Missing teeth solutions

A dental implant is a small titanium screw that takes the place of a missing tooth’s root. It is placed in your jawbone, and over the following weeks the bone bonds to it. Dentists call this bonding osseointegration. Once the implant is secure, a connector called an abutment is fitted, and this holds your new crown, bridge or denture. A denture held by implants doesn’t slip around, and implant crowns and bridges work much like natural teeth. Implants can replace a single tooth, several teeth or all the teeth in a jaw.

Teeth are lost for many reasons: decay, gum disease, accidents, wear with age, a condition you were born with, or a serious infection such as a failing root canal treatment. Whatever the cause, a gap can lead to other changes. Without a tooth to stimulate it, the jawbone underneath slowly shrinks. The teeth either side can tilt and drift into the space, which can upset your bite and change how your smile looks. Over time this can make chewing harder, affect what you eat and leave you feeling self-conscious. We can talk you through the options for filling the gap.

It depends on whether you still have some of your own teeth. If you have no teeth left in a jaw, the options are a removable denture, a denture held in place by implants, or crowns and a bridge supported by implants. If you have some teeth left, you could have crowns or a bridge supported by implants, your own teeth or both; a partial denture secured by implants or by teeth; or a bridge fixed to the teeth either side of the gap. At your consultation we’ll explain which options suit you, and what each involves and costs.

Each option has strengths and drawbacks. Removable dentures cost less, but they often need adhesive, can feel loose or uncomfortable, and can add to decay, gum disease and shrinkage of the bone and gums. An adhesive bridge needs little or no drilling of the teeth next to it, but it can come loose, so it is often seen as temporary. A conventional bridge means filing down the healthy teeth either side of the gap to hold it, and over time these crowns can loosen and lead to decay. An implant isn’t attached to the teeth next to it, so they are left untouched, and it can be combined with bone grafting where needed.

Implants are a well-established, tried-and-tested treatment. Like natural teeth, how long they last depends largely on how well you look after them and whether you keep up your regular hygienist and check-up visits. If they aren’t cleaned well, a coating builds up around them, just as it does on neglected teeth, and this can lead to gum infection, bleeding and soreness. With good care, and strong, healthy bone around them, implants can last for many years. But as with other implants in the body, such as a hip replacement, there is no lifetime guarantee.

Implants are usually placed under a local anaesthetic, which numbs the area while we work. Afterwards, much as after having a tooth out, you may have some discomfort in the week after surgery, such as a dull ache, swelling or slight bruising. How much depends on how many implants you have and how involved the surgery is. If you’re very nervous, or your treatment is complicated, intravenous (IV) sedation is available to help you feel deeply relaxed. General anaesthetic is rarely used for implants, and only for very complicated cases.

The implant itself sits in the jawbone, under the gum, so it can’t be seen. What shows is the crown, bridge or denture fitted on top. This is made for your mouth by dental laboratories we have worked with closely, so that the finished result looks as natural as possible. We’ll talk through how your new teeth will look at your consultation, before any treatment starts.

It depends on the type. Most crowns and bridges fixed to implants can only be fitted and removed by your dentist, so they stay in place from day to day. If you have a denture that clips onto implants, you can take it out yourself to clean it. If you’ve lost all the teeth in one jaw, there is also a removable implant bridge, which you take out to clean. We’ll explain the differences at your consultation.

Sometimes an implant doesn’t fuse with the bone and becomes loose, either while it heals or shortly afterwards. If that happens, it can be removed easily and your jaw heals in the normal way. Once the area has healed, another implant can be placed there. Or, if you have several implants, a bridge can be made using the implants that have bonded. We’ll talk you through what this would mean for you.

It can. Implants can’t decay, but like teeth they can develop gum problems, and bone can sometimes be lost around them. If that bone loss keeps progressing, the implant may be lost. Smoking and heavy drinking both reduce how long implants, and teeth, survive. Your protection is thorough daily cleaning, regular hygienist visits, which reduce the risk, and check-ups, so that any problem is found early, when it’s easier to treat. If an implant is failing, we’ll plan the next step with you.

Implants and the teeth they hold can be damaged in an accident, just like natural teeth. If you play contact sports, or sports with a ball, wear a mouthguard made by your dentist. If only the crown or bridge is damaged, it can usually be removed from the implant and replaced. If the titanium implant itself is damaged beyond repair and is too difficult to remove, it can safely be left in the jaw, and another implant placed alongside it.

We only use established implant brands, such as Straumann^®. Dr Ross Cutts works closely with the Straumann system and has experience with many others. Your crowns, bridges and dentures are made by dental laboratories we work closely with, including Borough Crown & Bridge and TPR Dental Prosthetics, so that they look as natural as possible and suit you. We’ll tell you which system we recommend for you, and why, at your consultation.

Often not. We use an iTero digital scanner, which records your teeth with the tip of a small hand-held wand instead of a tray of impression material. You and your dentist can watch the scan build up on screen, and the computer turns it into a three-dimensional model of your teeth. This is used to make your crowns, bridges and implant teeth, without the mess or taste of traditional moulds.

Most adults can have implants once their jawbones have stopped growing. They suit people in good general oral health who have lost a tooth or teeth through decay, gum disease, injury or another reason. The main question is whether there is enough healthy bone in your jaw to hold an implant. At your consultation we’ll examine you and arrange the tests needed, such as X-rays or a CBCT 3D scan, to see how much bone there is. If there isn’t enough, it can often be built up first with bone grafting.