July 11, 2016

Teeth replacements have come a long way in the last 30 years. Missing or extracted teeth raise common concerns of infection, but the proper replacement is the key to a confident smile. Today, however, the questions you need to ask your dentist or prosthodontist are a bit different: What's the difference between a dental bridge vs. implant? Which treatment option is right for me? Very often the dental implant is ideal, but numerous factors will need to be considered first, including if your tooth loss is recent or happened years ago.

PRACTICAL REASONS FOR BOTH

In the past, a bridge was your only choice, and still involves more than just the missing tooth. The adjacent teeth need to be "prepped" by removing most of the enamel in order to fabricate the bridge. With dental implants, however, the dentist replaces just the individual tooth for a result that is stronger and permanent. Nonetheless, a dental bridge may be your best option if the neighboring teeth have large fillings and need crowns or caps in the future. And if the tooth or teeth have been lost for a long time, the gum and bone will have receded and procedures beyond the implant are required before placement. The advantages and disadvantages to both procedures can ultimately be discussed with your dentist.

CHANGES IN YOUR ORAL CARE ROUTINE

Your ability to keep your mouth healthy will be easier with an implant. Dental bridges are cemented or "fixed" in the mouth, and involve at least three crowns connected together to fill the space of the missing tooth. This design creates challenges when brushing and flossing, so extra oral hygiene instruction and meticulous home care are crucial. When flossing, in particular, an additional step is needed to thread the floss under the false tooth.  In contrast, implants can replace teeth individually without affecting other teeth, making regular home care more successful. You can effectively brush and floss around an implant just like your natural tooth.

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DURABILITY

Dental implants are more durable than bridges, allowing them to provide protection that lasts a lifetime. The implant's metal cylinder is normally made of titanium, according to the American Academy of Implant Dentistry (AAID), and this material fuses with your jawbone naturally through a process called osseointegration. Because it's made of such a strong metal, they are very resistant to decay and gum problems. The average life of a dental bridge, on the other hand, is approximately 10 years. A portion of your natural tooth remains beneath it and normal wear may cause the bridge to fail more easily over time. In general, the remaining tooth structure continues to be susceptible to decay and gum disease.

AESTHETICS

What about aesthetics? There isn't always a simple answer, but your dentist or prosthodontist – the latter specializes in crown, implants and bridges – will be able to advise you. Often the implant will provide the most pleasing result, as your dentist can make the final tooth look just like your natural enamel. Sometimes, an implant can be placed immediately after a tooth extraction, preserving the natural level of bone and improving the final appearance of the dental work.

DENTAL BRIDGE VS. IMPLANT COST

The cost of the dental bridge is initially less, but it may need to be replaced at some point in the future. Implants – from preparation to final placement – may seem more expensive, but over time can be more cost-effective. Fortunately, most dental insurance providers are paying for a portion of or all of the steps involved. In addition, implant treatment can be more flexible, allowing patients to budget the cost in increments. After extraction, for example, a bone graft is sometimes needed. This graft typically has to heal for several months before implant placement, at which point osseointegration can take anywhere from three to six months before the process is complete.

So, dental bridge vs. implant? Make this decision after consulting with your dentist. He or she knows your mouth best and has the tools and knowledge to guide you through what's best for it. Although bridges are an older procedure, dental implants have become more commonplace over the years, and in most cases are the preferable treatment both in time and expense.

Donna M. Rounsaville, RDH,BS, colgate.com