Crowns, Bridges and Dentures

Your tooth is still present but is broken, worn or has a large filling

Start with the dental crowns page. A crown covers the visible part of a tooth; the tooth is filed down during preparation. The page also explains when a filling or onlay may be considered instead, depending on the remaining tooth tissue. Having had root canal treatment does not, on its own, decide whether a crown is needed; your dentist assesses the remaining tissue. The page also covers research findings on how long crowns remain in use⁵.

You have a missing tooth or several missing teeth next to each other

The dental bridges page compares fixed options attached to natural teeth. With a conventional bridge, neighbouring teeth are filed down and covered with crowns. A single missing tooth can also be replaced with an implant crown, without filing down the neighbouring teeth; the dental implants page explains this option. With a resin-bonded bridge, the replacement tooth is held by a wing bonded to the inner surface of a neighbouring tooth. At your examination, ask whether the neighbouring teeth already need crowns and whether they can support a bridge. The possibility of decay and pulp problems in supporting teeth² forms part of this decision.

You are missing some teeth or all the teeth in a jaw

The dentures page compares partial and complete dentures. A partial denture takes support from the remaining teeth. A complete denture rests on the gums in a jaw without teeth. You can remove and replace both types yourself. Dentures may help with eating and speaking difficulties caused by missing teeth⁶. The page also explains getting used to dentures, cleaning them and adjusting their fit.

You are considering a denture attached to implants or fixed teeth for a jaw without teeth

Not all implant-supported teeth are fixed. You remove an implant-supported removable denture for cleaning; only a dentist removes a fixed bridge. The full-mouth implants page compares these options, complete dentures without implants and shorter bridges supported by more implants.

In randomised studies of people with no teeth in the lower jaw, removable dentures attached to implants were, on average, rated more favourably than conventional dentures⁷. The size of the benefit is uncertain. This finding cannot be applied directly to the upper jaw: a 2026 consensus report notes that the advantage may not hold there, although newer studies reported improved satisfaction⁸.

Ask these questions at your examination:

• Can my tooth be kept? If a crown is proposed, ask whether enough tooth tissue remains. If extraction is proposed, ask for the reason to be explained for each tooth separately.
• What condition are my neighbouring teeth in? Ask what a bridge would involve for these teeth and whether an option that removes less tissue could be suitable.
• Could I manage a removable denture? Explain your expectations for daily use and cleaning. Ask for a practical demonstration of how to clean beneath a fixed bridge.
• What assessments would I need for implants? Discuss your bone, general health, medicines and the healing process with your dentist.
• Does every gap need to be filled? Ask about leaving a gap untreated, particularly where back teeth are missing.

A review of adults whose front teeth and premolars were present, but whose back molars were missing, found that leaving those gaps unfilled showed promise for chewing and satisfaction⁹. This finding cannot be applied to every gap.

If you are satisfied with your upper complete denture and your mouth tissues are healthy, an international consensus guideline does not recommend further treatment beyond regular maintenance, and recommends that you are told about the alternatives⁸.

Each treatment page explains its risks in more detail. Consider these differences when making your decision:

• Crowns and tooth-supported bridges. Tissue removed during tooth preparation does not grow back. In teeth with living pulp before treatment, the nerve and blood supply inside the tooth (the pulp) has been reported to lose its vitality after crowns, partial crowns and bridges¹. The certainty of the evidence is low. The problem cannot be attributed to preparation alone; previous decay and fillings may also contribute. In conventional bridges, decay and loss of pulp vitality in supporting teeth are among the main problems².
• Removable dentures. As the jawbone changes shape after extractions, dentures may become loose¹⁰. Pain, sores and slipping need assessment⁶. Teeth supporting partial dentures have been found to have a higher risk of extraction; this association does not prove that the denture caused the tooth loss¹¹.
• Implant-supported teeth. The implant itself and the teeth attached to it are assessed separately. With fixed full-arch bridges, implant loss¹², inflammation around implants, loose screws and porcelain fractures³ have been reported. Implant-supported removable dentures may also need replacement attachment parts, relining or repairs⁸.

Choosing a fixed option or using implants does not remove the need for maintenance and repairs.

A crown, a bridge, a denture and implant-supported teeth remaining in use are different outcomes. Results for single crowns on natural teeth⁵ cannot be applied directly to implant-supported crowns or bridges. For conventional bridges, remaining in place and remaining free of problems are different outcomes¹³.

Putting results from different patient groups side by side does not show which option is suitable for you. A 2007 review examining bridges and single implants found no study directly comparing them¹⁴.

These findings come from published studies, not from our own records. Detailed figures and follow-up periods are on the relevant treatment pages. There is no fixed evidence-based interval for relining or replacing removable dentures¹⁵; the decision is made after an examination.

With crowns and bridges, cleaning the natural teeth, restoration edges and spaces between teeth continues. Ask to be shown how to use suitable floss or interdental brushes beneath a fixed bridge. Studies of cleaning between teeth suggest that these tools, alongside toothbrushing, may reduce plaque and gum inflammation¹⁶. The certainty of the evidence is low, and these studies did not examine cleaning beneath bridges separately.

Removable dentures are cleaned outside the mouth. A review found that combining brushing with a chemical cleanser was more effective than either method alone¹⁷. Read the care section on the dentures page for products and storage methods suited to the material.

With implant-supported options, the tissues around the implants are monitored as well as the replacement teeth. The European Federation of Periodontology guideline recommends a planned programme of supportive care, with regular checks of the tissues around the implants¹⁸. Before deciding on treatment, ask how to carry out daily cleaning and what follow-up checks involve.

Contact your dentist if your removable denture causes pain, slips, no longer fits or is broken⁶. Have its fit checked instead of using more adhesive; adhesive cannot make up for a denture that does not fit⁴.

If toothache comes with swelling of the face or jaw, or a fever, seek an urgent dental assessment. A dental abscess needs urgent treatment¹⁹.

Swelling that makes breathing, speaking or swallowing difficult; eye swelling, eye pain or sudden vision problems; substantial swelling inside the mouth; or difficulty opening your mouth require emergency medical help¹⁹. Do not wait for a dental appointment; go to a hospital emergency department or call 112.

Ask for the scope of your treatment plan in writing. Check whether it includes:

• The type and material of the crown, bridge or denture, and which teeth it will restore or replace
• Any fillings, root canal treatment, gum treatment or extractions needed beforehand
• For implant-supported options, the implants, attachment components and any bone support needed
• Temporary crowns, bridges or dentures
• Follow-up checks, adjustments, re-cementing, relining, repairs and replacement parts

Also ask why an option is recommended, why other options were considered unsuitable and whom to contact if a problem develops.