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. 

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.

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.

Bridges require the preparation of the adjacent teeth to allow placement of an artificial tooth. It may be undesirable that healthy teeth have to be prepared for an artificial tooth to fill the space of the missing tooth. Furthermore, bridges are more difficult to keep clean and more susceptible to recurrent decay. This can lead to the replacement of the bridge adding more cost, more treatment of the supporting teeth. If the supporting teeth become too compromised then a possible elongation of the bridge might be the necessary.  On the other hand, implants do not require the destruction and restoration of adjacent teeth.  Although implants may be seem more costly, they are less costly overtime and less invasive on the adjacent teeth.  An implant can look, feel and function like a real tooth.  Hygiene for an implant is similar to that of a natural tooth.  

Yes! Implants my suggested option for a tooth/teeth replacement because its proven to last longer than a bridge, helps in preserving long term dental health because due to little to no bone/gum loss and provides the best possible aesthetic outcome. 

Dental implants have a 97% +/- long term success rate. It simply involves replacing the actual missing teeth rather then cutting down virgin or perfectly good adjacent teeth to place a bridge. Once you cut down a tooth, it's ireeversible. So an implant is less invasive with respect to other teeth. Bridges also breakdown with decay on the abutment teeth and need to be replaced on average every 7-10 years. Finally, you can floss between implants whereas it's very difficult to maintain and clean under  bridges. Bridges can collect food underneath and cause a smell or odour  in your mouth. As well, food can lodge under bridges and lead to gum irritation and infection in the worst case. 

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

If you are unfortunate to lose a tooth and are thinking about a replacement then think twice about a bridge A bridge involves cutting down other teethIf the teeth we're healthy then it is  a shame to deteriorate their healthIf the teeth are heavily filled then a bridge may cause the failure of the fillingYou are better to replace 1 tooth with 1 implant instead of using 2  teeth that are otherwise healthy and intactimplants are an artificial way to replace what nature gave you