How to choose between tooth bridge vs implant? Pros and cons, cost, and procedure comparison

Dani Dinkel

Written by Dani Dinkel RDH

If you need to replace a missing tooth, you’ve got lots of options. You can choose to have an implant, a bridge, or a partial. While all of these are better than a missing tooth, the two best options are dental implants and bridges.

But how do you know which option is best for you? Let’s compare the two restorations so you have all the information you need to make an informed decision.

How to compare dental bridge versus implant

Traditional dental bridge

Picture by Authority Dental under CC 2.0 license

You’ll need to factor in several things when comparing a dental implant to a bridge. Choosing between the two is not always easy, and you should work with your dentist to decide which option you are best suited for.

Candidate profile

While nearly all people can have a bridge placed, the same is not true for implant candidates. There are a few pieces of your medical and dental history to consider.

First, your tobacco use. Smoking causes an increased risk for the failure of both bridges and implants. It harms the gum tissue and is often associated with bone loss. Smoking can decrease the length of time your bridge will last, but a bridge is still an option for those who smoke. However, smoking will greatly reduce the success rate of an implant. The likelihood of the implant integrating with the bone is slim. Your dentist will probably not recommend an implant if you are a current smoker.

The same is true for those with uncontrolled diabetes and/or periodontal disease (gum disease). Both of these conditions impact the healing process and bone stabilization, making implants not an ideal choice for these patients. The good news is, both conditions are treatable. Once they have been treated and are in a stable condition, an implant may be an option.

Procedure and recovery

A bridge is less invasive than an implant. Placing a dental implant is considered a form of dental surgery, whereas a bridge is more of a routine procedure, much like placing a crown.

A bridge can be completed in two appointments. The first appointment will last approximately one to two hours, which is when most of the work is done. A second visit will be needed a couple weeks later, after the final bridge has been fabricated by the lab. The second appointment is relatively quick. Recovery time is minimal - the tissue in the area may be tender for a couple of days, but there should be no discomfort.

The process of placing an implant can take several months. Once the implant is placed in the jawbone, it will need to heal for about three months before the implant crown is placed. There are usually several visits leading up to the initial implant placement. You may need a day to recover from the implant placement. It is a more invasive procedure and your dentist may prescribe pain medications as needed.

One important thing to note is that when an implant is placed, there is no damage to the surrounding teeth. A bridge requires that the surrounding teeth also undergo the procedure. You will need at least one tooth on either side of the missing tooth to place a bridge. These “abutment” teeth will need to be shaped in order for the bridge to be placed on top of them. If the teeth are healthy, this causes unnecessary treatment and weakens their integrity.

Complications can occur in any dental procedure, but more can occur with an implant placement versus a bridge. Most complications are a result of health factors, so your dentist should do a thorough review of your medical history before recommending an implant. There can also be complications during the procedure, but a 3D scan of the area reduces those complications.

Everyday care

Implants are easy to care for. Simply brush and floss your implant along with the rest of your teeth. While they can’t decay, it is possible for the gum tissue around the implant to become inflamed and even infected, so it is still important to floss and keep the area clean.

Bridges require an extra step in their maintenance. You should brush your bridge along with the rest of your teeth and floss on either side of it. You’ll also need to floss under the pontic (the fake tooth) to remove any food particles. To do this, you’ll need a floss threader or a piece of floss with a rigid end. A floss threader is much like a needle and thread. It allows you to thread the floss under the bridge, and then floss the entire area. You should do this at least once per day.

Durability

There is no question that an implant has more durability than a bridge. A bridge may last 10-15 years if it is taken care of properly. An implant can last a lifetime. The titanium cylinder integrates with the bone and is resistant to bacteria, unlike bridges.

Appearance

Implants and bridges can both blend in with the surrounding teeth. An implant is going to be more aesthetic since it will be shaped to the gum tissue surrounding it, making it look like it is protruding from the gums, which it is!

A bridge can have a similar appearance at first, but the gum tissue and bone will begin to recede from under the pontic, making the bridge more noticeable. Plus, the pontic will be fused to the abutments (the real teeth that serve as ends of the “bridge), so it may be noticed that there is no space between the teeth.

Implant vs. bridge cost

Single tooth implant

Picture by Authority Dental under CC 2.0 license

One of the first questions many patients have is related to the cost of either procedure. Of course, the cost is understandably a key factor in making the final decision.

The cost for both implant and bridge will be greatly dependent on your location. There are other considerations as well, which will play into your total cost for treatment. For instance, a bridge can replace one or more teeth, so it will depend on how many “units” the bridge spans. Implants may require additional procedures like bone grafts and membrane placement, and your cost will depend on how many implants you are receiving.

The average cost for a 3-unit bridge is anywhere from $3,000 to $5,000. Most insurance companies offer benefits for bridges. They are considered “major” coverage, and many companies offer 50% coverage on major services. There is a bit of fine print that can go into insurance payment for bridges, so be sure to check the specifics of your dental insurance plan.

The average cost for a single implant is between $3,500-$6,700. More and more insurance companies are offering benefits for implants. Like bridges, they typically fall under the “major” services category. Keep in mind that your plan probably has annual limits on how much they will contribute, and implants usually fall outside of the yearly maximum.

Tooth bridge vs. implant: pros and cons summary

We’ve covered quite a bit of information talking about the pros and cons of implants and bridges. The two main areas of concern that most patients have are cost and effectiveness.

Bridges are less expensive initially and have fewer restrictions on who is a good candidate for the procedure. However, they cause unnecessary treatment on neighboring teeth and can lead to more extensive treatment down the road. Implants are more expensive but cause no problems with any other teeth and last a lifetime.

FAQ

Is a bridge better than an implant for front tooth replacement?

Implants have been the best way to replace a missing tooth for quite a few years now. An implant is especially beneficial to replace a front tooth because it will keep the bone intact. A bridge is still an excellent tooth replacement option but will not stabilize the bone. The bone around the missing tooth will begin to resorb, and you may start to notice a gap between the pontic (the fake tooth) and the gum tissue. This will become more and more noticeable over time.

Which solution: implant or bridge, is more cost-effective?

While implants have a greater cost upfront, they are actually a more cost-effective treatment over time. Once an implant is placed, it has a 97% success rate. There is a great chance that you will never have to have that implant replaced.

A bridge, on the other hand, will need to be replaced over time. Unlike implants, bridges can get decay under them, which would be cause for replacement. Also, if enough of the bone is resorbed over time, the teeth that support the bridge could become mobile. This is especially true in cases of periodontal disease.

Are implants and bridges the only options for tooth restoration?

Implants and bridges are not the only two options to restore a missing tooth. Full and partial dentures can also replace missing teeth. However, dentures will need to be taken in and out of the mouth daily and can actually cause excessive wear on the remaining teeth.

Also, dentures do not stabilize the bone, which means that the bone that supports the denture or partial denture will resorb over time and lead to ill-fitting dentures.

References

  1. Single-tooth replacement: bridge vs. implant-supported restoration - NIH
  2. The effect of cigarette smoking habits on the outcome of dental implant treatment - NCBI
  3. Cost-effectiveness modeling of dental implant vs. bridge - PubMed