Short answer: An implant consists of a screw placed in the jawbone in place of the missing tooth and a tooth made on top of it; it stands on its own without touching the neighbouring teeth. A bridge, on the other hand, replaces the missing tooth by preparing and crowning the teeth on either side of the gap and joining the missing tooth to them. Which one is suitable is assessed by the dentist according to the condition of the neighbouring teeth, the amount of bone, general health and the person's preference.
What is an implant?
A dental implant is a component, usually made of a tissue-friendly material such as titanium, that replaces the root of a lost tooth. It is placed in the jawbone, allowed to fuse with the bone, and a permanent tooth is then made on top of it. In this way the missing tooth is replaced independently of the neighbouring teeth. We explain who implants are suitable for in our article who is suitable for dental implants.
What is a bridge?
With a fixed bridge, the teeth on either side of the gap (the abutment teeth) are prepared so that crowns can be placed on them. The crowns for these teeth and the missing tooth in between are then made as a single connected piece and cemented in place. Because a bridge does not require surgery on the bone, in some cases it can be completed in a shorter time. For information on crown materials, see our article on dental crown types.
Key differences
Effect on neighbouring teeth
With a bridge, material has to be removed from around the abutment teeth. If these teeth are sound and have no fillings, preparing them just for a bridge can be seen as a significant disadvantage. If the abutment teeth already have large fillings or need crowns, a bridge can be an option that also treats these teeth. With an implant, the neighbouring teeth are usually not touched.
Bone and gums
When a tooth is lost, the bone in that area may tend to shrink over time. Because an implant transfers load to the bone, it can help slow this process. With a bridge, the bone under the missing tooth is not stimulated. On the other hand, an implant needs enough bone; if there is not enough bone, additional procedures such as bone grafting may come up.
Time and procedure
An implant requires a surgical procedure, and there is usually a waiting period of a few months for it to fuse with the bone. A bridge can usually be completed in fewer sessions. We explain the recovery process after an implant in our article on pain and recovery after an implant.
Care and cleaning
With a bridge, food and plaque can collect under the pontic; this area needs to be cleaned with special floss or an interdental brush. If cleaning is inadequate, decay and gum problems can develop in the abutment teeth. An implant is brushed and cleaned between like a natural tooth; however, inflammation can also develop around an implant, so regular care and check-ups are essential. For problems that can occur with bridges, take a look at our article on gum recession under a bridge.
What is assessed when deciding?
- The condition of the neighbouring teeth: Are they sound, filled, or in need of crowns?
- Bone quantity and quality: Assessed with X-rays and, if needed, 3D imaging.
- General health: Conditions such as uncontrolled diabetes, certain bone medicines and a history of radiotherapy to the head and neck can affect planning.
- Smoking: It can have a negative effect on both implant integration and gum health.
- Gum health: Untreated gum disease should be dealt with first for either option.
- Teeth-clenching habit and bite
- The person's expectations, timeline and attitude towards surgery
For details of the planning process, see our article on implant planning.
The role of orthodontics
When a tooth has been missing for a long time, the neighbouring teeth can tilt into the gap and the tooth in the opposite jaw can over-erupt towards it. In this case the space for both an implant and a bridge may become narrower, or the teeth may not be at a suitable angle. For some patients, moving the teeth into the right position with orthodontic treatment before an implant or bridge may be considered for a better result. We explain this on our implants and orthodontics page; for general information about tooth position, you can also see our gaps between teeth page.
When more than one tooth is missing
Where several teeth are missing, implant-supported bridges or removable dentures are also among the options. For situations where all the teeth are missing, see our articles on treatment options for people with no teeth and all-on-4.
Preparing for your examination
When you discuss the question of implant or bridge with your dentist, having some information ready makes the assessment easier. This includes a list of the medicines you take, any chronic conditions, whether you smoke and the dental treatments you have had before. It also helps to mention when and why you lost the tooth and whether any treatment was done in that area before. Do not hesitate to ask your dentist how each option would be carried out in your mouth, how long it would take, what care it needs and what the possible risks are. Noting your questions in advance helps you not to miss anything at the examination.
Frequently asked questions
Which lasts longer, an implant or a bridge?
Both options can be used for many years with good care; however, how long they last varies from person to person. Oral hygiene, bone and gum health, smoking and regular check-ups are decisive for both treatments.
Are healthy teeth prepared for a bridge?
With a bridge, the abutment teeth need to be prepared so that crowns can be placed on them. If the abutment teeth are sound, this is an important point to assess together with the dentist.
Can an implant be placed if there is not enough bone?
In some cases an implant may become possible with additional procedures such as bone grafting. Whether this is suitable is determined through imaging and an examination.
What happens if a missing tooth is not replaced soon?
Over time the neighbouring teeth can tilt into the gap, the opposing tooth can over-erupt and the bone in the area can decrease. Because these changes can make later treatment harder, it is helpful not to delay a dentist's assessment.
How can you find out what suits you?
The information here is general; the right option for you is determined through an examination and the dentist's assessment. For appointments and directions, see our contact page.
