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

the NY TImes article "A Dental Shift: Implants Instead of Bridges" states: "In an overwhelming majority of cases, implants to replace lost teeth are by far the best long-term solution for maintaining a healthy mouth. Also, because they rarely need to be replaced, in the long run they are more economical than bridges." Do you agree with this statement?

Doctor Answers 24

Dental implants are often more economical than bridges

I believe dental implants are often more economical than bridges. They are more conservative, have a high success rate, preserve bone and don't decay. In my experience, patients choose bridges over implants not because a successful implant isn't possible, but only because of higher up front cost. Implants are not only the standard of care, but a better value as well.

Cleveland Dentist
4.8 out of 5 stars 17 reviews

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

Deciding whether to do a dental implant versus a cemented bridge involves answering several questions. The first questions to answer are, why is the tooth missing and what is the condition of the rest of the mouth?
if you happen to be cavity prone, then dental implants can be a godsend because a dental implant has zero chance of getting a cavity. Likewise, if the neighboring teeth adjacent to the missing tooth are healthy, then it doesn't make sense to drill them down to make a cemented bridge. Another factor to keep in mind is that any time you make a cemented bridge for a patient you slightly increase the risk of getting a cavity because it becomes more difficult to clean around the bridge than when you have separate teeth.

The only time that it truly makes sense to do a cemented bridge to replace a missing tooth is when the neighboring teeth are already filled and the patient demonstrates excellent homecare and cavity control.

I hope that you found this to be helpful,
Dr. Champagne

Richard Champagne, DMD
Freehold Dentist
5.0 out of 5 stars 5 reviews

Dental Implants better than Bridges

As the article states, more people are choosing Implants over bridges. As far as being more economical, the main reason is that dental implants have a higher success rate and rarely need to be replaced. according to certain studies, bridgework may only last 8-10 years on the average.

A dental bridge has a fake tooth or "pontic" that rests on the gums. This is a very difficult situation to create a realistic looking tooth. Dental implants are placed below the gum surface and the crown erupts through the tissue just like a natural tooth. In addition, as the name states, a bridge splints the adjacent teeth together making hygiene difficult.

One major reason that people may choose an option is whether or not they wish to undergo a specific procedure. Although relatively non invasive, a Dental Implant placement is a surgical procedure. On the other hand, a bridge requires that the teeth on either side of the toothless space be trimmed down to support the fake tooth. A bridge is still a very good restoration, however a Dental Implant is the state of the art way to replace a tooth and the "standard of care".

The most important benefit of Dental Implants is often unrecognized. When a tooth is lost the bone is no longer in function. Because of this the bone slowly begins to disappear in this area. Denture patients often have little bony ridge remaining, and often times loss of a single tooth leads to an aesthetic nightmare. Implants act just like a natural tooth in terms of stimulating the bone. By placing an implant you are not only replacing a missing tooth, but you are maintaining bone

Dental Implants vs. Bridges: Replacing Missing Teeth

I agree completely that - except under certain circumstances -- dental implants are superior to bridges for replacing missing teeth. If you smoke, have untreated periodontal disease, have a large bony defect, or have two missing front teeth that are right next to one another you may be a better candidate for a bridge. The best way for you to find out is to consult with an experienced cosmetic dentist or prosthodontist who does a lot of implants.

Susan Goode Estep, DMD
Atlanta Dentist
5.0 out of 5 stars 3 reviews

Dental Implants vs. bridges

This statement has some truth, but like everything you need to do your research.

Dental implants are prone to some complications that few talk about.  Peri-implant disease is proving to be a big problem.  about 25-30% of implants will have peri-implant inflammation and disease.  A further 1-3% per year have problems with screw loosing etc.  This means that about 30% of implants will have some problems with them over the course of the years.  Implants are not forever, nothing is.  Bridges are not either and the average bridge will fail because of decay. 
Every case is different and it is worth while to explore all options and all materials, today with the wide body of evidence we are learning that titanium may not be the ideal implant material.  New advances are showing that ceramic implants may be overcoming some of the shortcomings of metal implants.  Make sure you talk to your dentist about all the options present today, not 20 years ago.

Dan Hagi, DDS
Toronto Dentist
5.0 out of 5 stars 4 reviews

Are Implants The Best Solution for a Lost Tooth?

In general, I agree that most of the time implants are preferable to fixed bridges.  As other dentists answering this question have stated, clearly implants have many advantages. 

However, there are times when the advantages of a fixed bridge may suggest that a fixed bridge would be preferable to the use of an implant.  Cost is usually somewhat higher for a single implant than a fixed 3 unit bridge, and that is usually the single biggest reason patients choose a bridge instead of an implant.  The second reason is wishing to avoid surgery.  A third is that some dental insurance plans do not cover implants, but will cover bridges.

If one already has crowns on either side of the missing tooth, then placing a 3 unit bridge may be preferable because it would then avoid any surgeries and the result is that the three teeth would all match.

Another challenge with implants is when they're used in the front of the mouth.  Sometimes there is a resultant loss of gum tissue after tooth removal and implant placement that leaves a space or hole between the teeth that looks unattractive and accumulates food debris.  There are times when cosmetic dentists may prefer a porcelain bridge over an implant because it oftentimes gives them more control over eliminating those holes or gaps.

I don't agree with the statement that implants rarely need to be replaced, implying that bridges do.  That statement is misleading.  First, I agree that the actual implant, if properly done, rarely will need replacement.  However, implants still need a middle piece, called an abutment, and then a crown over the top of the abutment.  I would expect the same lifetime for the implant crown as a conventional crown or fixed bridge.

What is really important is that the patient be fully informed as to the different solutions, advantages and disadvantages to each, difference in costs, and any risks and potential complications. 

Now, saying all that, as a dentist I would not hesitate to have an implant if I lost one of my teeth. In most cases I would prefer to have an implant in my mouth than a bridge.

Norman Huefner, DDS
Laguna Niguel Dentist

Dental Implants Provide a New Standard of Care

Yes dental implants are superior to bridges.  Bridges had a strong place in the past, but today dental implants are the most advanced and conservative option for replacing missing teeth.  I tell patients missing single teeth that dental implants are a "single tooth solution to a single tooth problem" meaning when you have one tooth missing implants won't involve the teeth surrounding the missing tooth.  Bridges require the teeth adjacent to the missing tooth to be reduced down even if they have no current problems to hold the bridge, but dental implants do not since they stand alone to hold the implant crown.  Dental implants are affordable and less expensive over the course of years giving you many advantages over bridges.

By far!

Implants and bridges may seem like they serve the same purpose, so they're both good options... but  implants by far ( for most people) are a better option!

  1. Implants engage the bone, bridges don't. Bone loss over time continues to happen under the bridge and eventually will contribute to its demise.
  2. Implants are self supported, they do not require the support of the adjacent teeth! Bridges have to lean heavily on the adjacent teeth and sometimes that means removing enamel, risk of future decay and tooth nerve problems.
  3. Implants are easier to clean. You can floss and brush an implant much like you would a natural tooth. With bridges you have to thread your floss underneath it and that can be a little nuisance.
  4. The biggest advantage that bridges had was that many insurance companies covered more of a bridge than an implant. However, thats changed over the years. Many of todays insurance companies recongize the value of an implant and either cover them or allow for an alternative benefit clause to cover a portion of them.

Hisham Kaloti, DDS
Mississauga Dentist
4.9 out of 5 stars 9 reviews

Dental Implants Vs. Bridges

When a single tooth is missing, the two most common treatment options are:
• A traditional tooth-supported bridge (3-unit bridge)
• An implant-supported crown
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 canal
Immediate 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.

John Frattellone, DMD
Red Bank Dentist

Choosing Between Dental Implants or Dental Bridges

What is the best solution for the particular patient? Depending on a patients budget, goals, lifestyle choices, and time restraints would determine what would be best for that case. I agree that Implants are the ideal solution to missing teeth as we are preventing future bone loss, allows patients to practice normal hygeine, have great success rates, and are supposed to last longer than bridges. 
On the other hand, for example, if the patient is a smoker who does not plan on quiting, does not have the budget to have an implant placed, or cannot return to my clinic for the restoration of the implant, then a bridge would be a good alternative for that patient. 

Irma Gavaldon, DDS, MS
Mexico Dentist
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.