Assessment and planning
We examine the space, the neighbouring teeth, the bite and the bone with X-rays and, for implants, a 3D scan. You leave with the options ranked for your mouth rather than a generic list.
About this treatmentDental condition · Wimpole Street, Marylebone
Missing tooth: what happens to the space, and the options for filling it
Losing a tooth is rarely just a gap. The neighbours on either side start to lean into the space within months, the tooth that used to bite against it drifts down or up to find contact, and the bone that once held the root begins to shrink because nothing is loading it any more. None of that is dramatic week to week, which is why so many people wait years before doing anything. By then the space is narrower, the bite is less even and the bone is thinner, all of which make replacement harder and often more expensive. There is no rule that says every gap must be filled; a molar at the very back can sometimes be left with little consequence. But the decision should be made deliberately, with a clear picture of what the alternatives are, rather than by default. Our Wimpole Street dentists walk you through implants, bridges and dentures, explain which suit your particular gap, and tell you plainly when doing nothing is reasonable.
Recognising it
How it usually feels
Neighbouring teeth tipping into the space
Without a contact to lean on, adjacent teeth tilt towards the gap and create food traps.
The opposing tooth growing longer
A tooth with nothing to bite against slowly erupts further, disturbing the bite.
Chewing shifted to one side
Favouring the other side overloads those teeth and can strain the jaw joint.
A sunken look to the lip or cheek
Front-tooth gaps and multiple missing teeth remove the support that keeps soft tissue in shape.
Speech that sounds different
Air escaping through a front gap alters certain consonants.
Food packing and gum soreness at the site
Tipped teeth and an uneven ridge collect debris that is hard to clear.
Behind the symptoms
What's going on
- 01
Extraction for decay or infection
A tooth too broken down to restore, or one with an infection that root canal treatment cannot resolve, is removed. This remains the most frequent route to a gap in adults, and the timing of replacement depends on how the socket heals.
- 02
Advanced gum disease
When periodontitis has dissolved most of the bone around a root, the tooth loosens beyond the point of saving. Replacement here needs the surrounding gum condition brought under control first, or the new tooth inherits the same problem.
- 03
Trauma
Falls, sport and cycling accidents account for many lost front teeth, often in otherwise healthy mouths. A tooth knocked clean out can sometimes be replanted if it is handled correctly and reinserted quickly.
- 04
Teeth that never developed
Some adults are born without certain teeth, most commonly the upper lateral incisors or lower second premolars. The baby tooth may hang on into adulthood, then fail, leaving a space in a spot where the bone has never fully formed.
- 05
Fracture below the gum
A crack running down the root, often in a heavily filled or root-treated tooth, cannot be repaired. The tooth may feel fine for a while, then become tender and infected, and extraction is the only option.
Before your appointment
What you can do today
- If a tooth has just been knocked out, pick it up by the white crown, not the root, and put it back in the socket or into milk while you travel to a dentist.
- Keep the gap clean with a soft brush and a single-tuft brush along the exposed sides of the neighbouring teeth, which are now more prone to decay.
- Try to chew on both sides rather than avoiding the gap entirely, so that the other side is not overloaded.
- Photograph the gap and the way your teeth meet now; it helps you and us notice drift over time.
- Do not buy temporary tooth kits online for anything longer than a social event; they trap plaque and can irritate the gum.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
In the chair
How we treat it at Wimpole Street
Dental implant
A titanium post placed in the bone acts as an artificial root, and a crown is fitted once it has integrated. It stands alone, so the neighbouring teeth are untouched, and it maintains the bone around it.
About this treatmentFixed bridge
The teeth either side are prepared for crowns and a false tooth is suspended between them. Quicker than an implant and useful where those neighbours already need crowns, at the cost of trimming healthy enamel otherwise.
About this treatmentResin-bonded bridge
A false tooth with a thin metal or ceramic wing glued to the back of one neighbour. Minimal drilling, well suited to front gaps with a light bite, though less robust than a conventional bridge.
About this treatmentPartial denture
A removable plate carrying one or more teeth. The least invasive and least costly route, and a sensible interim while an implant site heals or while you decide.
About this treatmentFees
Costs to expect
A consultation with X-rays at Wimpole Street is expected to be £95, with a 3D scan quoted separately if implant planning needs it. A single implant with its crown is indicative from £2,950. A conventional bridge is from £995 per unit, so a three-unit bridge replacing one tooth is typically from £2,985. A partial denture is from £795.
Bone grafting, where the ridge has shrunk too far for an implant, and any treatment of the neighbouring teeth are itemised separately once we have seen you. An implant usually costs more at the outset than a bridge but does not involve the adjacent teeth, and we set out the long-term trade-offs in writing before you decide.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Don't wait if
When to see a dentist
- A tooth has come out today, whether knocked out or crumbled away.
- The teeth next to a gap have started to tip or feel different when you bite.
- Food constantly packs into the space and the gum there is sore.
- You have several missing teeth and chewing has become effortful.
- A baby tooth has survived into adulthood and is now loose.
- You would like to know which options genuinely suit your gap before committing.
FAQ
Common questions
Drift of the neighbouring teeth begins within a few months and most of the bone shrinkage happens in the first year, so the ideal window for planning is within six months. That said, gaps that have been present for years can still be restored; there may simply be extra steps, such as grafting or uprighting a tipped tooth.
Not always. An implant leaves the neighbours alone and preserves bone, which favours it in a healthy mouth. If the teeth either side are already heavily filled or crowned, a bridge uses them productively and is finished in weeks rather than months. Smokers, uncontrolled diabetics and those with little bone may also be better served by a bridge.
Sometimes. A second molar with no tooth behind it and a stable opposing tooth can be left, provided you accept slightly reduced chewing on that side. A first molar, or any gap with teeth both sides, is more likely to cause drift and is usually worth replacing.
A simple acrylic denture or a resin-bonded bridge can fill a front gap for the three to six months of healing. For back teeth many patients manage without a temporary. We plan the interim at the same time as the final tooth so you are never left with a visible gap.
Modern ceramics are matched to the shade and translucency of your own teeth, and implant crowns emerge from the gum much as a natural tooth does. The most challenging cases are single upper front teeth in people with a high smile line, and we will be honest about what is achievable in yours.
Marylebone, W1
Wimpole Street opens 1 October 2026
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
