Missing a Tooth? Implants, Bridges and Dentures Compared

The short answer

There are three established ways to replace a missing tooth, and a fourth option — leaving the gap — that is sometimes reasonable.

An implant replaces the root as well as the visible tooth and leaves the neighbouring teeth untouched, but it involves minor surgery, enough bone to hold it, and several months of healing. A bridge is fixed in place and finished in weeks rather than months, but the teeth on either side are reshaped to carry it, and that cannot be undone. A denture is removable, involves no surgery, and can replace several teeth at once — but it takes some getting used to. The NHS puts it plainly: “It can take a few weeks to get used to wearing dentures.”

None of these is the right answer for everyone. Which one suits you depends on how much bone you have, the condition of the teeth either side of the gap, your medical history and what you want to spend.

Suitability for treatment depends on a clinical assessment. This treatment may not be appropriate for every patient.

What happens if you replace nothing

Leaving a gap is not automatically a mistake. A missing wisdom tooth usually needs no replacement at all, and a single missing back tooth in an otherwise stable bite sometimes doesn’t either. But two changes are documented in the literature, and both are worth understanding before you decide.

The bone at the site changes shape. A systematic review by Tan and colleagues in Clinical Oral Implants Research (2012) pooled human studies of what happens to the jaw after an extraction and reported horizontal ridge loss of 29–63% and vertical loss of 11–22% over six months, with most of that change occurring in the first three to six months. That does not mean the jaw collapses. It means the ridge narrows and flattens. It matters most if you might want an implant later, because the amount of bone left is what determines whether one can be placed without grafting first.

The surrounding teeth may move. Guo and colleagues (Clinical Oral Implants Research, 2021) measured 40 healed single-tooth gaps in the back of the mouth over the three months following implant placement, while the site was still unrestored. Eighteen of the 40 teeth in front of the gap, and 24 of the 40 behind it, had migrated towards it. That tells us movement around an unrestored space is common but not universal over a short window; it is not a study of gaps left untreated for years. The same study found greater reduction in the gap’s width in patients under 30 than in those over 50.

Taken together, these findings are a reason to make a decision within a sensible timeframe — not a reason to panic. If you are unsure, an assessment now tells you which options are still open to you, which is more useful than guessing.

Option 1: Dental implant

An implant is a small titanium post placed into the jawbone, where it takes the role of a tooth root. Bone grows into contact with its surface over a period of months — a process called osseointegration — after which an abutment is connected and a crown fitted on top. The finished tooth is fixed; you clean it in your mouth rather than taking it out.

Who it suits

An implant tends to make most sense when a single tooth is missing and the teeth either side are healthy and unrestored, because it is the only one of the three options that leaves them alone entirely. It also suits people replacing a tooth at the back of the mouth where there is nothing behind the gap to anchor a bridge to.

You need enough bone to hold the fixture, or to be willing to have that bone rebuilt.

Trade-offs

Placement is carried out under local anaesthetic; IV sedation is available for anxious patients. The main trade-offs are time and cost. From extraction to finished crown, the process usually spans several months, because osseointegration cannot be rushed. Fees rise further if you need a bone graft or a sinus lift.

Smoking is worth raising early, because the evidence on it is clear. A meta-analysis by Chen and colleagues (PLoS One, 2013) reported a relative risk of implant failure of 1.92 (95% CI 1.67–2.21) in smokers. The same analysis found no statistically significant association for diabetes (RR 0.90, 95% CI 0.62–1.32) and concluded that the relationship warrants further study — so one of those two factors has firm evidence behind it and the other does not, and it is more honest to say so than to list them together.

Implants can also fail. Among the strongest long-term figures available are those from Howe, Keys and Richards (Journal of Dentistry, 2019), a systematic review and sensitivity meta-analysis of 10-year outcomes. It reported implant-level survival at 10 years of 96.4% (95% CI 95.2–97.5%) — but when the authors ran a sensitivity analysis that accounted for patients lost to follow-up, the estimate fell to 93.2% (95% CI 90.1–95.8%). The second figure is the more conservative one, and it is the one worth holding in mind. Implants are not maintenance-free. Gum disease around an implant (peri-implantitis) is a recognised cause of implant loss, which is why cleaning and regular review matter.

Cost

At this practice, a single implant is from £2,200 and a bone graft from £400 (prices correct as of July 2026, subject to clinical assessment). Fees vary considerably between practices and between cases — our full UK implant cost guide explains what drives the difference and what a quoted “from” price often leaves out.

Option 2: Bridge

A bridge is a fixed replacement that spans the gap, supported by the teeth on either side. In the NHS’s description, it is “made by taking an impression of the surrounding teeth, which will eventually support the bridge.”

There are two broad designs. A conventional bridge uses crowns cemented onto the neighbouring teeth, which are reshaped to receive them. A resin-bonded (adhesive) bridge uses a thin metal or ceramic wing bonded to the back of an adjacent tooth, which needs far less preparation — often almost none. Which design is appropriate is decided at assessment.

Who it suits

A bridge is frequently the better clinical choice when the teeth either side of the gap are already crowned or heavily filled. If those teeth need restoring anyway, using them to carry a bridge costs you nothing in healthy tooth structure — and that changes the calculation completely.

It also suits people who cannot have or do not want surgery, who don’t have enough bone for an implant and would rather not graft, and who want the gap dealt with in a matter of weeks.

Trade-offs

The central trade-off with a conventional bridge is that healthy enamel is removed from two sound teeth to replace one missing one, and that cannot be reversed.

The long-term data are worth reading carefully, because survival and success are not the same thing. Tan, Pjetursson, Lang and Chan (Clinical Oral Implants Research, 2004) reviewed conventional bridges and estimated a 10-year survival rate of 89.1% (95% CI 81–93.8%) — that is, the bridge still in place. The 10-year success rate, meaning still in place and free of complications, was 71.1% (95% CI 47.7–85.2%). The same review put the 10-year cumulative risk of decay at the supporting teeth at 9.5% (95% CI 4.6–18.9%) — a wide interval, and worth reading as such — and the risk of the bridge coming loose at 6.4%. A bridge that is still there is not necessarily a bridge that has been trouble-free.

Cleaning also takes more effort. You cannot floss between the units in the usual way; you clean underneath the false tooth with superfloss or an interdental brush.

Finally, a bridge replaces the crown but not the root.

Cost

Bridge fees depend on the design, the materials and the number of units involved, so they are quoted after examination rather than from a list — see our full price list and read more about dental bridges. Bridges are also available on the NHS where clinically necessary, within Band 3 (£332.10 at the time of writing, July 2026).

Option 3: Denture

Dentures, in the NHS’s words, “are false teeth that are used to replace missing teeth. They fit over your gums and some types also clip onto any remaining teeth you have.” A partial denture replaces one or more teeth; a complete denture replaces a full upper or lower arch.

Who it suits

A denture is often the more sensible option when several teeth are missing in different parts of the same arch. One partial denture can replace four teeth spread across the mouth. Replacing the same four teeth with individual implants means paying for four separate implants, so for multiple scattered gaps a denture is usually the lower-cost route. Fees for each are quoted after assessment.

It is also the practical answer where there is not enough bone for implants, where cost is the deciding factor, or where you need something in place while a site heals before a longer-term plan is carried out.

Trade-offs

A denture comes out, and that is the adjustment most people find hardest. The NHS is straightforward about it: “It can take a few weeks to get used to wearing dentures,” and suggests you “practice taking them in and out and eating softer foods until you’re comfortable with your regular diet.”

Because a denture rests on the gum ridge, and the ridge changes shape after teeth are lost (Tan et al., 2012), dentures are adjusted and relined over time rather than fitted and forgotten. Cleaning matters more, not less: NHS guidance is to remove and brush dentures every morning and evening, and not to wear them overnight unless your dentist recommends it, because “trapped food increases the risk of gum infections and tooth decay.”

Cost and the middle option

Denture fees vary with design and materials and are quoted after assessment; see the full price list and our page on implant-retained dentures. Dentures are covered on the NHS within Band 3 where clinically appropriate.

There is also a middle path that is often overlooked. A small number of implants can be used to hold a denture firmly in place, combining the cost profile of a denture with better stability. The McGill Consensus Statement on Overdentures (European Journal of Prosthodontics and Restorative Dentistry, 2002) proposed the mandibular two-implant overdenture as the first-choice standard of care for people with no lower teeth. At this practice, adding two implants to retain a denture is from £3,800, and fixed full-arch options start at £9,750 for All-on-4 full-arch implants and £12,500 for a six-implant fixed bridge (prices correct as of July 2026, subject to clinical assessment).

Side-by-side comparison

Prices correct as of July 2026 and subject to clinical assessment. Evidence figures are cited in full in the sources below.

Which is right for you

There is no universal ranking here. In practice the decision usually falls out of a few specific circumstances.

A bridge is often the better choice when the teeth either side of the gap already need crowns. In that situation an implant means paying for three restorations where a bridge gives you one, and no healthy tooth structure is sacrificed because it was going to be prepared anyway. A bridge is also the better answer when a medical condition or medication makes surgery inadvisable, when there is too little bone and you would rather not undergo grafting, and when a front tooth needs replacing quickly ahead of a fixed date.

A denture is often the better choice when several teeth are missing across an arch, when the remaining bone will not support implants, and when the cost of fixed treatment would mean going without treatment altogether. A well-made partial denture that you actually wear is a better outcome than an implant plan you cannot fund. Dentures also serve well as an interim while a site heals.

An implant is often the better choice when a single tooth is missing between two healthy, unrestored teeth, when the tooth at the back of the arch is gone and there is nothing behind it to support a bridge, and when you would rather not have a removable appliance.

And sometimes nothing is the right answer — a missing wisdom tooth, or an unopposed back tooth where the bite is stable, may need monitoring rather than treatment.

What settles it is an examination: how much bone you have, what the neighbouring teeth look like on an X-ray, how your bite works and what your medical history allows. A new patient consultation here is from £55, subject to clinical assessment (price correct as of July 2026), and it exists to give you the options rather than a single recommendation. You can read more about dental implants in Leeds or see the full price list before you book.

Suitability for treatment depends on a clinical assessment. This treatment may not be appropriate for every patient.

Frequently asked questions

Is a bridge better than a dental implant? Neither is better in general terms — they suit different situations. If the teeth either side of the gap are healthy and unrestored, an implant avoids touching them. If those teeth already need crowns, a bridge often makes better use of the work required. The published 10-year figures favour implants on survival, but that comparison ignores case selection: bridges are frequently chosen precisely because the case was not suitable for an implant.

Can I still have an implant if the tooth came out years ago? Often, yes — but it depends on what bone remains. Most ridge change happens in the first six months after extraction (Tan et al., 2012), so a long-standing gap does not necessarily rule an implant out. Three-dimensional imaging at assessment shows what bone is there and whether grafting would be needed first.

How long does each option take? An implant takes several months, because bone needs time to integrate with the fixture before the final crown is fitted. A bridge or denture is generally completed in weeks rather than months. The number of appointments depends on the design and is confirmed at assessment. Whether a temporary tooth can be provided in the meantime depends on the site and is confirmed at assessment.

Are any of these available on the NHS? Bridges and dentures are, within Band 3 (£332.10 at the time of writing, July 2026), where a dentist judges them clinically necessary. Implants are not routinely available: the NHS states that “implants are usually only available privately and are expensive,” and are “sometimes available on the NHS for patients who cannot wear dentures for certain reasons, such as mouth cancer or an accident.”

Can a denture be made to feel more secure? Sometimes. A small number of implants can be used to hold a denture in place, which is a recognised approach for the lower jaw in particular. Whether it is appropriate for you depends on bone volume and general health, and would be assessed at consultation.

What happens if I do nothing? Sometimes nothing of consequence, particularly at the back of the mouth where the bite is stable. But the ridge changes shape over the first six months after an extraction (Tan et al., 2012), and movement of neighbouring teeth into an unrestored space has been measured over a three-month window (Guo et al., 2021). Having the gap assessed keeps your options open even if you decide not to treat it yet.

Sources

1. Tan WL, Wong TLT, Wong MCM, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clinical Oral Implants Research 2012;23(Suppl 5):1–21. https://pubmed.ncbi.nlm.nih.gov/22211303/
2. Guo D, Pan S, Mühlemann S, Zhou Y, Jung RE. The migration of neighboring and antagonist teeth three months after implant placement in healed single tooth-missing sites. Clinical Oral Implants Research 2021;32(2):233–241. https://pubmed.ncbi.nlm.nih.gov/33258186/
3. Howe M-S, Keys W, Richards D. Long-term (10-year) dental implant survival: a systematic review and sensitivity meta-analysis. Journal of Dentistry 2019;84:9–21. https://pubmed.ncbi.nlm.nih.gov/30904559/
4. Tan K, Pjetursson BE, Lang NP, Chan ESY. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years — III: conventional FPDs. Clinical Oral Implants Research 2004;15(6):654–666. https://pubmed.ncbi.nlm.nih.gov/15533126/
5. Chen H, Liu N, Xu X, Qu X, Lu E. Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis. PLoS One 2013;8(8):e71955. https://pubmed.ncbi.nlm.nih.gov/23940794/
6. Thomason JM. The McGill Consensus Statement on Overdentures: mandibular 2-implant overdentures as first choice standard of care for edentulous patients. European Journal of Prosthodontics and Restorative Dentistry 2002;10(3):95–96. https://pubmed.ncbi.nlm.nih.gov/12387249/
7. NHS. Dental treatments. https://www.nhs.uk/live-well/healthy-teeth-and-gums/dental-treatments/
8. NHS. Dentures. https://www.nhs.uk/tests-and-treatments/dentures/
9. NHS. What is included in each NHS dental band charge. https://www.nhs.uk/nhs-services/dentists/dental-costs/what-is-included-in-each-nhs-dental-band-charge/