Top 5 Reasons to Select a Dental Implant or a Dental Bridge
- An implant feels the most like a natural tooth.
- An implant has the most convenience, “set it and forget it”.
- An implant lasts the longest.
- A bridge takes the least time to make, is most convenient to make and acts like a retainer.
- A bridge may have a lower fee and doesn’t need additional surgery to place like an implant.
What Can You Do for Missing Teeth?
A missing tooth feels tragic. Something in your mouth that was always there is suddenly missing, and you can feel the valuable job that it once did is no longer done. Food is harder to chew, speech is more difficult, other remaining teeth must work harder, and they will start to move in different directions, changing your bite and making them more vulnerable to fracture cavities or losing them as well. Your tongue temporarily expands to fill the space and help guide food away from the hole.
Tooth Replacement Options for Missing Teeth
Rather than suffering indefinitely, replacing missing teeth is a good idea to preserve what you have in terms of function and feeling. There are three types of tooth replacement commonly used.
One type is a very old technique and uses plastic or metal in a removable appliance called a full or partial denture.
Another type is newer and uses good natural teeth to support a replacement tooth now called a pontic. This type of replacement harnesses the power of your existing teeth to maintain a replacement and in modern times is now called a bridge or a fixed bridge.
A fixed bridge is made by reshaping the attached teeth (called abutments) into a shape that will allow the new porcelain material to be added onto the natural tooth. This new porcelain resembles the preexisting tooth in shape, color and function. At the same appointment, a temporary bridge is made and temporarily cemented so the missing tooth is immediately replaced in a temporary way. When the new final bridge is ready, the temporary bridge is removed, and the new final bridge is cemented with long term cement onto the ‘abutment’ teeth.
The third and newest type of tooth replacement is a dental implant. This tooth replacement type stands by itself and doesn’t rely on your existing teeth to support it. When complete, an implant and the crown that fits into the implant resemble the tooth that it replaces in almost every aspect. It is easier to clean than a bridge, and it also usually lasts longer.
An implant can be placed into the mouth at the same time as the problem tooth is removed, and then left to heal. This eliminates a second surgery after the removal to place the implant. This can work very well under good circumstances. This is called an ‘immediate’ implant.
If the area heals three to six months before an implant is placed, this is called delayed placement. In both cases, when the bone has matured around the implant, a digital scan of the implant is sent to the laboratory, and a connecting device called an implant abutment is made, along with a crown to fit over it. A custom abutment made by the laboratory will make the home care of cleaning the implant easier and is much sturdier than a ‘stock’ abutment which is not custom made for the tooth. The implant abutment is inserted into the implant and tightened to factory specifications with a special implant screw. The crown is then cemented onto the abutment. In some cases, the abutment and the crown are attached together at the laboratory, and they are inserted into the implant as one piece. The access opening is then closed over with composite filling materials for the final touch.
How to Know What's Best for You
So how to choose the best approach? Well the answer relies on you as much as the dentist.
The fastest treatment and lowest fee are in the removable denture.
This can be a temporary fix, as most people dislike the extra plastic, the need to remove it after meals to clean, and the need to remove it at bedtime. In some cases, it causes gagging, and it sometimes stays in a drawer unused, or it can be easily lost or misplaced. It also is subject to breakage since the plastic fatigues after a few years in the mouth. Most removable dentures are made with special “custom” impressions and ‘custom’ trays, and are made to specially fit into the mouth after several fitting visits when both color and tooth shape are chosen.
The middle ground is occupied by the fixed bridge. Since it is attached to the neighboring teeth permanently, it can’t be lost or misplaced. It lasts perhaps three to five times longer than a removable denture, doesn’t have extra plastic to cause gagging, is not removed after meals, and looks much more like your natural teeth than the removable denture. It is also quickly made as a replacement, doesn’t require additional surgery like an implant, and it acts as a retainer to keep neighboring teeth from shifting.
On the other hand, special cleaning methods are needed to clean under a bridge, since the replacement tooth or pontic is suspended over the gum, and not attached to the gum. There is a small space that may collect food and must be cleaned with extra dental items. This space may grow over time, since the bone where the tooth was removed will eventually shrink in some cases.
The preference of most people is the implant for the following reasons; it is most like the tooth it replaces, it doesn’t need additional items to clean (unless it is an implant supported bridge, so it resembles the tooth supported bridge in this regard), and it stands by itself so it does not require permanently modifying the neighboring teeth to support the “pontic”.
The single implant has no space underneath so doesn’t collect food like a tooth supported bridge does. In addition, the implant helps to preserve bone, so that a hollow space under the pontic doesn’t develop as in the case of a fixed tooth supported bridge.
On the downside, it can have the same or a higher fee than a bridge, and it takes longer to make, considering the time it takes for bone to heal after the implant is placed. In most cases this is a period of three to six months healing time before a crown can be placed. During the waiting period, a temporary appliance of different types can be used to provide esthetics and to keep the neighboring teeth from shifting into different positions.
There are no wrong choices, but most people have a strong preference in choosing the best for themselves. Among the three typical choices to be made are; the fee, the time it takes to finish, and the outcome to live with.
The choice is usually clear to make after reviewing the pros and cons of each method in a consultation with your dentist. Unfortunately, there is no choice that includes the lowest fee, the shortest time and the most comfortable outcome, so picking the most important characteristics for yourself is usually how most people decide on the best choice between a dental implant and a bridge.
Robert Korwin DMD, MICOI, MAGD is an award-winning dental expert who has served the Middletown-Red Bank-Monmouth County area for over 35 years. His practice offers a full range of general, reconstructive and cosmetic dental procedures with an emphasis on patient comfort. Advanced Dentistry with a Gentle Touch, includes sedation dentistry, and the practice works with individuals to maximize their dental health, ensure their comfort and minimize financial concerns. For more information, please call (732) 219-8900 or book an appointment with Dr. Robert Korwin.