Most people take their teeth for granted, so losing them is an unpleasant shock as they realize why strong and healthy teeth are so important. Losing teeth, especially those right in the smile line, can significantly damage self-confidence and make eating much harder. Replacing missing teeth as soon as possible becomes a priority.
Two solutions for tooth loss are dental implants or dental bridges. Both restore missing teeth but use quite different techniques. Understanding how each solution works and its benefits helps determine if it is the best option for your needs.
What is a Dental Implant?
An implant consists of a screw inserted into the jawbone, requiring a short surgical procedure. The screw is made from titanium or a ceramic called zirconia and supports an abutment that fastens onto it, protruding just above the gum line like a very small, stubby tooth. The abutment will hold the implant restoration, which can be a crown or bridge.
Dental implant treatment is versatile, restoring single, multiple, or entire arches of teeth, including fixed and removable solutions. While crowns and bridges are permanently fitted onto the abutments, an implant-supported denture is a removable prosthesis. The denture clips onto the implants firmly but can still be snapped out easily for cleaning.
Advantages and Disadvantages of Dental Implants
The advantages of choosing dental implants can include the following:
Protect your jawbone. Dental implants replicate real tooth roots, helping prevent bone resorption after natural teeth are removed. They stimulate the surrounding bone so it remains strong and healthy. This is a major advantage as jawbone loss can destabilize remaining teeth and affect facial appearance. It is why people with complete tooth loss often have sunken-in facial features.
Share the stresses of biting and chewing food. When you lose natural teeth, your remaining teeth come under additional stress when you bite and chew food. Dental implants help share these loads, so they are spread evenly across the arch and prevent unnecessary and excessive wear and tear on natural teeth.
Protect natural teeth. Dental implants are self-supporting, so there is no need for our dentists to reshape these teeth, which is the case when someone has a dental bridge. When a dental bridge is fitted, these teeth are substantially reshaped, removing tooth structure to create enough room for the crowns that support the bridge.
Dental implants can last for years. Dental implants can last for years or life with the right aftercare, so they are a long-term solution for missing teeth.
Disadvantages of choosing dental implants can include the following:
The initial cost is higher. The biggest downside of dental implants is that the initial cost of treatment is higher, especially if multiple teeth need replacing or when additional procedures like bone grafting are needed. Over time, dental implant treatment can become much more cost-effective.
Oral surgery is required. Oral surgery is needed to insert the implants correctly. Not everyone wishes to have surgery or is suitable for it.
Treatment takes longer. It can take three to six months or more to complete treatment, whereas a dental bridge can be fitted within a few weeks.
What is a Dental Bridge?
A dental bridge is supported by natural teeth, usually on either side of the missing tooth. Crowns are fitted over these adjacent teeth, called abutment teeth, and the crowns are attached to the artificial tooth, called a pontic.
There are three types of dental bridges:
Traditional Dental Bridge
A traditional bridge has crowns fitted on the teeth on either side of the gap, which supports the pontic between them.
When abutment teeth are unavailable or unsuitable on either side of the gap, one or two teeth on the same side might be used as support instead, so the pontic is cantilevered off the crown and unsupported on one side.
A Maryland bridge does not use crowns but instead has ‘wings’ made from metal or ceramic that fit on the inner surfaces of the abutment teeth and cannot be seen. These wings support the pontic between them. A Maryland bridge is usually only used to replace small front teeth as it is much weaker than a traditional or cantilever bridge.
Advantages and Disadvantages of Dental Bridges
The advantages of dental bridges can include the following:
Quick to complete. A dental bridge can be fitted in two or three weeks.
Cost-effective. Treatment is cost-effective and provides good, reliable results.
Minimally invasive. No surgery is needed, and teeth can be prepared using local anesthetic.
Disadvantages of dental bridges can include the following:
Abutment teeth must be ground down substantially. Your dentist must remove a significant amount of tooth structure to make and fit the crowns. Otherwise, they would look and feel too big and bulky. Once removed, this tooth structure will not regrow, and these teeth will always need crowns.
There is a higher risk of tooth decay and infection in abutment teeth. As the crowns begin to age and possibly leak, there is a higher risk of the teeth underneath becoming infected and decaying.
Abutment teeth come under additional stress and strain. The abutment teeth must support the pontics and the additional stresses and strains as you bite and chew. This could lead to these teeth failing.
Jawbone loss. The jawbone underneath the pontics will continue to resorb. Over time, this could lead to a gap developing underneath the pontics that can become unsightly and trap food and bacteria.
How to Choose the Right Solution
If you have missing or failing teeth, dental implants are often regarded as the gold standard for replacing them. However, it is important to understand the pros and cons of implants and tooth-supported bridges.
For example, suppose the abutment teeth supporting a dental bridge will benefit from being crowned and are perhaps decayed or damaged. In that case, you might wish to choose a dental bridge instead of implants.
On the other hand, implants can be preferable if you want a long-term solution, especially if the teeth adjacent to the gap are strong and healthy. Also, all restorations need to be replaced periodically. When the time comes, replacing a single implant crown will cost less than a three-tooth or three-unit bridge.