Dental Implants Vs. Bridges: the Best Solution for Lost Tooth?

If the teeth on either side of the space are virgin teeth, no question, an implant is the best choice.  If the teeth on either side have crowns or large fillings, it is worth considering a bridge.

Over the past 5-10 years dental implants have become the treatment of choice for tooth replacement over dental bridges in the majority of cases.  Dental implants allow you to not touch the adjacent teeth keeping unnecessary forces off of them.  In addition, when an implant is placed in the bone and chewing forces are applied to it  bone formation is stimulated.  Finally, an implant allows for much easier hygiene (flossing) around the area than does a bridge.  The only time that a dental implant is not the treatment of choice is if the patient has a severe bone deficiency that cannot be improved by bone grafting. 

If you look at the big picture, as in decades, implants are best. There is no periodontal disease with implants, there is no decay. When done right, they may last a lifetime.
Bridges statistically need replacement in 15-20 years (averages). Failures come from decay on teeth that hold up the bridge, gum disease on said teeth, root canals, etc. If ONE tooth has a problem, the whole structure is compromised and needs replacement.
Implants are cheaper in a few ways. If third party benefits apply (Delta, Premera, etc), and annual maximums are reached, treatment can be timed to get better use. If a bridge was $4500 and Delta maxed out at $1000, then the out of pocket cost is $3500. If the implant was $2000 and crown and abutment comes to $2500 (same fee as bridge), the implant can be done this year. $1000 from insurance, $1000 out of pocket. Next year the crown and abutment is done, $1000 from insurance, $1500 out of pocket. $2000 from insurance instead of $1000.
Also, in a 30 year window, the bridge may be done 2 or 3 times, while the implant was done just once. The fee for the bridge in one thing now, but in 15-20 years, it might be double.

Dental implants and bridges are both great treatments for replacing missing teeth, each having their own pros and cons. When considering which is right for you, you want to make sure to take into account several factors:
- Are you cavity prone? Implants cannot get cavities, while a bridge can be susceptible to decay.
- Do the teeth neighboring the space have issues as well or are they "virgin teeth?" If the teeth adjacent to the space need work (such as crowns), a bridge may be a more economical option to replace a missing tooth. If the neighboring teeth are virgin teeth that do not require a restoration, it's usually best not to drill down the healthy tooth structure for a bridge when you can do a dental implant and not mess with the adjacent teeth.
- Do you smoke? Dental implants have a higher rate of failure in patients that smoke. Although, a bridge can also be susceptible to gum disease in smokers.
- Do you have adequate bone where the tooth is missing? If not, you may require more extensive bone grafting, sinus lift, gum grafting, etc. prior to having the implant placed, which may make it much more expensive than a bridge.
- Convenience: Implant treatment can often take several months to finish. In cases where a front tooth is involved, you may have to have a temporary flipper (removable temporary) or temporary tooth in the meantime while the implant is healing. Bridge work typically can take 2-4 weeks to complete compared to implants which can take anywhere from 3-6 months.
Hope this helps!

When a single tooth is missing, the two most common treatment options are:• A traditional tooth-supported bridge (3-unit bridge)• An implant-supported crownWhen a tooth-supported bridge is used to replace one missing tooth, the adjacent teeth are cut down or ground down into peg shapes so the bridge has a support system. This process unfortunately destroys natural enamel and tooth structure, but must be done in order to fit the new cemented bridge in place. Even though a 3-unit tooth-supported bridge can be functional for many years, the compromised teeth (those healthy teeth cut down to support the bridge) frequently develop decay, periodontal bone loss or need root-canal treatment. This often leads to future problems that will be more expensive and complicated to treat later. So even though the immediate problem of a missing tooth is remedied with a tooth-supported bridge, future problems with adjacent teeth are created.An implanted-supported crown is far superior to a traditional tooth-supported dental bridge:• Adjacent natural teeth are preserved – not destroyed• A dental implant looks, feels and functions like a natural tooth• Dental implants are designed to remain aesthetically pleasing for a lifetime• The bone is upheld, preventing a visible bony defect• Cleaning is easier and more hygienic • Implants do not decay and you will never need a root canalImmediate implant placement of dental implants into fresh extraction sockets was shown to be a predictable and successful procedure when proper protocols were followed. Placement into infected sites has been considered a relative contraindication. However, data from animal research, human case reports and case series, and prospective studies showed similar success rates for implants placed into infected sites compared to implants placed in non-infected or pristine sites.Implants can be placed into sites with per apical and periodontal infections. The sites must be thoroughly debrided prior to placement. Guided bone regeneration is usually performed to fill the bone-implant gap and/or socket deficiencies.