I can't face job interviews because of my teeth

Most people who come to this page talk about appearance, but what they describe is really two things. The first is the side people see: missing teeth, putting your hand over your mouth when you laugh, keeping your mouth closed in photos. The second, and less talked about, is the functional side: some sounds coming out wrong with missing front teeth, speech breaking off when a removable denture moves, and saliva becoming harder to control. In a job interview, it is often the second that is really difficult.

It helps to know why speech is affected. The s, sh and z sounds are made by passing air through a narrow gap between the tongue and the front teeth; if those teeth are missing, the gap cannot be formed and the sound changes. For f and v, the lower lip touches the edge of the upper front teeth; without the teeth, that point of contact is lost. This is not a matter of willpower but a physical limitation. The more a person notices it, the less they speak and the shorter their sentences become.

Then a cycle begins. Someone who speaks little does not stand out in meetings, struggles to explain themselves on the phone and keeps putting off job interviews. After a while they start describing it as part of their personality: 'I've always been the quiet type.' One of the things we see most often at the clinic is that sentence changing after treatment.

The good news on timing is this: appearance is the part that improves fastest. With a fixed solution, the tooth is in place on the day it is fitted. Speech takes a little longer because the tongue is getting used to new surfaces; in most patients it settles within a few days to a few weeks. Reading aloud shortens this time noticeably.

There is a solution for the in-between period too, and this is the part people ask about most. In most plans you do not need to be without teeth during treatment: a temporary denture can be fitted in the same session as the extractions, a temporary bridge can be made if there are enough sound teeth in the mouth, and in the 72-hour process there is no in-between period at all, as try-in teeth are used for the first two days and the final fixed teeth are fitted on day 3. So the answer to 'will I have to go around like this for months?' is usually no.

Let us also be honest about one thing: dental treatment is not a personality change. Someone who shies away from giving presentations does not become a natural speaker on the day their teeth are replaced. What changes is that the limitation is lifted: you can now speak without thinking about covering your mouth, and your attention stays on the person in front of you. For most patients this is the real difference, and it is no small thing.

The time depends on the state of your mouth and the plan chosen. The following are realistic expectations.

In this situation the first step is usually the hardest: bringing the subject up.

1. 1

   Say what is worrying you

   Saying 'I have a job interview coming up' or 'I feel self-conscious when I speak' at your consultation directly changes how the plan is built. If you do not say it, the dentist may build a plan that is medically correct but does not fit your timetable.

2. 2

   Share your date, if you have one

   If you have an interview, a wedding or a presentation coming up, say so. There is swelling in the first few days after surgery; the timetable can be built around it, and usually it can be.

3. 3

   Imaging and examination

   A panoramic X-ray or a CBCT scan. This decides which options are on the table and what a realistic timescale is.

4. 4

   Discussing the plan for the in-between period

   What will you use during treatment? On a route with a waiting period, a temporary denture or a temporary bridge; in the 72-hour process there is no in-between period: try-in teeth are fitted for the first two days and the final fixed teeth on day 3. When this question is not asked, the patient has a hard time during the waiting period.

5. 5

   Trying out the shape and shade of the front teeth

   The length, shape and shade of the teeth can be tried out before the final teeth are made; in the 72-hour process this happens at the try-ins on day 1 and day 2. This is the stage at which everything that needs saying should be said, before the final teeth are prepared.

6. 6

   Supporting your speech as it adjusts

   Reading aloud several times a day helps the tongue learn the new surfaces faster. If speech problems are easing, they are part of getting used to the teeth; if they are not easing, an adjustment is needed.

Answers to the question 'Will I have to go around like this for months?' In most plans there is no period without teeth.

The following are the consequences of putting things off and of not speaking up.

The sequence below is for the 72-hour plan, in which the final fixed teeth are fitted on day 3; if a different route is chosen, the timescales are longer.

1. The first 48 hours

   Swelling and bruising peak during these two days, and your appearance is at its worst in this period. If you have an important interview, do not let it fall on these days; the timetable can be built around this from the start.

2. The first week

   The swelling goes down and your appearance recovers quickly. Some sounds may come out differently when you speak; reading aloud is the most effective thing during this period. In most patients, there is a clear improvement within this week.

3. Weeks two and three

   Speech largely settles. If at this point the same sounds are still coming out wrong in the same way, it is not part of getting used to the teeth and an adjustment is needed; make a note and bring it up at your check-up.

4. After the first month

   Because the final teeth were fitted on day 3, there is no separate bridgework stage and no second period of getting used to new teeth. At check-ups the bite is reviewed again; if any detail of the appearance or your speech does not suit you, mention it at these appointments.

In this situation, what determines the cost is not urgency but the state of your mouth. But time pressure can bring some items forward.

The solution chosen

A removable denture, a removable denture on implants or a fixed bridge. The difference between them determines most of the total.

The in-between solution

If a route with a waiting period is chosen, a temporary denture or temporary bridge may be a separate item; in the 72-hour process there is no separate in-between solution. Ask whether it is included in the quote; if not being left without teeth matters to you, this item is non-negotiable.

Work on the front teeth

In the area that shows, matching shape, shade and texture takes more craftsmanship. This is the item that appears on the bill as labour and directly determines the result.

How tight the timetable is

Wanting to be ready by a particular date can change the order of the plan. This does not directly increase the cost, but it affects how concentrated the sessions are and how many trips you need to make.