Dental Implants
A dental implant replaces a missing tooth's root with a titanium post in the jawbone and supports a crown on its own. A traditional bridge replaces the tooth by attaching a false tooth to crowns placed on the healthy teeth on either side of the gap. Implants avoid reshaping neighbouring teeth, help maintain bone at the site, and are easier to clean, but they require surgery, healing time, and usually a higher upfront cost. Bridges are faster and involve no surgery, but they depend on the adjacent teeth. Both are reliable, long-lasting options; the better choice depends on your neighbouring teeth, bone, health, timeline, and budget.
Key takeaways
- If the teeth beside the gap are healthy and unrestored, an implant avoids drilling them down for bridge crowns.
- If the neighbouring teeth already need crowns, a bridge can treat them and replace the missing tooth at the same time.
- Implants help preserve bone where the tooth was lost; a bridge does not stop bone shrinking under the false tooth.
- Systematic reviews show high 10-year survival for both tooth-supported bridges and implant restorations.
- Upfront cost is usually higher for an implant, but long-term costs depend on maintenance and future treatment of supporting teeth.
How Each Option Works
Traditional dental bridge
A three-unit bridge is the most common type. The teeth on either side of the gap (called abutment teeth) are reshaped and covered with crowns, and a false tooth (a pontic) is fused between them. The whole bridge is cemented in place. It is usually completed in two or more dental visits over a few weeks.
Other bridge types include:
- Resin-bonded (Maryland) bridge: a false tooth attached with small wings bonded to the back of the neighbouring teeth, requiring little or no reshaping. Often used for front teeth.
- Cantilever bridge: supported by a tooth on only one side of the gap.
- Implant-supported bridge: a bridge anchored on implants rather than natural teeth, used to replace several teeth in a row.
Dental implant with a crown
An oral surgeon places a small titanium implant into the jawbone at the site of the missing tooth. Over the following months, bone bonds to the implant surface (osseointegration). Your dentist then attaches an abutment and a crown. In selected cases, an implant can be placed at the same time as the tooth is removed, and a temporary crown may be attached the same day. Learn more on our dental implants page.
Side-By-Side Comparison
| Factor | Dental implant | Traditional bridge |
|---|---|---|
| Effect on neighbouring teeth | None; stands on its own | Neighbouring teeth are reshaped for crowns |
| Surgery | Yes, minor oral surgery | No |
| Treatment time | Usually a few months, longer if grafting is needed | Usually a few weeks |
| Bone at the gap | Helps maintain bone at the site | Bone under the false tooth continues to shrink |
| Cleaning | Brush and floss like a natural tooth | Needs a floss threader or special brush under the false tooth |
| Risk of decay | The implant cannot decay; gums still need care | Supporting teeth can develop decay at the crown edges |
| If a problem occurs | Usually affects only that implant or crown | Problems with one supporting tooth can affect the whole bridge |
| Upfront cost | Usually higher | Usually lower |
| Candidates | Adequate bone (or grafting), healthy gums, reasonable general health | Healthy supporting teeth with strong roots |
Which Lasts Longer, An Implant Or A Bridge?
Both options perform well. Systematic reviews that pooled long-term studies found that the large majority of conventional tooth-supported bridges and implant-supported restorations were still in function after 10 years. The ways they fail tend to differ:
"The 10-year probability of survival for fixed partial dentures was 89.1%." — Tan et al., Clinical Oral Implants Research, 2004
- Bridges most often run into problems because of decay or root canal problems in the supporting teeth, or loss of retention.
- Implants are most affected by gum inflammation around the implant (peri-implant disease), smoking, and mechanical issues such as a loose screw or chipped crown, which are usually repairable.
With good home care and regular dental visits, both can last many years. Crowns on either option eventually wear and may need to be replaced.
Effect On Your Jawbone
When a tooth is lost, the bone that held its root begins to resorb. A bridge replaces the visible tooth but places no load on the bone under the false tooth, so that area can continue to shrink over time, sometimes leaving a visible gap or dip under the bridge. An implant transmits chewing forces into the bone, which helps maintain bone volume at the site.
If you have been missing a tooth for some time, you may have already lost bone. A bone graft, or for upper back teeth a sinus lift, can rebuild the site for an implant. 3D CBCT imaging shows exactly how much bone is available.
When A Bridge May Be The Better Choice
- The teeth on either side already have large fillings or crowns that need replacing anyway
- You are not a candidate for surgery because of medical conditions or medications
- There is not enough bone and you prefer to avoid grafting
- You need the tooth replaced quickly
- Cost is the deciding factor and your insurance covers bridges more generously
When An Implant May Be The Better Choice
- The neighbouring teeth are healthy and unrestored, and you want to keep them that way
- You want the replacement to function independently, like a natural tooth
- You want to help preserve bone at the site of the missing tooth
- You prefer to floss normally rather than threading under a bridge
- The tooth is being removed now and immediate implant placement is possible
Cost Of An Implant Vs A Bridge In Ontario
Fees vary by office and case, but some general patterns apply:
| Cost factor | Implant | Bridge |
|---|---|---|
| Number of units | One implant, abutment, and crown | Usually three crowns (two supports and one false tooth) |
| Providers | Oral surgeon for the implant; dentist for the crown | Usually your dentist only |
| Extra procedures | Possible extraction, bone graft, sinus lift, 3D imaging, sedation | Possible root canal treatment or build-ups on supporting teeth |
| Future costs | Occasional crown or component replacement | Bridge replacement, and treatment of supporting teeth if they develop problems |
A single implant with crown in Ontario often costs more upfront than a three-unit bridge, but the difference narrows when grafting is not needed and widens when it is. For a detailed breakdown, read dental implant cost in Ontario.
Insurance
Many private dental plans cover bridges under major services. Coverage for implants varies more: some plans cover them, some cover part of the treatment, and some pay an "alternate benefit" equal to the amount they would pay for a bridge. Request a predetermination with procedure codes for both options before deciding. Our office can file claims electronically; see our insurance page.
What About Replacing Several Missing Teeth?
When two or more teeth in a row are missing, options expand:
- A longer tooth-supported bridge, if the end teeth are strong enough
- Two implants supporting a three- or four-unit implant bridge
- A removable partial denture
- For a full arch, implant-supported dentures or a fixed full-arch bridge; see implant-supported dentures vs regular dentures
Real-World Scenarios
Every patient is different, but these common situations show how the decision often plays out:
- A healthy young adult missing one front or premolar tooth. The neighbouring teeth are unfilled and healthy. An implant is often preferred because it avoids reshaping two healthy teeth. If growth is not yet complete, a temporary option may be used until an implant can be placed.
- A molar lost years ago, with heavily filled teeth on both sides. Both neighbouring teeth need crowns anyway. A bridge can crown them and replace the missing tooth in one treatment, although an implant is still possible if bone allows.
- A cracked tooth that must come out. If the socket is healthy, an implant may be placed at the same visit as the extraction, sometimes with a temporary tooth the same day. Otherwise, socket preservation keeps the site ready for an implant later.
- An upper back tooth with limited bone below the sinus. An implant may need a sinus lift first, extending the timeline. A bridge may be considered if the patient prefers to avoid grafting.
- A patient with medical conditions that make surgery less suitable. A bridge or removable option may be the safer choice.
Maintenance: Caring For An Implant Or Bridge
Both options need daily care to last:
| Care step | Implant | Bridge |
|---|---|---|
| Brushing | Twice daily around the crown and gumline | Twice daily, including the crowns on supporting teeth |
| Cleaning between teeth | Regular floss, interdental brushes, or a water flosser | Floss threader, super floss, or interdental brushes under the false tooth |
| Professional cleanings | Regular dental hygiene visits with checks of the gum around the implant | Regular hygiene visits with checks for decay at the crown edges |
| Night guard | Recommended if you grind your teeth | Recommended if you grind your teeth |
| Smoking | Increases the risk of implant complications | Increases the risk of gum disease around supporting teeth |
Questions To Ask At Your Consultation
- What is the condition of the teeth next to the gap?
- Do I have enough bone for an implant, or would I need grafting?
- How long would each option take from start to finish?
- What are the expected costs for each option, including the dentist's portion?
- What maintenance will each option need over the long term?
- Can the implant be placed at the same time as my extraction?
Implant Consultations In Waterloo Region
Our oral surgery office at 96 Union Street East, near Uptown Waterloo, works with dentists across Waterloo, Kitchener, Cambridge, Guelph, and Stratford to plan tooth replacement. We place the implant and any bone grafts, and your own dentist designs and fits the final crown or bridge, so you keep continuity with your regular dental care. Dr. Garry Toor has an extensive background in immediate implants, and 3D imaging is available in the office for precise planning.
If you are weighing an implant against a bridge, ask your dentist to send a referral or call +1 (519)-743-7811 for an implant consultation. Read more in dental implants in Waterloo.
Sources
- Pjetursson BE, Tan K, Lang NP, et al. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. I. Implant-supported FPDs. Clinical Oral Implants Research, 2004.
- Tan K, Pjetursson BE, Lang NP, Chan ES. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. III. Conventional FPDs. Clinical Oral Implants Research, 2004.
- Dental implants, Dr. Kevin J. McCann Oral & Maxillofacial Surgery.
FAQ
Is A Dental Implant Better Than A Bridge?
Neither is better for everyone. An implant is often preferred when the neighbouring teeth are healthy, because it avoids reshaping them and helps preserve bone. A bridge may be better when the neighbouring teeth already need crowns, surgery is not suitable, or a faster result is needed.
Which Is Cheaper, A Bridge Or An Implant?
A traditional bridge usually costs less upfront. An implant can cost more initially, particularly if bone grafting is needed, but may avoid future treatment on the supporting teeth. Compare written estimates for both options.
How Long Does A Dental Bridge Last Compared With An Implant?
Both have high survival rates, with most still in function after 10 years in long-term studies. Bridges most often fail because of problems with the supporting teeth, while implants are most affected by gum health and smoking.
Does A Bridge Cause Bone Loss?
A bridge does not cause bone loss, but it does not prevent it either. The bone under the false tooth can continue to shrink after the tooth is lost. An implant helps maintain bone at the site.
Can A Bridge Be Replaced With An Implant Later?
Often, yes. If a bridge fails or needs replacement, an implant may be possible, sometimes with bone grafting. The supporting teeth would then be restored individually.
How Long Does It Take To Get An Implant Compared With A Bridge?
A bridge is usually completed in a few weeks. An implant commonly takes a few months from placement to final crown, and longer if grafting is needed; same-day implants are possible in selected cases.
This article is general patient education and does not replace an examination, diagnosis, or the written instructions from your own surgeon or dentist. If you have heavy bleeding, trouble breathing or swallowing, or rapidly spreading swelling, call the office or go to the nearest emergency department.