Symptoms, explained
Missing a tooth: what your options really are
A gap changes things. Some gaps show every time you smile and quietly chip away at your confidence. Some just make chewing a chore. Some don’t bother you at all. Whichever yours is, there’s a ladder of options — from honestly leaving it alone to replacing the tooth so well you stop thinking about it.
This page can’t diagnose you. The right option depends on things only an examination shows — the neighbouring teeth, your gums, your bite, and the bone under the gap. The tests in the chair — a proper look, X-rays, sometimes a 3-D scan — make the call. You’re not expected to know which option fits your mouth. That’s our job.
And so you know how we think: the gentlest option that truly works for you is the right one. We’d rather talk you down the ladder than up it.
Toothache right now? We keep same-day slots — and we answer.
Call nowFirst, the honest question: does every gap need filling?
No — and a dentist should say so. If the gap is near the back and you’re chewing comfortably, living without that tooth can be a perfectly sound choice. Many people chew well without their back molars.
In younger patients there’s sometimes a second no-false-tooth option: braces can close the gap using your own teeth, so there’s nothing artificial in your mouth at all. Whether that’s on the table depends on which tooth is missing and how your bite lines up.
What you should do
Raise the gap at your next check-up, or book a consultation. We’ll tell you honestly whether doing nothing is a safe choice for your particular gap — for some it genuinely is.
A bonded bridge: the gentlest fixed option
A bonded bridge is a false tooth with a slim wing on the back. The wing is glued to a neighbouring healthy tooth — usually just one — with little or no drilling. Your own teeth stay whole.
Because nothing gets ground down and nothing goes into the bone, this is the most conservative fixed way to fill a gap — and it keeps every other option open for later.
What you should do
Book a consultation and ask about a bonded bridge — especially if the idea of drilling healthy teeth puts you off. It puts us off too.
An implant: the most tooth-like replacement
An implant is a small titanium post placed in the jaw where the root used to be. The bone slowly fuses to it — anywhere from about six weeks to six months, depending on the spot — and then a crown is fitted on top. It looks and works like a tooth, and it doesn’t touch the neighbours at all.
That’s why so many people ask for one. But an implant is only the right answer when the foundations are right, so before we say yes we check:
- Enough healthy bone. Bone shrinks once a tooth is gone, so we look properly — X-rays, and when needed a 3-D scan of the jaw.
- Healthy gums. Active gum disease has to be treated before any implant is placed.
- The honest risk factors. Smoking, uncontrolled diabetes and heavy grinding all lower the odds — we’d rather tell you that before than after.
- A jaw that’s finished growing. For teenagers, we hold the space another way and place the implant once growing is done.
Not enough bone usually isn’t the end of the road: bone can often be rebuilt with grafting, sometimes as a separate step first and sometimes at the same visit as the implant.
Done well, implants have an excellent track record — in well-planned cases, more than nine in ten are still going strong ten years later. But they’re not fit-and-forget. The gum around an implant can get inflamed and infected just like the gum around a tooth, and that’s far easier to prevent than to fix. Daily cleaning and regular check-ups are part of the deal.
What you should do
Book an implant consultation. We’ll examine, scan if needed, and give you an honest yes, no, or “yes, after some groundwork” — with a quote before anything starts.
A conventional bridge: when the neighbours need help anyway
A conventional bridge puts a crown on the tooth either side of the gap and hangs the false tooth between them. It’s fixed, it’s proven, and it makes the most sense when the neighbouring teeth already need crowns of their own — then one piece of work solves three problems.
But if those neighbours are healthy and untouched, a bridge means drilling them down. That’s a real cost to two innocent teeth — and it’s why a bonded bridge or an implant usually sits higher on our list.
What you should do
If the teeth next to your gap already have large fillings or crowns, ask us to compare a bridge and an implant side by side for your case. Sometimes the bridge genuinely wins.
Dentures: the removable option — and how to steady a loose one
A removable partial denture replaces one tooth or several on a plate you take out to clean. The plastic version is simple, and easy to add a tooth to later if you lose another. The slim metal-framework version rests on your own teeth, feels less bulky, and is easier to keep clean. For longer gaps — several missing teeth in a row — a denture is often the most practical answer.
If you’ve lost all the teeth in a jaw, a full denture is the traditional answer. And if a full lower denture has never felt secure, that’s not you doing it wrong — the lower jaw simply gives a denture very little to grip. Two implants can anchor it so it clicks firmly into place. For a loose lower denture, that’s the recognised first-choice standard — not a luxury.
What you should do
If you’re already wearing a denture that floats, rocks or rubs, don’t just live with it. Book a visit and ask what would make it stable — there is usually an answer.
About to lose a tooth? Say so before it comes out
One thing most people aren’t told: the bone that held a tooth starts shrinking soon after the tooth comes out — roughly half the ridge’s width can go in the first year, most of it in the first few months. Implants care about that bone the most.
So if there’s any chance you’ll want an implant one day, tell us before the extraction. We can remove the tooth gently and place a bone graft in the socket that same day to hold the ridge. Sometimes the implant itself can even go in on the day of the extraction; other times the site needs weeks or months to heal first. It depends on infection, the state of the socket, and how firm a grip the implant can get on the day.
What you should do
If an extraction is planned — here or anywhere — and an implant is even a maybe, say so before the tooth comes out. It changes how we take it out and what we do with the socket that day.
Go to an emergency department NOW — don’t wait for us — if you have: swelling under the tongue or into the neck, difficulty swallowing or breathing, an eye swelling shut, or rapidly spreading facial swelling with fever. These are medical emergencies first and dental problems second. Two more that can’t wait: a permanent tooth knocked out just now is a race against the clock — contact us or the nearest dentist immediately. If you can, push it gently back into its socket right away, or carry it in milk — never in water, never dry. And an extraction socket that won’t heal, or teeth going loose with no explanation, needs an urgent appointment — not watching and waiting.
What it costs
Whatever the treatment, we quote before we treat — always. If you’re on a medical aid, we claim directly: you pay only co-payments and anything your plan doesn’t cover or has already used up.
On a medical aid? See what your scheme’s published benefits say — and we confirm with a benefit check before treatment.
Not sure which pattern is yours?
Tell us what you’re feeling — we’ll take it from there.