Dental Bridges vs. Implants: What’s the Difference?

We come into this world with 32 teeth — and, man, do we give them a workout. Whether we’ve chomped down on a cherry pit, face-planted in a tumble or just gone to bed without brushing one too many times, most of us are likely to lose at least a few of those pearly whites by the time we hit our 60s.

The consequences aren’t great. Missing teeth can interfere with your ability to eat and to speak. Your remaining teeth can drift into the now-empty space, leading to changes in your facial structure and jawline. And then there’s the loss of self-esteem that missing teeth can bring.

It’s good to know that your dentist can offer two well-established ways to replace a missing tooth: a dental implant and a dental bridge.

We spoke with dentist Anne Clemons, DMD, to learn about the differences between the two ­— and how to choose the procedure that’s best for you.

Which is better?

Dental implants are small threaded posts that replace missing tooth roots. A surgeon places the dental implant into your jaw during oral surgery. Once the implant heals, your dentist places a crown on top.

Dental bridges, on the other hand, fill in for missing teeth without replacing the roots. At its most basic, a bridge consists of crowns that are placed over your natural teeth on each side of the missing tooth, and an artificial tooth that “bridges” the gap between them.

From a day-to-day perspective, says Dr. Clemons, the difference between the two isn’t dramatic. “As far as something that stays in the mouth and provides basic chewing ability, most patients find that they are relatively similar,” she says.

Occasionally, anatomical factors might make your dentist recommend one approach over the other. But in many cases, your dentist is likely to say that either approach would be OK for replacing your missing tooth.

While they’ll help you weigh your options, the decision often comes down to questions of convenience, cost and the length of the replacement process.

Let’s look at some of the pros and cons of each:

Dental bridges: pros and cons

When it comes to restoring your smile, dental bridges offer many benefits:

• They look natural when new.
• They restore your chewing and speaking functions.
• Bridges prevent neighboring teeth from shifting into the gap left behind by missing teeth.
• Bridges don’t require bone grafting or invasive surgery.
• Installing a bridge generally takes only two visits, spread out over a couple of weeks.
• The initial cost of a bridge is usually lower than an implant.
• The procedure is more likely to be covered by insurance.

“The main upside to a bridge is that it tends to be a quicker process, start to finish,” clarifies Dr. Clemons. “You don’t have that surgical side of things that you have with an implant, so that can definitely be a plus.”

On the other hand, there are some drawbacks to bridges:

• They don’t last forever. According to the American Dental Association, it’s not uncommon for a bridge to need replacement after five to seven years.
• The procedure involves shaping and placing crowns on neighboring teeth that might have never needed treatment.
• Patients report more cavities and tooth decay after receiving bridges. That’s because it’s hard to effectively brush and floss around them.

“A bridge can be a pain to clean,” Dr. Clemons notes. “Normally, a person can floss between each tooth. But with a bridge, you have three teeth connected, and no way to get between them. There are special flosses and tools for getting beneath a bridge, but it’s another step in your daily routine, and just a little bit more annoying.”

Dental implants: pros and cons

Dental implants are an increasingly popular choice for replacing a missing tooth. Here are some of the benefits:

• Dental implants retain a natural appearance longer than bridges do.
• They restore your chewing and speaking function.
• Dental implants prevent neighboring teeth from shifting into the gap left behind by missing teeth.
• They provide tooth replacement without doing damage to any of your neighboring teeth.
• Dental implants don’t get cavities.
• Dental implants can last a lifetime — although the crowns on top of the implants generally only last around 15 years.

“That said,” adds Dr. Clemons, “dental implants still need care and maintenance. But typically, a single tooth implant is going to be a lot easier to keep clean than a bridge.”

But like bridges, dental implants have some drawbacks:

• Installing an implant requires oral surgery, which comes with risks like infection, nerve damage, sinus damage or improper placement.
• From start to finish, it can take as long as six months and multiple visits to install a dental implant and crown.
• Dental implants may not be appropriate for those under 18, whose jaws may still be growing.
• Dental implants are more costly than bridges.
• Dental implants are less likely to be covered by insurance.

“It’s a longer process in general to get an implant,” Dr. Clemons states, “mostly because the implant needs several months — and maybe more — to heal before it can be connected to the crown. So, that’s certainly something to consider.”

How to choose what’s right for you

There are a lot of factors in play when deciding between a dental implant and a dental bridge, including convenience, cost and how long it takes to complete the process. When it comes to weighing the pros and cons, your dentist is your best resource, advises Dr. Clemons. “That’s the bottom line, 100%.”

Beyond that, she says it’s a question of individual preferences:

• How much treatment are you willing to go through?
• How quickly do you want this done?
• How do you feel about oral surgery?
• How much effort will you put in to keeping it clean?
• And what about the issues of replacements and cost?

“The answers to these questions are very individual,” Dr. Clemons recognizes, “and your situation may vary. So, it’s just not possible to make a blanket recommendation.”

Fortunately, your dentist can help you sort through these variables. “They really are the best place to start,” she assures.