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Losing a tooth in the back of your mouth can feel frustrating. The lower premolars and molars—the teeth you use most for chewing—are especially important for eating, speaking, and keeping your smile healthy. When one of these teeth is lost due to decay, gum disease, or injury, it’s natural to wonder what the best replacement option might be.

While removable dentures and bridges may be an option , we generally recommend dental implants for replacing premolars and molars, especially in the lower jaw. Implants are small titanium posts that act like artificial tooth roots. They are placed into the jawbone and topped with a crown that looks and feels like a natural tooth. Below are the main reasons why implants are often considered the gold standard for replacing missing back teeth.
 

A missing tooth or teeth can be a major dental issue for most people with aesthetic and functional problems. This is not a good look at the front of the mouth but even from the side, a large gap can ruin a smile. Teeth are designed for a certain reason , whether that be for biting and tearing food ( front teeth) or chewing ( molars). The loss of even one tooth can impact on everyday eating habits and long term issues with the bite. For example, teeth will slowly move into the space left by an extracted tooth by either drifting in sideways or the opposing tooth moving up or downwards ( over eruption). This can dramatically impact on how one eats and damage the other teeth in the long term. The answer is to the replace the tooth in good time!

Most dental implants are made from titanium which is classified as a biocompatible material. However, reports have suggested that 0.6% of the population may have a hypersensitivity or allergic reaction to titanium and this would not be a suitable material. Increasing, we are hearing that patients would like to avoid any form of metal within the mouth as a personal choice akin to not having amalgam fillings. This is perfectly acceptable and there is an alternative option with zirconia ( zirconium dioxide) implants. These are metal free dental implants that are white in colour and hence are aesthetically pleasing. We use zirconia a lot in dentistry and the material is routinely used for crowns on back teeth and crowns for implants. We have never come across an allergic reaction to zirconia nor seen any form of hypersensitivity. Zirconia is bioinert meaning it does not release any ions like some metals can which reduces the risk of an immune response.
 

One of the most common causes of discoloured teeth is due to a 'dead tooth' or a tooth that is root filled. All of our teeth are supplied by nerve and blood supply. Now when a tooth needs a root canal treatment, this supply called the pulp is removed which can lead to the deposition of blood products within the tooth which is then absorbed by the tooth leading to a darker colour. On a back tooth, this may not have any major issue but on a front tooth is a different matter altogether!
 

Teeth can be lost for various reasons such as tooth decay, trauma, failed root canal treatments or periodontal (gum) disease. The loss of teeth can have a significant impact on not only everyday function but aesthetics and general confidence when out and about. Replacing missing teeth is vital as this will restore function ( eating is important!) , improve aesthetics and prevent the adjacent and opposing teeth from moving into undesirable positions. The latter is a particular problem if the teeth are not replaced for a few years as this will make any dental implant treatment far more complicated.
 

Our case of the month for April 2025 is a familiar one where there was some relapse after past braces and a front tooth had started to twist over the adjacent tooth. In the grand scheme of things, this is a minor issue but if you have already had braces and a front tooth starts to rotate, this is incredibly frustrating!

Now the good news is that we can correct this in a short space of time, with a discreet solution, with minimum fuss and at an affordable fee. The answer lies in the Social 6 lingual brace which is placed on the inside of the teeth making it the only truly invisible brace system. Please take a look at the before and after photos so see how it works.

A smile says a thousand words, as the old saying goes. However, if you never smile what does that tell us?

In most cases, hiding a smile means that one is embarrassed with their teeth and lack overall confidence. This is perfectly understandable and something we see on a daily basis. The good news is that a smile transformation is no longer an arduous process which costs the earth, as our case of the month highlights.
 

Our case of the month for February is a fantastic one which highlights the extent of the versatility of the Invisalign system. It truly is a replacement for fixed braces with many benefits. In the past, it was correct to say that certain cases could not be treated with Invisalign and that fixed ( train track) braces were the only option. However, times change, technology advances and the advent of digital dentistry has changed the landscape of dental care.

Our client came to us after seeing several dentists and being told that multiple teeth needed to be removed and that fixed braces were needed for over 2 years. She was all set up for this but after the first initial comprehensive examination with Dr Nissit Patel, we had alternative options available. The key is in the planning and after careful deliberation and diagnostic projections, we were able to provide a treatment plan that not only kept all of the teeth but one that could be completed using Invisalign as the sole orthodontic technique.
 

A smile speaks a thousand words as the old saying goes. Sometimes, it is the little changes that really make a difference. This may not be evident to everyone but if a small enhancement gives you more confidence then this make a huge difference to ones wellbeing. 

One of the ways we can enahnce a smile is with a technique called composite bonding. Our case of the month for January 2025 is really a classic one where bonding was used to improve the smile symmetry in a subtle yet striking way.
 

To answer this question, we really need to differentiate the two treatments as they are two different treatment entirely. 

Composite bonding is an additive process. In simple terms, we carefully sculpt composite resin over the teeth in question. This can be used to treat chipped, fractured, uneven and gappy teeth. Composite can also be used to replace old fillings on front ( or back) teeth. The great advantage of bonding includes:

1. Treatment is completed in one visit; an instant smile transformation!
2. Minimally invasive. There is little, if any, drilling of the underlying teeth needed.
3. Biologically safe for the teeth and gums. There is no risk of damage to the nerve.
4. Composite can be easily maintained.
5. More affordable than porcelain veneers or ceramic crowns.
6. Composite will protect the underlying teeth from further wear and tear.