The field of tooth replacement is now replete with many more options than were available in previous decades. The traditional bridge is still available and utilized, but newer implant technologies present the patient with several advantages worth considering.

Implants have evolved significantly over the last quarter century thanks to advances in materials, procedures, and a widening library of professional experience and study. Mini dental implants are also now available, offering minimal intrusion and an immediate solution for patients who struggle with loose dentures.

The Different Types of Dental Bridges

Dental bridges get their name from their ability to connect one or more adjacent false teeth between two permanent teeth. There are three main variations on the standard dental bridge.

Photo Courtesy of Bin im Garten via Wikimedia. CC/BY

The Traditional Bridge

The most common type of bridge uses porcelain false teeth fused to a metal or ceramic brace. The traditional bridge is secured through the utilization of a crown atop the teeth on either side of the missing tooth or teeth.

The Cantilever Bridge

This style of dental bridge isn’t common in the present day as it’s quite stressful to the other teeth, especially when used in the back of the mouth. The cantilever bridge is used when only one permanent tooth is available next to the missing tooth.

Maryland Bonded Bridges

These bridges are crafted of porcelain, porcelain fused to metal, or plastics fused to a porcelain framework. Maryland bonded bridges attach to existing teeth using porcelain or metal wings.

Common Problems with Dental Bridges

A fundamental problem with the dental bridge is its dependence on the ongoing health of the adjacent crowned teeth. In the event one or more of the crowned teeth begins to decay or acquires nerve damage, the entire bridge will need to be repaired or replaced. To make matters more challenging, cleaning one’s teeth while wearing a bridge can be difficult.

The crowned teeth must be cared for just like all of your other teeth, with regular brushing, flossing, and the use of an antiseptic mouthwash. You must also clean the area underneath the bridge. You will need to use a nylon threader for flossing, which requires precise placement to reach between teeth.

Many bridge wearers have found that using a water flosser is the best cleaning option. Without attentive and careful cleaning, you may find yourself having to replace or repair your bridge several times throughout your lifetime – an expensive long-term proposition.

What are Dental Implants?

Dental implants rely on a titanium post inserted into the jaw bone which serves as the root of an artificial tooth. The titanium post is first fitted with a small temporary crown. After a period of time–usually a period of six weeks to nine months depending on the individual and the location of the implant– the temporary crown is removed, and a permanent crown is affixed. The permanent crown in one or multiple implants may also be used to secure bridges for other missing teeth.

There are several immediate advantages of dental implants over bridges. Unlike bridges, dental implants do not rely on other teeth for positioning. When a bridge is employed, the teeth that anchor the bridge are permanently affected by the crowning process. Implants do not affect other teeth. Bridges are also more prone to becoming loose over time, making dental implants the best option for comfortable chewing.

The Cost Factor

Dental implants are generally going to be more expensive than bridges, at least in the short term. In her New York Times article, A Dental Shift: Implants Instead of Bridges, writer Jane Brody investigates the longer term cost-benefit calculus for the bridge versus implant dichotomy, concluding that implants are more cost effective in the long term.

When properly cleaned and maintained, a bridge should last between eight and fifteen years whereas dental implants are meant to last a lifetime.

“In an overwhelming majority of cases, implants to replace lost teeth are by far the best long-term solution for maintaining a healthy mouth,” said Brody.  “Also, because they rarely need to be replaced, in the long run, they are more economical than bridges.”

In Brody’s breakdown of the total costs involved, she finds the average implant cost is between $3,500 to $4,000 per tooth (possibly more if other procedures are required). This price range is more expensive than that of a bridge by roughly a third.

The Mini Dental Implant

Miniature Dental Implants (MDIs) use titanium to root the appendage in place. MDIs are smaller than conventional implants and can accommodate a range of bone density and availability, both factors critical to a healthy implant.

Many patients who’ve previously been told they don’t have the adequate bone density for implants may find a solution in MDIs. Other patients may have been told that major bone grafting would be required before the installation of an implant. With MDIs, this bone grafting may be minimal or possibly unnecessary altogether.

Installing an MDI is considerably less intrusive to the gums than installing a standard implant. “[MDIs] are so narrow they are typically inserted directly through the overlying gum tissue and into the bone underneath. Consequently, the need to surgically cut and ‘flap’ open the gum tissue can be avoided.”

Dental Implants as a “Preferred Method”

As noted in Jane Brody’s article as well as by several qualified sources throughout the dental community, the use of implants rather than bridges has emerged over the last quarter century as the preferred method of tooth replacement.

Implant-based replacements are commonly regarded as being more comfortable, more aesthetically appealing and more cost effective over the long term. Unlike bridges, implants do not negatively impact the health of adjacent teeth.

Implants are steadily emerging as the more durable option. Whereas the American Dental Association quotes a 10-year life span for bridges, a multitude of clinical studies show that implants have a success rate of 95-98 percent for periods of 20-50 years. A qualified board certified oral surgeon can help you better understand the differences between these and find what is right for your specific situation.