What’s the difference? – Cleveland Clinic

We come into this world with 32 teeth — and, man, we give them a workout. Whether we’ve chopped into a cherry pit, face-planted into a bat, or simply gone to bed without brushing multiple times, most of us are likely to lose at least a few of those pearly whites by the time we hit 60s.

The consequences are not great. Missing teeth can affect your ability to eat and speak. Your remaining teeth may drift into the now empty space, leading to changes in your facial structure and jawline. And then there is the loss of self-esteem that losing teeth can cause.

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

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

Which one is the best?

Dental implants they are small threaded posts that replace the roots of missing teeth. A surgeon places the dental implant in your jaw during oral surgery. Once the implant has healed, your dentist places a crown at the top.

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

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

Occasionally, anatomical factors may cause your dentist to recommend one approach over another. But in many cases, your dentist is likely to say that either approach would be fine to replace the missing tooth.

While they will help you weigh your options, the decision is often based on convenience, cost and 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 space left behind by missing teeth.
• Bridges do not require bone graft or invasive surgery.
• Installing a bridge generally requires only two visits, over a two-week period.
• The initial cost of a bridge is usually lower than an implant.
• The procedure is more likely to be covered by insurance.

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

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

• They don’t last forever. According to American Dental Associationit is not unusual for a bridge to need replacement after five to seven years.
• The procedure involves shaping and placing crowns on adjacent teeth that may never have needed treatment.
• Patients report more cavities and tooth decay after getting bridges. This is because it is difficult to effectively brush and floss around them.

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

Dental implants: pros and cons

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

• Dental implants retain their natural appearance longer than bridges.
• They restore your chewing and speaking function.
• Dental implants prevent neighboring teeth from shifting into the space left behind by missing teeth.
• They provide tooth replacement without damaging any of your neighboring teeth.
• Dental implants do not create cavities.
• Dental implants can last a lifetime — although crowns over implants generally only last about 15 years.

“That said,” adds Dr. Clemons, “dental implants still require care and maintenance. But usually, a single tooth implant will be much easier to keep clean than a bridge.”

But, like bridges, dental implants have some disadvantages:

• Installing an implant requires oral surgerywhich comes with risks such as infection, nerve damage, sinus damage or improper placement.
• From start to finish, it can take up to six months and multiple visits to install a dental implant and crown.
• Dental implants may not be suitable for people under the age of 18, whose jaws may still be growing.
• Dental implants are more expensive than bridges.
• Dental implants are less likely to be covered by insurance.

“It’s a longer process in general to get an implant,” states Dr. Clemons, “mainly because the implant takes several months — and maybe more — to heal before it’s attached to the crown. So that’s definitely something to consider.”

How to choose the right one for you

There are many factors that come into play when deciding between a dental implant and a dental bridge, including convenience, cost, and the time it takes to complete the procedure. 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, he says it’s a matter of individual preference:

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

“The answers to these questions are very individual,” acknowledges Dr. Clemons, “and your situation may vary. Therefore, it is not possible to make a general recommendation.”

Fortunately, your dentist can help you sort through these variables. “It’s really the best place to start,” he assures.