Dental Bridges vs Implants: 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.
What 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 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 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 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 better suited to a removable or fixed partial denture. You can compare dentures and implants here.
A cantilever bridge can 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 cleaned and reattached. Another advantage is that unlike traditional bridges, they require minimal alteration of the anchoring teeth.
Here is more detailed breakdown of 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 complete (which take anywhere from 3-6 months), 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 used to improve the color and shape of the teeth replaced or covered up. Modern porcelain 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.
Affordable
A traditional bridge is around $700 – $1,500 per unit. A more detailed outline of the costs can found below.
Low risk
If a bridge fails, crowns and pontics can replaced relatively quickly and painlessly.
Fast
The entire process can usually completed in a few weeks.
The drawbacks include:
Damaging natural teeth
Preparation involves removing a considerable amount of tooth structure from adjacent teeth. Once its done, these teeth can never again used 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 replaced periodically
Typically every 5-7 years.
The following factors should considered when deciding between a dental bridge or dental implant:
Insurance coverage
Bridges covered by most dental insurance plans, so you should able to reclaim a considerable percentage of the cost. Implants on the other hand 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 replaced every 10-15 years due to normal wear and tear, the implant itself permanent barring any uncontrollable circumstances such as accidents and diseases. Bridges typically need to 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.
Oral hygiene
A special type of floss and possibly other dental hygiene tools 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 brushed and flossed as if it were an ordinary tooth.
Appearance
Modern bridges look very natural, but as bone and gum tissue 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.
Procedure duration
Start to finish, bridges 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.
The cost of a bridge varies based on the following factors:
- Material made from (composite resin, metal alloy covered in porcelain, zirconia, etc.)
- Number of teeth (units) replaced and where they are in your mouth
- Condition of the adjacent/anchoring teeth
- The experience and popularity of your dentist
- Where you live
Dental Implants
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 will 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?
Implants
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. the longer-term because they don’t have to 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 grinded down. If money is an issue, please see these ways you can reduce the cost.
Bridge
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. 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.
