Bridges vs. Implants - That is the question

By: Jean Johnson

“Back in the late 1980s and early 1990s when I started losing teeth and my local dentist in a small university town began installing bridges in my mouth, he mentioned implants in passing. I didn’t pay much attention because he said that I probably didn’t have enough bone and also that the procedures were a last, very expensive resort,” said Kim Anderson. “I really did get the impression that implants were things only the super rich in Hollywood afforded. Even after I moved to Portland and I had to get a partial plate, my neighborhood dentist made no mention of implants. It wasn’t until the partial failed, and I tried a new Asian woman fresh out of school that she said it was either implants or dentures. Now that I realize that if I’d only started years earlier with implant surgery, I could have saved more of my own teeth. It’s true the implants are terribly expensive, but it’s worth it to me. And they easily took care of the areas where I lacked sufficient bone with grafts.”

Humans are human no matter what profession they enter. And when a dentist is in a busy practice it’s only natural to keep an eye to the bottom line as well as let a little of their journal reading slip when they are pressed for time. While implants can take business away from neighborhood practitioners, bridges are procedures well within the ability of most restorative dentists. More, “some dentists don’t keep up with changes in the field once they finish school,” said Nader M. Rassouli, DDS, MS, Portland prosthodonist in private practice and owner of Sylvan Implant and Reconstruction Dentistry.

The first dental implants were placed in 1967. By the 1980s and 1990s, long-term studies on the first cases gave sufficient credence to the technology for use to spread. Master’s degree programs devoted to implanting multiplied and prosthodontists with the skill to handle case loads began setting up practices around the country and world.

A major advantage of an implant over a bridge is that the teeth adjacent to the missing tooth are left undisturbed. When a 3-unit bridge is installed, for example, teeth on either side of the missing tooth - the abutment teeth - must be prepared, or ground down, to receive the bridge. The abutment teeth are not only compromised by the down sizing, they also have to bear the load of the missing tooth. On the cutting edge side of the coin, implants affect only the tooth in question and treat the problem directly.

Graziano Giglio, DDS, PhD, associate professor of clinical dentistry at Columbia University School of Dental and Oral Surgery, and private practitioner specializing in periodontics and implants, underscores the benefits of implants over bridges. “What’s good about implants is that you’re not touching the adjacent teeth. Adjacent teeth remain virgin,” Giglio said. “You’re not drilling into them to put some type of anchor on there to anchor the pontic which is the fake tooth. The adjacent teeth remain untouched. That’s an advantage with placing an implant.”

The short answer on bridges vs. implants then seems to be two thumbs up for implants. Even if you’re not facing dentures the way Kim Anderson was, implants are a smart way to restore a missing tooth without harming its neighbors. It might cost more, but once paid, patients can look forward to spending less time in the dental chair and more time smiling.

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Questions to Ask Your Family Dentist About Tooth Replacement Options:

1. What is the anticipated life span of the suggested bridge?

2. What is the condition of the teeth on which the bridge will anchor and how much will the new load stress them?

3. Does she or he have a list of respected implant specialists in the community or region?

4. Over a span of 10 to 30 years, how do bridges and implants compare in terms of longevity?

5. Does your professional have any literature on bridges and implants that you can take home to study?