One of the biggest dilemmas facing many of our patients is what to do about my missing teeth. As a dentist, the answer is not always consistent or obvious. There are four basic choices and none of the choices are right or wrong in every instance. It depends on the size of the space, your age, where it is in your mouth and how important the tooth is to your overall dental health. Moving between the choices from the least to the most expensive treatment, which translates to the easiest to the hardiest (remember the dentist is like the plumbers “time is money” thus the harder the job the more time it takes). We will start with the first treatment and that is “oh well I lost my tooth.” Obviously wisdom teeth or severely crowded areas of your mouth often fall into this category and no treatment is necessary. Number 2 is a removable appliance of some nature. That can be anything from a simple tooth attached to a temporary retainer, to a chrome removable partial denture with many teeth attached. If there are large spaces, this is often the best choice as you pay by the appliance, and not by the tooth. So if there are a lot of missing teeth on the appliance, it isn’t more expensive. The downside to all removable appliances is function. It is something in your mouth that may be a little foreign to you. The 3rd choice is fixed bridgework in which “caps” are placed on either side of the space and a “bridge” fills in the gap. Unlike the removable appliances you pay by the tooth and it requires modification of your teeth for it to function. Thus there are Novocain shots and all the other issues typically associated with dental procedures. The last options are dental implants which are artificial roots that are placed in your jaw and a cap are attached to the implant. This has the advantage of not relying on other teeth for support, but once again you pay by the tooth. Although we restore several teeth each week this way, a surgeon has to place the implants. As we all know specialists are not known for being inexpensive, therefore the cost can exceed $3500.00 per tooth by the time you are all done. Thus this process often times is above our patient’s insurance coverage limits. Once again, all of these are just choices and there is no consistently right or wrong answer to those choices as it is based on individual needs and desires. But in general the more expensive the process, the more it looks and functions like your natural teeth. That being said, implants are by far the most durable and functional therefore often times are lifetime restorations and therefore are best choice if you can afford them.