Replacement Options for Missing Teeth

By: Dr. Jim Arnold Last Updated: January 21, 2010

Question: “Dr. Arnold, I recently had a tooth removed, and my dentist says that I need to replace it. How important is this, and should I get an implant or a bridge?”

Answer: After losing a tooth, it is generally very important to replace that missing tooth to prevent the other teeth from shifting. Teeth that have shifted often create areas that are difficult to keep clean, which can lead to periodontal (gum) problems and decay (cavities). Additionally, teeth which have shifted may no longer fit together properly, thus causing excessive wear, additional tooth loss, headaches, and a host of other problems.

Dental implants have been used for decades to replace missing teeth. Modern implants are made of a titanium alloy and are biocompatible (accepted by the body). “Root form” implants are surgically placed in the jaw bone, and the healing time is generally three to six months, depending upon how dense the bone is. During this time, the bone osseointegrates, or “fuses” to the implant.

Once the implant is well-supported by the bone, an abutment is placed. The abutment fits into the implant, extends above the gums, and provides something to attach a traditional crown to. Implant bridges are also common, as well as implant placement to increase the stability of a denture.

Implants are most beneficial in situations where the teeth adjacent to the space are ideal, they line up well, and the bone quantity and quality are excellent. In these cases, the other teeth don’t have to be reshaped, and “bone grafts” are usually unnecessary.

Bridges are often best when the adjacent teeth are compromised and restoration to excellent form and function is needed anyway. This process involves reshaping the teeth that the bridge will attach to. It usually takes two to four weeks to have a bridge fabricated, and the cost of a three-tooth bridge (replacing one missing tooth) is similar to the cost for the implant surgery and a crown.

Obviously, many considerations must be taken into account in order to make the right decision for each patient. Ask your dentist what he or she would do if they were in your situation, and that will probably give you a pretty clear indication as to which route you should choose.

Dr. Jim Arnold is a practicing dentist in Chesterton and Valparaiso. He is also a clinical mentor with the Hornbrook Group and serves on the Advisory Board for the Academy of Comprehensive Esthetics as the Fellowship Chairman. You may send questions to his office at: 1830 South 11th Street, Chesterton, IN 46304 or email them to: More information on this or many other dental topics can be found at