A missing tooth isn’t only a gap. The jaw changes around it, the teeth beside it move, and the choice you make now sets up the next twenty years. Most people come in wanting to know which option is best. The more useful question is which one is right for your mouth, your budget, and how long you want it to last.
What changes after a tooth is lost
Bone responds to being used. A tooth root loads the bone around it every time you chew, and when the root is gone that stimulus goes with it. The bone in that spot gradually loses volume, most noticeably in the first year. Meanwhile the teeth on either side start to tilt toward the space and the tooth above or below it can drift down into it.
None of this is an emergency. It is a reason not to leave the decision open indefinitely — the more bone you still have, the simpler and less expensive the replacement tends to be.
The four options, compared honestly
A dental implant is a post placed in the jawbone that the bone bonds to over roughly six weeks to six months, depending on the site. It stands on its own, doesn’t touch the neighboring teeth, and helps keep the jawbone in that area from shrinking. It costs the most up front and takes the longest. It also lasts the longest.
A fixed bridge spans the gap using the teeth on either side as anchors. It’s faster and cheaper. The trade is real: those two teeth get reduced to carry the bridge, whether or not there was anything wrong with them.
A removable partial denture clips onto the remaining teeth. It’s the least expensive, involves no surgery, and comes out at night. Some patients stop noticing it. Others never quite do.
A full denture replaces an entire arch. Adaptation varies a lot between people. Implant-supported options sit between a conventional denture and a set of individual implants, and are worth understanding before you assume dentures are the only path — see types of implants.
When an implant isn’t the right call
Plenty of people are told an implant is the answer when it isn’t, or that it’s impossible when it isn’t. Active gum disease has to be treated first. Smoking, uncontrolled diabetes, and certain medications all affect how well the bone heals around the post, and they change the odds enough to talk about openly. And if the teeth on both sides already need crowns, a bridge can be the more sensible plan, because those teeth are being restored regardless.
Not having enough bone is a different matter — that’s usually solvable with bone grafting rather than a reason to rule implants out. Cases involving significant bone loss, difficult anatomy, or an implant that failed elsewhere are a large share of what comes through this practice.
How the decision gets made here
Dr. Janette is a board-certified oral and maxillofacial surgeon (Diplomate, American Board of Oral & Maxillofacial Surgery). He completes the surgical placement and coordinates the restoration with your own dentist — and if you don’t have one, he’ll help you find a good fit. The point of the consultation is a straight answer about which of the four options actually suits your case, including when that answer is “not surgery.”
Whether you’re in- or out-of-network depends on your plan; we identify your coverage before your consultation and help you navigate your dental benefits. You’ll have a written estimate after the consultation and before any treatment begins. Third-party financing is available if paying over time helps. What implants cost goes into more detail.
Common questions
There’s no deadline, but waiting has a cost. Bone volume is greatest right after the tooth comes out and decreases from there, and the neighboring teeth drift into the space over time. Replacing sooner usually means a simpler, less expensive plan than replacing later.
Usually not. A temporary is common while the bone bonds to the implant. What’s possible depends on where the tooth is and how much bone is there, which is part of what the consultation determines.
It helps keep the jawbone from shrinking in that area, because the bone is being loaded again. It won’t reverse bone that’s already been lost — that’s what grafting is for.
Sometimes. If the teeth on both sides already need crowns, a bridge may make sense because those teeth are being restored anyway. Dr. Janette will tell you when that’s the case rather than steering you toward surgery you don’t need.
That’s common and usually solvable. Bone grafting rebuilds the site so an implant can be placed, and cases involving significant bone loss or a failed previous implant are a large part of what this practice handles.