Replacing teeth
Dental prosthesis: crown, bridge, denture or implant?
A broken tooth, a tooth damaged by a large cavity, or one or more missing teeth: a dental prosthesis gives your mouth back its function (chewing, speaking) and its appearance. There are several kinds, fixed or removable, supported by teeth or by implants. None of them is "the best" for everyone: the choice depends on the condition of your teeth and gums, your bone, the number of teeth to replace and what you expect. This guide explains the main options in simple words, based on the reviews of studies cited in the text. It is here to inform you; it does not replace an examination.
Why replace a missing tooth?
A missing tooth does not just leave a gap. Over time, the neighbouring teeth can tilt into the space, and the opposite tooth can drift down or up because it has nothing to bite against. You end up chewing on one side only, and a visible gap often makes people self-conscious when they smile. Replacing a tooth is not always necessary (for example a back tooth when the bite stays stable), but the decision is made at the examination.
Fixed prostheses
The crown
A crown is a "cap" that covers a damaged tooth whose root is healthy: after a large cavity, a fracture, or a root canal treatment that has weakened the tooth. The tooth is shaped, an impression (or a scan of the mouth) is taken, then the crown is made and cemented in place.
It can be porcelain-fused-to-metal (metal covered with ceramic) or all-ceramic (zirconia, lithium disilicate). A recent meta-analysis finds that, after five years, about 96 to 98% of the main types of crowns are still in place: modern all-ceramic crowns do as well as porcelain-fused-to-metal ones, and "monolithic" crowns (made from a single block) crack or chip less (Pjetursson et al., 2026, PubMed).
The bridge
A bridge replaces one or more missing teeth by resting on the neighbouring teeth. These are shaped to carry crowns that are joined to a false tooth in the middle. It is fixed and does not come out. It lasts a little less long than a single crown: a meta-analysis finds that about 88 to 93% of bridges are still in place after five years, depending on the material, and about seven bridges out of ten have no complication at all over that period (Romandini et al., 2026, PubMed). The most common complications are decay at the edge of the crowns, the bridge coming loose and chipped ceramic.
The main drawback of a bridge is that neighbouring teeth, sometimes healthy ones, have to be shaped. That is why, for a single missing tooth, an implant is often discussed too.
Implant-supported prostheses
An implant is a titanium screw (sometimes zirconia) placed in the bone, where it replaces the root; a crown, a bridge or a full denture is then attached to it. The implant does not touch the neighbouring teeth. A review of 139 studies finds a five-year survival of about 97% for implant-supported prostheses; but complications (gums, screws, ceramic) remain common, which is why follow-up matters (Pjetursson et al., 2014, PubMed). See the detailed guide: dental implants. Implants need enough bone, healthy gums and an assessment beforehand, often with a scan.
Removable prostheses (dentures)
The removable partial denture
It replaces several missing teeth and hooks onto the remaining teeth with clasps. You take it out to clean it. It needs less work on the teeth than a bridge, but it is bulkier, and the teeth that carry the clasps must be cleaned very well so they do not decay.
The complete denture (full denture)
When no teeth are left in a jaw, a complete denture stays in place by suction on the gum and the palate. An upper denture often holds well; a lower one moves more, because the area it rests on is smaller and the tongue lifts it.
Implant-supported dentures
To help a lower denture that moves, it can be "clipped" onto two implants (sometimes just one). A meta-analysis finds better satisfaction, comfort, speech and stability than with a conventional lower denture (Egido Moreno et al., 2020, PubMed). For the upper jaw, however, a review finds no clear difference in satisfaction between a well-made conventional denture and an implant-supported one (Michaud et al., 2024, PubMed).
Comparing the options
| Option | Fixed or removable | Involves the neighbouring teeth | Notes |
|---|---|---|---|
| Crown | Fixed | No (covers the tooth itself) | Damaged tooth with a healthy root |
| Bridge | Fixed | Yes (teeth are shaped) | Replaces 1 to a few teeth |
| Implant + crown | Fixed | No | Needs enough bone and an assessment |
| Removable partial denture | Removable | Clasps on the teeth | Less shaping, bulkier |
| Complete denture | Removable | — (no teeth left) | Less stable in the lower jaw |
| Implant-supported denture | Removable, clipped on | — | More stable, especially in the lower jaw |
The steps of a prosthesis
- The examination: condition of the teeth, gums and bone, often with X-rays (see the guide to tooth names to find your way around).
- Treatment beforehand: cavities, gums, and any root canal treatments or extractions.
- Preparation and impression: shaping of the teeth for a fixed prosthesis, impression or scan.
- The try-in: the shade, shape and bite are checked before the final fitting.
- Fitting and check-ups: adjustments in the following days, then regular check-ups.
For a fixed prosthesis, a temporary tooth protects the shaped tooth and your appearance while the prosthesis is being made.
Getting used to a denture
In the first weeks, a new denture can make speaking and eating awkward, make you produce more saliva and cause sore spots. Start with soft foods cut into small pieces, chew on both sides at the same time, and read or talk out loud to get your normal speech back. A sore spot is adjusted at the dentist's: never file down the denture yourself.
Caring for your prosthesis
- Fixed prosthesis: brush twice a day and clean under the bridge and around the implants (interdental brushes, suitable floss), just as for natural teeth.
- Denture: take it out and clean it every day with a brush and mild soap or a suitable product, over a sink filled with water so it does not break if you drop it. Also brush your gums, your tongue and your remaining teeth.
- At night: unless your dentist advises otherwise, take the denture out to let your gums rest, and keep it in a box with water.
A review points out that poor denture hygiene promotes inflammation of the gum under the denture (stomatitis), sores and, in frail older people, lung infections; most of these complications can be prevented with good hygiene and suitable advice (Dakka et al., 2022, PubMed). Dentures also encourage the growth of yeasts (Candida) if they are not cleaned regularly (Madhan Kumar et al., 2025, PubMed).
How long does a prosthesis last?
No prosthesis lasts forever. Crowns and bridges often last many years if the teeth that carry them and the gums stay healthy. A denture wears out, and above all the gum and bone underneath it change over time: it needs to be checked regularly, and sometimes relined (refitted) or remade. Come and see the dentist if your prosthesis moves, hurts, or if you chew less well.
In practice
- Have a full examination before choosing: the condition of your mouth guides the choice.
- Treat cavities and gums before any prosthesis.
- Ask about the advantages and limits of each option in your case.
- Clean your prosthesis every day, and take your denture out at night unless advised otherwise.
- Come back for check-ups: a prosthesis needs monitoring just like natural teeth.
Frequently asked questions
What is the difference between a bridge and an implant?
A bridge rests on the neighbouring teeth, which have to be shaped; an implant replaces the root in the bone and does not touch the neighbouring teeth, but it needs enough bone and a minor surgical procedure.
Is a ceramic crown as strong as a crown with metal?
According to the studies, modern all-ceramic crowns, such as zirconia or lithium disilicate, have a five-year survival comparable to that of porcelain-fused-to-metal crowns.
Can I sleep with my denture in?
In general, you are advised to take it out at night to let your gums rest and to keep it in water; follow your dentist's advice for your own case.
My lower denture moves, what can I do?
Have it checked: it may need to be refitted; and if the problem continues, a denture clipped onto one or two implants often improves stability and comfort.
How much does a dental prosthesis cost?
The cost depends on the type of prosthesis, the material and the treatment needed beforehand; it can only be given after the examination, which is when the possible options can be explained.