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Comparing options

Dental implant or bridge for a missing tooth?

Both fill the gap of a missing tooth with a fixed tooth you don't take out; the difference is what they rest on. An implant stands in the bone on its own, while a bridge rests on the teeth either side, which are reshaped to hold it.

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In short

Is an implant or a bridge better for a missing tooth?

It depends on your teeth. An implant replaces the tooth without reshaping its neighbors and helps keep the bone, but it needs surgery and months of healing. A bridge is usually quicker and needs no surgery, but the teeth either side are reshaped, which is irreversible. In a systematic review, survival at 10 years was similar for both.

From the office of Dr. Angela Berkovich, DMD, Deerfield Beach · (954) 427-3000

Last updated

What each one rests onTwo drawings of three tooth positions with the middle tooth missing. Left, a bridge: the two neighboring teeth are made smaller, shown with dashed outlines, and a joined set of crowns sits over them and spans the gap. Right, an implant: the neighboring teeth are whole, and a post in the bone holds a single crown in the gap.Illustration, not to scaleBridgeRests on both neighborswhich are reshaped to hold itImplantStands in the bone on its ownneighbors left as they are

What each one rests on

A bridge is anchored to the teeth on either side of the gap, which have enamel removed so the crowns fit over them. An implant replaces the root in the bone, so the neighboring teeth are not shaved down.1,2,3

Neighboring teeth
Implant: left as they are. Bridge: reshaped to hold it1,3
Bone
Better preserved with an implant; can shrink under a bridge1
Time
Implant: three to nine months of healing. Bridge: usually two visits2,3
10-year survival
Implant crowns 89.4%, conventional bridges 89.2%4
Bridges last
5 to 15 years on average3

Questions that point one way or the other

Your exam and a 3D scan answer these:

  • Are the teeth either side healthy and unfilled, or do they already need crowns?
  • Is there enough bone where the tooth is missing?
  • Are your gums healthy?
  • Do you have health conditions or habits, such as smoking or unmanaged diabetes, that affect implant healing?
  • How soon do you need the gap filled?

Implant and bridge, side by side

For a single missing tooth with healthy teeth either side.

Implant and bridge, side by side
AspectImplantBridge
Rests onA post in the jawbone2,3The teeth either side of the gap
Neighboring teethNot shaved down2,3Enamel removed; not reversible
SurgeryYes, to place the post2,3No
Time to the final toothMonths of healing first2,3Usually two visits
Survival at 5 years in studies94.5%493.8%
Typical problemsMostly technical, such as loose screws4Mostly biological, such as decay in the supporting teeth
NeedsEnough healthy bone and healthy gums2,3Healthy supporting teeth

When a bridge is the better choice

  • When the teeth either side already have large fillings or need crowns anyway, a bridge restores them and fills the gap in one plan.3,5
  • When implant surgery isn't advised for you, for example with active gum disease, severe bone loss, unmanaged diabetes or smoking.2
  • When you need the gap filled sooner than an implant's healing time allows.2,3
  • A removable partial denture is another option when several teeth are missing or surgery isn't wanted.6

Questions patients ask

Does a bridge damage the neighboring teeth?

It changes them: enamel is removed from the teeth either side so the bridge crowns fit over them, and that can't be undone. Those teeth must be healthy to carry the bridge, and the problems bridges had in studies were mostly biological, such as decay or loss of vitality in the supporting teeth.3,4

Why does bone matter?

Without a root, the bone where a tooth was can shrink. An implant replaces the root and helps preserve that bone; under a bridge the bone can resorb. Enough healthy bone is also what makes an implant possible, which is why the exam includes a CBCT scan (a 3D X-ray of your jaw).1,2

Is an implant always possible?

No. It needs enough healthy jawbone and good oral health, and it isn't advised with active gum disease, severe bone loss, unmanaged diabetes or smoking. Where an implant isn't advised, a bridge or a removable partial denture fills the gap without surgery.2,6

How are implants planned here?

On a CBCT scan, in software, with a surgical guide made from the plan so the implant follows the planned position. The scan also shows whether there is enough bone, one of the questions that decides between an implant and a bridge.7

Who you'll see

Dr. Angela Berkovich, DMD

Dr. Angela Berkovich, DMD

Dentist, trained at Oregon Health & Science University School of Dentistry

Dr. Berkovich will look at the teeth beside the gap and the bone under it, and explain which option suits your mouth.

Medical content reviewed by Dr. Angela Berkovich, DMD on .

Office: 1348 E Hillsboro Blvd Suite A, Deerfield Beach, FL 33441. (954) 427-3000

About Dr. Berkovich

Sources

  1. American Academy of Periodontology: Single tooth dental implants
  2. Cleveland Clinic: Dental implants
  3. Cleveland Clinic: Dental Bridges: Types & Who Needs Them
  4. PubMed: Pjetursson et al. 2007, survival of tooth- and implant-supported fixed restorations: systematic review
  5. American Dental Association (MouthHealthy): Crowns
  6. American Dental Association (MouthHealthy): Dentures
  7. PubMed: Wismeijer et al. 2018, ITI Group 5 consensus on computer-assisted implant surgery

General information, not a diagnosis or a promise of results. Individual results vary, and whether a treatment suits you depends on your exam.

Talk it through at a consultation

Bring your questions and any X-rays you already have. We'll look at your teeth, explain which options are reasonable for you, and what each one involves.

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