Neither a dental implant nor a bridge is better for everyone. Dental implant vs bridge comes down to what each asks of the teeth beside the gap, of the jawbone, and of you over time. A traditional bridge rests on the neighboring teeth, while an implant is a post in the bone that stands on its own. An exam shows which one your mouth fits.
How does a bridge replace a missing tooth?
A traditional bridge holds an artificial tooth in the gap by attaching it to the surrounding teeth. The American Dental Association (ADA) says crowns can be used to attach bridges. Depending on the type of bridge, the ADA says its success depends on the foundation. So keeping the remaining teeth healthy and strong is very important.
What a bridge asks of the teeth beside the gap
Our post on why dentists recommend crowns explains that fitting a crown means shaping the tooth down. Enamel removed this way does not grow back. With a bridge, that shaping can land on neighboring teeth that were otherwise sound. The bridge then depends on those teeth for as long as it stays in your mouth.
What a bridge asks of you over time
The ADA says people with bridges may find that a water flosser helps them reach every nook and cranny.
A 2007 systematic review in Clinical Oral Implants Research pooled studies with a mean follow-up of at least five years. For bridges held by teeth, the most frequent complications were biological ones, like caries and loss of pulp vitality. Published in 2007, it cannot include restorations placed in recent years.
How does a dental implant replace a missing tooth?
An implant replaces the root instead of leaning on the neighbors. The Food and Drug Administration (FDA) says the implant body is surgically inserted in the jawbone in place of the tooth's root. It also says an abutment usually attaches to the implant body and extends through the gums to support the artificial tooth.
The stages of an implant
The ADA says there are generally three phases. First, the dentist surgically places the implant in the jawbone. Next, the bone around it heals in a process called osseointegration, where the bone grows around the implant and holds it in place. Finally, the replacement tooth goes on, and for a single tooth it is a custom crown.
What an implant asks of the bone and your health
When a tooth is lost, the bone under it typically thins. The root no longer passes bite pressure into it, as our post on what decides the cost of dental implants explains. A 2021 systematic review in the Journal of Clinical Periodontology found variable bone resorption after an extraction socket heals on its own. The amount depends on tooth type.
An implant sits in the bone. The FDA lists helping keep the jawbone from shrinking and nearby teeth stable among its benefits.
Surgery, healing and health limits
The tradeoff is surgery and healing. The FDA names damage to nearby natural teeth during placement and a loose abutment screw among the risks. It also says complications can occur soon after placement or much later, and that implant failure can mean another surgical procedure.
Health sets limits too. The ADA says your health is more of a factor than your age. It says chronic illnesses such as diabetes or leukemia may interfere with healing after surgery. People with these issues may not be good candidates. Using tobacco can slow healing as well.
What an implant asks of you over time
The FDA says regular cleaning of the implant and the teeth around it is very important. It lists difficulty cleaning the gums around the implant among the risks.
That 2007 review also found technical complications significantly more frequent with implant-supported restorations than with bridges held by teeth. They included chipped ceramic and a loose abutment or screw.
Dental implant vs bridge: when does each fit better?
The ADA and FDA pages do not name a winner. They describe what each option asks of your mouth, and an exam weighs those asks against your teeth, bone and health.
When a neighboring tooth needs a crown
A bridge can fit better when a tooth beside the gap already needs a crown. The ADA says crowns can be used to attach bridges. If a neighbor needs a crown anyway, ask your dentist whether that crown could also anchor a bridge. That only holds if the tooth is strong enough to be the foundation.
When health is a concern
A bridge can also fit better when health makes implant surgery or healing a concern. The FDA ties implant failure to infection and to delayed healing. It says infection may be more likely with uncontrolled diabetes, and delayed healing may be more likely in people who smoke. The ADA says a traditional bridge is attached to surrounding teeth for support, while an implant needs bone to heal around it.
When to ask about an implant
The ADA lists not wanting good tooth structure removed to make a bridge as a reason to ask your dentist about an implant.
If more than one tooth is missing
For more than a single tooth, the ADA says custom-made bridges or dentures will be made to fit your mouth and your implants. It also describes dentures as removable appliances that can replace missing teeth. Our dentures and partials page covers partials, which rest on the teeth you still have.
What decides which one fits your mouth?
Three things shape the answer: the condition of the teeth beside the gap, the amount of bone under it, and your general health. Hanover Dental Care places implants and restores them, and it has CBCT 3D imaging, a scan that shows the jawbone in three dimensions. Our dental implants page walks through the steps from consultation to final restoration, and our crowns and bridges page covers bridges.
Cost and next steps
Cost is part of the decision, too. Our post on what decides the cost of an implant covers the pieces of an implant quote and how insurance often treats them.
Missing a tooth and unsure which way to go? Call Hanover Dental Care in Montpelier at (804) 544-2499, or send a message through our contact page.