may drift. Chewing may be harder. Bone shrinks under the gap.

NHS charges are set nationally and reviewed each April. Any NHS charge shown here is the England charge from 1 April 2026. Charges differ in Scotland, Wales and Northern Ireland. Private fees are a guide. Your dental team will confirm the exact cost on your treatment plan before you agree to go ahead. Not all treatments are available on the NHS. Your dental team will tell you what is covered in your case.

No one option is right for everyone. Your dental team will think about several things before they advise you:

• How much bone you have. Implants need enough bone depth and width. You may need a bone graft if a lot of bone has been lost.
• Your general health. Some things can affect whether an implant suits you. These include diabetes that is not under control, blood-thinning medicines, or past radiotherapy to the jaw.
• Smoking. It greatly lowers the chance that an implant will work. Your dental team may advise you to stop before implant surgery.
• The teeth next to the gap. If they already need crowns, a bridge can make good use of that treatment. If they are healthy, an implant leaves them as they are.
• How many teeth are missing. If you have several gaps, dentures or dentures held by implants (implant-retained dentures) may be more practical.
• Budget and time. Implants take more time and money. Dentures or bridges may be more practical in the short term.
• What you prefer. Some people strongly prefer a fixed tooth. Others are happy with one they can take out.

These questions can help you make the best choice for you:

• Which option would you advise for me, and why?
• Is a dental implant suitable for me?
• Would any of my nearby teeth need drilling for a bridge?
• How much bone do I have? Would I need a bone graft?
• What will each option cost over 10–20 years?
• What happens if I choose not to replace the tooth at all?
• How will each option affect how I eat and speak?
• How do I clean and look after each option?

You do not have to decide straight away. Take time to think about your options. Ask any more questions before you agree to treatment.

NHS charges are set nationally and reviewed each April. Any NHS charge shown here is the England charge from 1 April 2026. Charges differ in Scotland, Wales and Northern Ireland. Private fees are a guide. Your dental team will confirm the exact cost on your treatment plan before you agree to go ahead. NHS availability varies by area. Not all treatments are available on the NHS. Your dental team will talk with you about the best option for your case.