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I Lost a Tooth — Now What?

First aid, options and costs for replacing missing or cracked teeth


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Illustration: AARP

Losing a baby tooth when you were a kid might have been exciting, and even profitable if the Tooth Fairy was generous.

And, as a child, if you lost a permanent tooth playing sports or in an accident, you might remember the adage to soak the tooth in milk and get to a dentist ASAP. If you were able to get to the dentist quickly, it might have been possible to reimplant the tooth.

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We all expected to lose teeth as children. But adult tooth loss is common too. By age 64, the average adult has three or more missing or decayed teeth, according to the American Dental Association. A third of adults 65 and older have lost at least six teeth. And a tenth of people over 65 have lost all of their teeth. Common reasons for tooth loss in older adults: gum disease and tooth decay.

Unfortunately, as an older adult, losing a tooth is not exciting or profitable, and, sadly, the tooth can’t be reimplanted, says Sally Cram, spokesperson and consumer adviser for the American Dental Association, and a periodontist specializing in dental implants in Washington, D.C. 

So what do you do when you lose a tooth as an adult?

First, take action

While you might consider going to the emergency room when you lose a tooth, you don’t need to unless you’ve fallen and might have face fractures. Otherwise, your first stop should be to get to your dentist as soon as you can. Be careful not to scrape the tooth or rub it if you need to remove debris, says the Mayo Clinic, because this can damage the root surface, making the tooth less likely to survive.​

If there is dirt or other material in your mouth, rinse your mouth for no more than 10 seconds in lukewarm water. Don’t put it under running water, because that could damage the cells on the root surface.

Once at the office, your dentist will be able to examine the area, take some X-rays and determine what options are available, Cram says.

Next, find out if you can repair the tooth

You know that awful feeling when you bite down on that Moose Munch popcorn and hear a loud crack? Yep, you’ve probably broken or chipped a tooth.

And there are so many other ways to crack a tooth, from accidents to anxiety.

“Since the pandemic, and since everybody in this world is so stressed ... we are seeing more fractured teeth,” says Cram.

You might assume that a crack means that you will lose the tooth, but sometimes it can be fixed.

“If it’s a minor crack, we can either do a filling or a crown,” says Cram. “If there is a major fracture that extends down to or into the root of the tooth, that is quite often not repairable, and the tooth would need to be extracted.”

If that tooth is extracted, it may need to be replaced.

Teeth play an important role in our bodies. When teeth are lost, it can be harder to speak clearly and chew food.

That said, certain teeth aren’t needed to function — hello, wisdom teeth! — and don’t need to be replaced. For example, older adults may function fine without the end molar in the back, Cram says.

Every situation is different, and you should discuss your tooth loss and replacement options with your dentist, Cram says.

Three tooth replacement options  

Once you and your dentist meet, you’ll likely have several options to replace the tooth, which vary in complexity and cost.

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 Here are three common choices:

1.  A removable partial denture 

 Your dentist will start by taking an impression of your teeth, to make sure that the partial denture fits and functions well with your opposing teeth, Cram says.

 After a couple of weeks, the lab will send your denture back to your dentist, and it can be inserted. The denture includes a clasp that attaches to your tooth and is easily removed for cleaning and sleep. It has a metal or acrylic base that matches the color of your gums. The denture also includes the replacement tooth or teeth, generally made from porcelain or plastic.

Typical cost: An acrylic partial denture averages between $695 and $1,200.

2.  A fixed bridge 

Unlike a removable denture, a fixed bridge is cemented in place. The teeth adjacent to the missing tooth are capped (or crowned) and connected with a fake tooth. The bridge is usually made of a metal base with tooth-colored porcelain or can be all porcelain.

 Cram suggests waiting until the area where you lost a tooth to fully heal before inserting a bridge, typically four to six weeks. 

Typical cost: A bridge can cost between $1,000 to $5,000 per tooth.

3.  A dental implant

A dental implant is considered to be a secure and stable replacement for a lost tooth.

The implant process takes place in three phases:

  • First, implant posts, made of titanium and other materials compatible with the human body, are surgically inserted into the upper or lower jaw.
  • Next, the bone around the implant begins healing and starts to grow around the implant and hold it in place, which makes the implant stronger. It can take several months for this process to be complete.
  • Finally, the implant is ready for placement of the artificial tooth. Your dentist will create a new tooth for you (a crown), designed to blend in with the rest of your teeth.

As this is a surgical process, check with your dentist to make sure you’re a good candidate. Certain illnesses, including diabetes and leukemia, and tobacco use, may hamper healing after surgery.

Typical cost: The cost of each dental implant generally ranges from $3,000 to $4,500, from start to finish.

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Since these options require at least several weeks, if you have a missing tooth in a prominent area (such as a front tooth), you can ask your dentist about a temporary tooth. Also known as a “flipper,” it can sometimes be made in as little as 24 to 48 hours in your dentist’s office.

Choosing a dentist or dental specialist for your replacement tooth or teeth

“Many general dentists do extractions, dentures, implants and crowns,” says Cram. But you may prefer a specialist, such as a periodontist or an oral surgeon, to extract teeth and insert implants. Either your dentist or a prosthodontist will build the superstructure, the crown, on top of the implant,” Cram says.

If your dentist doesn’t handle the type of procedure you need, they will refer you to a specialist.

Medicare and other insurance coverage for tooth loss

For the most part, Medicare doesn’t cover routine dental coverage, such as cleanings and fillings, or more comprehensive dental work, such as tooth extractions, implants and dentures.

Most Medicare Advantage plans offer basic dental coverage for oral exams, cleanings and X-rays without a deductible. Some Medicare Advantage plans offer coverage for more extensive services, such as root canals and extractions, generally with a 50 percent copay, and an average annual cap of $1,300, according to a Kaiser Family Foundation analysis.

Employer-sponsored, ACA Marketplace dental coverage and private dental insurance typically offer similar coverage to Medicare Advantage plans, according to the KFF analysis: Routine services are covered at 100 percent, and more comprehensive services are covered at 50 percent, after meeting a deductible.

Payment plans and lower-cost teeth replacement options

Replacing a lost tooth can be expensive and unexpected. If you don’t have the budget to pay for dental services immediately, Cram suggests asking your dentist if they will work with you.

Dental schools can cut costs

Dental schools are underutilized for many, many patients,” says Mark Wolff, Dean of the University of Pennsylvania School of Dental Medicine.

You may be surprised to learn that in addition to routine dental care, you can also get tooth replacement procedures at dental schools. In addition to new dental students, schools have practicing dentists who are learning new specialties, Wolff says. “In all cases, we supervise very closely to make sure that the care that’s delivered is always good, always safe care. It’s a true quality-assured practice.” Wolff says his dental school has a 95 percent satisfaction rate.

The best part? Most of the procedures that a dental school in each area offers are between 30 and 50 percent less than those same procedures in private practice, says Wolff.

You can find out if you’re located near any of the 70 U.S. dental schools by searching the Commission on Dental Education’s database.

Government-funded programs

The federal government’s Health Resources & Services Administration (HRSA) provides community health centers (CHC) nationwide, and 90 percent of them provide additional dental services, including teeth replacement with bridges, implants and dentures, depending on income levels.

You can find a local health center using HRSA’s Find a Health Center tool.

The best option is prevention

Losing a tooth as an adult is fun, said no one, ever. But losing teeth as an adult isn’t a given, either.

“Actually 90 to 95 percent of all dental problems that could cause you to lose your teeth are preventable,” Cram says. “And they’re preventable by doing simple things: brushing twice a day, flossing once a day, and seeing your dentist periodically for checkups, X-rays and cleanings."

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