Missing Teeth

There are a vast variety of options and sub-options for dealing with missing teeth from simply accepting the space to replacing all of the teeth with dental implants. The ideal approach is unique to that individual and we can discuss the below options in more detail if required at your consultation.
Dentures
Dentures are removable prostheses (sometimes referred to as ‘plates’) that can replace anything from one to all of the teeth in a jaw. Sometimes the remaining teeth benefit from adjustment in the mouth to facilitate the fit of the denture. Dentures replacing some teeth are often best made of cobalt-chromium whilst dentures replacing all teeth are best made of acrylic. Temporary dentures are usually made of acrylic. The main advantage of dentures are that they do not involve any surgery or particularly invasive procedures. The main disadvantage is that they will inherently move and require adaptation on your part to function with well. 

Dental implants can be placed to help stabilise dentures, often via simple stud attachments.
Conventional Bridges
This involves drilling down one or two teeth adjacent to the tooth to be replaced to make room to fit a ‘cap’ over the tooth (or teeth) similar to a crown. A conventional bridge is then constructed in a dental laboratory whereby a crown that fits over the tooth that has been reduced with a false tooth (‘pontic’) attached to it is constructed. The main risk of removing tooth tissue to fit a bridge is that the nerve inside the tooth dies necessitating root canal treatment or tooth extraction. An additional risk is that when the bridge fails, the supporting tooth or teeth may be lost, complicating tooth replacement in the future.
Resin Retained Bridges
These types of bridges incorporate metal ‘wings’ attached to the false tooth which are bonded to the back of the adjacent teeth. The main advantage is that this is a non-invasive procedure and no damage is done to the supporting tooth, even if the bridge fails. The main disadvantage is that they may not last as long as conventional bridges, although they are generally expected to last around 8 years and sometimes can last over 20 years.
Dental Implants
A dental implant is a piece of titanium which is shaped like a screw. This is placed into the jaw bone and is used to support a crown, bridge or denture. Dental implants can be used to replace anything from one tooth up to all of your teeth with a variety of material and connection options possible.

The surgery to place dental implants is generally better than people expect and usually provided under simple local anaesthesia. We do everything possible to ensure you are comfortable during the procedure. Following implant placement surgery, usually 3-6 months are allowed for the implants to integrate with your jaw bone. Following this, moulds of your mouth are taken to proceed to construct the crown, bridge or denture to be attached to the implants.

The main advantages of dental implants are that they can feel similar to your own teeth, avoid the need to drill adjacent teeth or rely on them for support, preserve bone and offer very high long-term success rates. The main disadvantages are that surgery is required, the healing times mean treatment can take some time from start to finish and long-term complications can be challenging to manage. 
In order to undergo dental implant treatment you must be relatively fit and healthy with good oral hygiene practices and no active tooth decay or infections. Certain amounts of bone height and volume are required within the jaws, this is usually assessed via a 3D cone beam CT scan. If necessary, bone can usually be built up with a bone graft which may be your own bone or a substitute bone.

At the end of treatment I will write to you with the details of any implant and bone grafting materials that have been used. You should always keep this information safe, because if you require treatment for the implant many years in the future the dentist will need the details in order to provide this for you. This is another reason to ideally maintain long-term contact or review with your implant dentist.

There are a number of different companies that manufacture dental implants. It is important to use a well established system with a strong research base and good long-term support in case of maintenance requirements. In practice I utilise Neoss. They have further helpful information with diagrams available here. 

I have a specific interest in dental implant treatment and organise and teach on courses to a variety of dentists including other registered Specialists. My approach is to consider dental implants in the context of each specific person’s unique situation and the relative merits when compared with alternative tooth replacement options. My general rule of thumb is to maintain as many healthy teeth as possible rather than to actively remove and replace them. We would always discuss your aims as part of the consultation.

If you are interested in much more in-depth information then Wikipedia is of course always a useful source of information.