When addressing the loss of a single tooth, there are typically two options – a dental bridge or an implant. Patients ask me which of these is the better treatment option, and there are times when I have a strong recommendation, and others where it is truly up to the patient. To illustrate this, I want to share a case that I saw in my office recently.
After walking him through the diagnosis, I gave him three treatment options:
- Extraction and bone graft, followed by wearing a removable flipper (partial denture) while the bone graft heals and then an implant.
- Extraction and bone graft, followed by wearing a removable bridge while the bone graft heals and then two months later impressions for the final bridge.
- Extraction and no bone graft with a metal-based partial denture that is removable.
We both immediately discarded the third option since most people don’t want a removable denture. Having ruled that out, we looked at the first two options. Most people know the implant is the best option long-term. However, it’s not always the best option with all things considered.
With that in mind, here are a few nuances to consider when deciding whether you should get a bridge or an implant.
Both an implant and a bridge require several appointments over several months. A bridge typically requires three appointments totaling four hours over a three-month period. The patient will also wear a temporary bridge for two months. An implant requires eight appointments totaling five hours over an eight-month period, half of these appointments being with a specialist. The patient will also wear a partial denture for three months. If time is a main concern, the bridge is the better option.
When you’re talking about teeth, longevity is important particularly if you hope to get to 100 with all your teeth. The likelihood of a bridge failing over a 10-year period is much higher than an implant, but a bridge does have very good outcomes over 10 years. If we look at a 15-year period, it is more likely the bridge will fail and at that point require an implant for each tooth the bridge encounters. If an implant makes it through the first year, it’s very likely it will last for more than 10 years. If longevity is a main concern, the implant is the better option.
Generally, an implant is more expensive than a bridge. In John’s case, the cost of the implant came out to about $1,500 more than the cost of the bridge. However, when you consider that the whole treatment is over $6,500, the added cost is not that much higher. If cost is your main concern, the bridge is the better option.
If aesthetics is a main concern, it really depends on where the tooth is and what the teeth around it have endured. In John’s case, the aesthetics slightly favor a bridge. However, another patient may have better aesthetics with an implant. If aesthetics, it’s important to have a conversation with your dentist to determine the best course of treatment to maintain or improve the aesthetics of your smile.
5. Mode of Failure
In my opinion, this is the main factor to consider – what is the patient’s most likely mode of failure? If the patient has a high-risk profile for cavities, then an implant is the better option since bridges are prone to cavities. If they have a high-risk profile for periodontal disease, the bridge is the better option given gum issues increase the risk of implant failure. If the patient has high biomechanical risk (weak teeth and a strong bite), then an implant is a better option because it is much stronger than a bridge.
In some cases, like John’s, it really comes down to what is important to the patient. Time, money, and aesthetics are all important factors to consider when deciding between a bridge or an implant. In John’s case, he ultimately chose an implant because he felt strongly he would make it to 100 with all his teeth. I believe he made the right choice because it was the best choice for him.
Not sure if a bridge or implant is right for you? Schedule an appointment with our dentist office in Brandon, FL. We’ll be happy to go over your risk profile and treatment options and establish a plan that works for you.