Dental Bridge vs Implant: Which Is Better for One Missing Tooth?

For one missing tooth, a bridge and a single implant last about equally well in the research. A large systematic review found that about 89% of both were still in place after 10 years: 89.2% of conventional bridges and 89.4% of implant crowns (Clinical Oral Implants Research). The bigger differences are elsewhere. A bridge needs the teeth next to the gap to be filed down; an implant needs surgery and 3 to 9 months of healing before the final tooth goes on (Cleveland Clinic).

What each option is

Dental bridge

The American Dental Association describes a bridge, also called a fixed partial denture, as artificial teeth that "bridge" the gap and are attached to the surrounding teeth for support. A fixed bridge can only be removed by a dentist (ADA MouthHealthy). Cleveland Clinic lists four main types (Cleveland Clinic):

• Traditional bridge: crowns on the teeth on both sides of the gap hold a false tooth in between. This is the most common type.
• Cantilever bridge: a crown on one side only. It is not as strong as a traditional bridge.
• Maryland (resin-bonded) bridge: metal wings glued to the backs of neighboring teeth. Mostly used for front teeth, because it can't handle the chewing forces on back teeth.
• Implant-supported bridge: rests on implants instead of natural teeth, usually for three or more missing teeth in a row.

Single dental implant

An implant is a post placed in the jawbone during surgery. Over the next months the bone fuses to it. Then an abutment and a crown are attached on top. There must be enough jawbone; if not, a bone graft may be needed first (Cleveland Clinic). Our article on bone grafts for implants explains that step.

Dental bridge vs implant: side-by-side

Sources: Cleveland Clinic (bridges), Cleveland Clinic (implants), Pjetursson et al., FDA.

How long do bridges and implants last?

This is where popular advice and the research do not quite match. Cleveland Clinic says a bridge lasts 5 to 15 years on average and that "in general, dental implants last much longer than bridges" (Cleveland Clinic). The pooled data are closer than that statement suggests:

• A 2007 review of studies with at least 5 years of follow-up estimated 5-year survival of 93.8% for conventional bridges and 94.5% for implant crowns, and 10-year survival of 89.2% and 89.4% (Pjetursson et al.).
• A 2012 review of single implant crowns found the implants themselves survived better than the crowns on them: 95.2% of implants vs 89.4% of crowns at 10 years (Jung et al.). In other words, an implant crown may need replacing while the implant stays.
• Cantilever bridges did worse in the 2007 review: 80.3% at 10 years (Pjetursson et al.).

The reviews are older and pool many study designs, so treat the numbers as broad ranges. Your own result depends heavily on hygiene, smoking and the health of the teeth involved. For more detail on implants, see how long dental implants last.

Complications: different problems, not fewer

For bridges, the 2007 review found the most frequent problems were biological: tooth decay and loss of nerve vitality in the supporting teeth. Implant work had significantly more technical problems, mainly chipping of the porcelain, loose abutments or screws, and crowns coming loose (Pjetursson et al.). The 2012 implant review found screw loosening in 8.8% of single implant crowns within 5 years, and soft-tissue problems in 7.1% (Jung et al.).

Cleveland Clinic adds that if decay or injury damages the support teeth, the bridge is weakened, and weak support teeth can fracture (Cleveland Clinic).

Which is better for you?

A bridge often makes more sense when

• The teeth next to the gap already have large fillings or crowns, so preparing them costs little healthy tooth.
• You can't have surgery, or don't want to wait months.
• There isn't enough bone and you'd rather avoid a graft.

An implant often makes more sense when

• The neighboring teeth are healthy and unrestored. Cleveland Clinic notes that implants don't require enamel removal the way bridges do (Cleveland Clinic).
• You want to keep bone in the gap. The FDA lists helping to keep the jawbone from shrinking as a benefit of implants (FDA).
• You are a non-smoker in good general health. The FDA notes smoking may slow healing and lower long-term implant success.

For a front tooth, the choice also depends on gum and bone shape. Ask your dentist to show you what each option would look like.

One more point from the 2007 review: its authors recommend a conventional bridge with a support tooth at each end, or an implant, as the first-choice plans. They rank a cantilever bridge, or a bridge supported by a mix of implants and natural teeth, as second options for special cases (Pjetursson et al.). If a quote proposes one of those, ask why.

Daily care and recovery

A bridge is quick to recover from. Cleveland Clinic says teeth and gums usually heal in one to two weeks, though the bridge can take a little longer to feel natural. Cleaning takes more effort than with a single crown: you need to clean under the false tooth every day with floss threaders or small interdental brushes, because plaque left there can cause gum inflammation or decay in the support teeth (Cleveland Clinic).

An implant crown is cleaned much like a natural tooth, with brushing and flossing. The FDA stresses that regular cleaning around the implant and regular dental visits are "very important for long-term success" (FDA). Recovery is longer, because of the surgery and the months of healing before the crown.

With either option, call your dentist if the tooth feels loose, you see a crack, chewing hurts, or your gums bleed or feel sore (Cleveland Clinic).

Cost

For U.S. price ranges, see our dental implant cost guide.

Getting a bridge or implant abroad

The timeline matters more than usual when the dentist is a flight away:

• Bridge: two visits, with about 2 to 4 weeks between them while the lab makes the bridge (Cleveland Clinic). Some dentists mill bridges in-office the same day. Either way, it can fit into one stay or two short trips.
• Implant: surgery on trip one, then 3 to 9 months of healing (Cleveland Clinic), then a second trip for the crown. Add more time if you need a graft.

Either way, ask for your X-rays and a written treatment plan. For implants, ask which brand and model is used; the FDA advises keeping it for your records (FDA). A U.S. dentist will need it for repairs. Our dentist question checklist and the dental implants in Mexico guide can help you compare clinics.