If you have lost one or more of your natural teeth, it is important to determine the best way to replace them as soon as possible. Replacing missing teeth will not only help restore your smile and self-confidence, but also minimize the negative effects that tooth loss can have on your gums, jawbone and remaining teeth such as: shifting of the teeth, difficulty speaking properly, shift in occlusion (bite) and increased risk of tooth decay and periodontal disease.
The following guide compares dental bridges and dental implants (the two most popular options available) by outlining their benefits and drawbacks to help you determine which one is the best for your situation.
In This Guide
- What are dental bridges?
- What are dental implants?
- Benefits and drawbacks of bridges
- Bridges compared to implants
- Cost comparison
- Which should you choose
- What to read next
What are Fixed Dental Bridges?
A bridge is a common dental restoration that can replace one or more missing teeth by literally bridging the gap they left behind.
A fixed bridge is permanently cemented into place and can only removed by your dentist. It consists of one or more false teeth called “pontics” (one for each missing tooth) in the middle and one or more anchoring crowns called “abutment” teeth on either side (see diagram). The pontics (made from porcelain, gold, zirconia, alloys etc.) fill in the gap while the abutment teeth are secured to the natural teeth adjacent to the gap, holding the bridge in place.
To connect the bridge to the neighboring natural teeth, the natural teeth must be shaved/filed down in order to provide space for the crowns to correctly align with opposing teeth and enough surface area to enable a strong bond/connection. The natural teeth must be relatively healthy (structurally sound and free from decay) for this to work. The biggest downside to this process is that it is irreversible. Once the natural teeth are modified, they cannot be used as regular teeth ever again.
If you need to replace more than three consecutive teeth, you might be better suited to a removable or fixed partial denture. You can compare dentures and implants here.
A cantilever bridge can be used if it isn’t possible to place a crown on both sides of a gap. This type of bridge is anchored by one or two crowns (depending on how much support is required/the length of the bridge) located on only one side of the gap.
Another alternative is the Maryland (or resin-bonded) bridge. In this case, the pontic(s) have “wings” on both sides (see diagram) which are bonded onto the back surfaces of the adjacent teeth using a composite resin cement. These bridges aren’t as strong or permanent as the other types so they can pop off/fall out if subjected to too much force or wear and tear. However, this problem isn’t a big deal as the prosthesis can easily be cleaned and reattached. Another advantage is that unlike traditional bridges, they require minimal alteration of the anchoring teeth.
Here is more information about the different types of bridges.
What are Dental Implants?
A dental implant is an artificial tooth root (or “post”) made of titanium that connects to the jawbone and supports a crown. After being inserted into the jawbone via a short surgical procedure, the post must osseointegrate (fuse) with the jawbone so it is firmly anchored in position. Once the osseointegration process is complete (which can take anywhere from 3-6 months), an abutment is attached to the post. The abutment protrudes above the gum line and provides the surface that the dental crown is screwed or cemented onto.
Two or more dental implants can be used to create an implant-supported bridge.
Benefits and Drawbacks of Bridges
The benefits of choosing a bridge include:
- A very natural look. They can be used to improve the color and shape of the teeth being replaced or covered up. Modern porcelain is extremely sophisticated and a skilled dental technician can fabricate a bridge that will closely mimic the natural translucencies and multiple shades found in natural teeth.
- Straightforward procedure. They are a very common solution to tooth loss and a routine procedure for many dentists.
- Affordability. A traditional bridge is around $700 – $1,500 per unit. A more detailed outline of the costs can be found below.
- Low risk. If a bridge fails, crowns and pontics can be replaced relatively quickly and painlessly.
- Fast. The entire process can usually be completed in a few weeks.
The drawbacks include:
- Damaging natural teeth. Preparation involves removing a considerable amount of tooth structure from adjacent teeth. Once this is done, these teeth can never again be used as regular teeth and must always be crowned.
- Increased risk of cavities and decay. Removing some of the structure of a tooth increases the risk of it decaying and the need for a root canal treatment in the future.
- They need to be replaced periodically – typically every 5-7 years.
Bridges Compared to Implants
|Implants vs Bridges Comparison|
|How Long They Last||15+ years||5-7 years|
|Insurance Coverage||Rarely covered||Covered by most plans|
|Long-Term Dental Health||Little to no gum/bone loss||Some bone/gum loss|
|Oral Hygiene||Brush & floss like normal||Need special floss & brush|
|Appearance||Best possible aesthetics||Very natural looking|
|Procedure Duration||Multiple visits over 3-6 months||2-3 visits over a few weeks|
The following factors should be considered when deciding between a dental bridge or dental implant:
Bridges are covered by most dental insurance plans, so you should be able to reclaim a considerable percentage of the cost. Implants on the other hand are rarely covered by dental insurance. However, you may be able to claim at least part of the cost of the crown.
How long they last
Well-maintained implants will last for many years and typically for a patient who is 45 years or older, they are for life. The crown needs to be replaced every 10-15 years due to normal wear and tear, but the implant itself is permanent barring any uncontrollable circumstances such as accidents and diseases. Bridges typically need to be replaced periodically (every 5-7 years), but they can last up to 10+ years by practicing excellent oral hygiene.
Long-term oral health
Bone and gum tissue loss will occur under a bridge where the tooth was missing/extracted, which can have a destabilizing effect on adjacent teeth. An implant on the other hand simulates a natural tooth root by stimulating the surrounding area with the forces produced by chewing, which preserves the bone and gums.
A special type of floss and possibly other dental hygiene tools are required to clean underneath the pontics of a bridge and keep the area free from plaque. An implant also requires excellent oral hygiene, but can be brushed and flossed as if it were an ordinary tooth.
Modern bridges look very natural, but as bone and gum tissue are lost over time, gaps can open up underneath the pontics. An implant provides the highest quality aesthetic results. The crown emerges from your gums in exactly the same way as a natural tooth.
Start to finish, bridges are completed in two or three visits over the span of a few weeks. Implants require multiple visits over the course of 3-6 months and additional procedures such as bone grafts and sinus lifts are required in some cases.
|Cost of Dental Implants vs Bridges for One Tooth|
|Maryland (Resin-Bonded) Bridge||$1100 to $2300|
|Traditional (Cantilever) Bridge||$2100 to $4500|
The cost of a bridge varies based on the following factors:
- Material it is made from (composite resin, metal alloy covered in porcelain, zirconia, etc.)
- Number of teeth (units) being replaced and where they are in your mouth
- Condition of the adjacent/anchoring teeth
- The experience and popularity of your dentist
- Where you live
Maryland (Resin Bonded) Bridges
Each wing can cost from $250 – $550, while each replacement tooth ranges from $600 – $1,200. A typical bridge with two wings and one replacement tooth will cost from $1,100 – $2,300.
Traditional or Cantilever Bridges
A traditional or cantilever bridge costs around $700 – $1,500 per unit, or from $2,100 – $4,500 for a three-unit bridge (1 false tooth and 2 anchor crowns).
Bridges are initially more affordable than implants, but implants are more cost-effective in the long term. Factors that affect the cost include:
- Surgery complexity
- How many and which teeth are being replaced
- Brand and material of crown, abutment and post
- Your location
- Surgeon’s expertise, experience and popularity
A single implant will typically cost around of $4,000 (including crown and abutment). If used to support a bridge, the cost of 2 -6 dental implants plus the bridge ranges from $3,500 – $30,000 or more. A 3-4 unit bridge supported by two dental implants ranges from $5,000 – $15,000 (average of $8500).
Making the Decision – Which Should You Choose?
Best option if you are a candidate and can afford them.
Implants are the longest-lasting method of replacing teeth and provide the best aesthetic results. They are expensive, but they are the best dental restoration method available and cost less in the longer-term because they don’t have to be replaced nearly as often as a dental bridge. In addition, an implant preserves the jawbone and gum tissue and doesn’t require healthy teeth to be grinded down. If money is an issue, please see these ways you can reduce the cost.
Best if you are looking for a quick solution and want to avoid surgery.
Implant surgery is not suitable for everyone. People who have medical conditions that compromise their immune system or how fast they heal are at a higher risk of implant failure (see this page for a list of contraindications). In these situations, a dental bridge will provide the most predictable and positive results. A bridge is also a good option if you want to avoid invasive surgery or would prefer to have your teeth replaced within a matter of weeks instead of months.
Once you’ve decided, the next step is to find a good dentist.
What to Read Next
- Overview of Dental Bridges
- Dental Implants vs. Dentures
- How to Much Do Dental Implants Cost?
- How to Save Money on Dental Implants
- How Painful are Dental Implants?
- Dental Implant Problems – What Can Go Wrong
Over to You
What did you decide was the best option for you? Let us know in the comments why you’re leaning towards implants or a bridge.