One of the most important questions that we get from our patients is how to replace a missing tooth or missing teeth with either dental bridges, partials, or dental implants. A lot of our patients come to us with missing teeth, whether it's one or ten. There are three main options for replacing missing teeth.
- Dental Implants
- Dental Bridges
- Dentures (or Partial Dentures)
What is a dental bridge?
A dental bridge is used to replace teeth that are missing between other existing teeth. With a dental bridge, there has to be an existing tooth on either side of the space. It can't be a space that has teeth on one side but no teeth on the other side.
With dental bridges, we put caps or crowns on the two teeth on either side of the space, and those caps or crowns hold false teeth in between them. It creates an entire restoration that's one piece, replacing anywhere between three and up to six, seven, eight teeth. There has to be an anchor or support on either side of the space. It will be at least three teeth long, but it can be longer if there are other false teeth in the middle of the support teeth.
Learn More About Dental Bridges
What is a dental implant?
A dental implant is used when there's one or more teeth missing. A dental implant is actually screwed into your bone and will essentially take the place of the root of the tooth that was previously missing. Eventually, a crown or a false tooth will be attached to this dental implant once it's screwed into your jawbone.
Learn More About Dental Implants
What is a partial denture?
A partial denture is a dental apparatus that can be taken in and out of your mouth. People often think of dentures as a complete set of teeth, and they definitely can be. Those are called full dentures. However, dentures can replace not all of your teeth. You can have some of your original teeth, and the partial denture can replace the teeth that are missing. These restorations are called partial dentures.
To recap, partial dentures will replace some of the teeth, and they must be supported by your existing teeth. There are also full dentures that replace all the teeth. These dentures can be supported by just your tissue, basically the gums, or they can be supported by implants.
What are the differences between bridges and implants?
There are a couple of differences between bridges and implants.
- Bridges require work on the teeth on either side of the space where the missing tooth used to be. The bridge will be supported on those teeth, which act as anchors. Those anchor teeth will support a restoration that includes crowns or caps on those anchor teeth as well as false teeth connected to them. The false teeth are what replace the missing teeth.
- Implants are standalone restorations, meaning they don't need any support from the teeth on either side of the space. Implants are placed into your bone and are separate standalone restorations. They may touch the teeth on either side, but they're not connected.
- When you have a dental bridge, it's all one piece, which means you're no longer able to floss between those teeth because it's all one piece. You have to either floss under it using a floss threader or use a water pick to flush any food debris or plaque that gets caught above or below that bridge restoration.
- Implants, once placed in your mouth, function as normal regular teeth.
Both bridges and implants can look very natural, depending on the type of material used. We try to use porcelain because it looks the most lifelike. It also depends on the location in your mouth as well as the shape of your gums and bones.
Both bridges and implants can look incredibly lifelike if done properly and the right materials and labs are used to achieve that result.
Is a dental bridge or a dental implant better?
People often ask, "Is a bridge better here? Is an implant better here?" It depends on the situation in your mouth and your individual oral health. It also depends on what's important to you as the patient.
One of the biggest differences between bridges and implants is the time it takes for the restorations to be completed. Bridges tend to be quicker. If you came in today for an appointment, we could have the final restoration in your mouth within two weeks, which is great, especially if you're going to an event, traveling, or need the restoration done quickly. Bridges are convenient. Implants take longer because there are more moving parts to consider.
Often, when we do implants, they're replacing a tooth that's sick or broken, which means there may be infection or damage present. That infection or damage has to be repaired and healed before the implant can be placed. We want to put implants into healthy bone to give them the best chance of succeeding and solidifying in your mouth.
Once the implants are placed, we usually can't put a tooth or teeth onto the implant until it's solidified. Implants can take anywhere from 6 to 9 months to be completed. That's another thing to consider.
What are the pros and cons of dental implants?
One of the biggest pros is that when the implant is finished and placed in your mouth, it looks and feels like a normal tooth. It has the shape of the tooth it replaced. It's not connected to the teeth on either side, so you can brush and floss it like normal. It's relatively long-lasting as long as you take care of it. We've had implants in our patients' mouths for 15, 20 years. That's a great service that dental implants provide.
One major con is that it takes longer to complete. The whole process can take between four to nine months, depending on the condition of your bone and if there's infection that needs to be cleaned out first. After the implant is placed, we usually wait a couple of months for it to solidify and become structurally sound in your bone. We can't attach a tooth right away. That needs to be considered.
Another con is that it requires more scans. We have to do a cone beam scan to ensure there's enough bone support for the implant. For bridges, we don't need to do that.
What are the pros and cons of dental bridges?
One of the biggest pros of dental bridges is that they can be done relatively quickly. Like dental implants, they look great, they're strong, and they're extremely lifelike in their appearance. They also feel really good.
A con of a dental bridge is that they're harder to clean. Since it's all one piece, you can't floss between the false tooth and the anchor teeth. You have to floss above or below the bridge using a floss threader or a water pick. It's a con because it takes more work to keep it clean and keep your mouth healthy, but it's doable.
Another potential con is that the teeth supporting the bridge can develop cavities at some point. Like most restorations, nothing lasts forever. The bridge may need to be replaced eventually.
Dental implants are newer technology, so we don't have as long a history of data on how long they'll last, but we know they can last a long time.
For bridges, we have more data showing they usually last between 10 to 15 years. Implants can last that long, but because they're newer, we don't have as much data on their longevity.
What are the pros and cons of partial dentures?
The biggest pro of partial dentures is that they are inexpensive. They cost less than bridge and implant options.
A major con is that they don't look as good. They also don't feel as good because partial dentures are removable, meaning they won't stay in your mouth permanently. You'll take them out after meals and when going to bed. You need to clean them and store them in a denture cleaner or storage box. When you wake up, you'll put them back in your mouth. They don't feel as solid or secure when eating compared to bridges and implants. They can trap food, plaque, and bacteria underneath.
If you have implant-supported dentures, those can be screwed into the implants relatively permanently and are only removed once or twice a year for cleaning, which alleviates some of the cons of a denture.
What is the best option for replacing one missing tooth?
For replacing one missing tooth, the best option is a dental implant because there's no need to involve any other teeth. A bridge can be placed if one tooth is missing, as long as there are anchor teeth on either side of the space. However, if those teeth are healthy, you ideally don't want to touch them, which would be required if doing a bridge.
An implant is preferable because you don't have to alter the teeth on either side. You can just place the implant, attach a crown, and have a replacement tooth.
What is the process for getting a dental bridge?
For dental bridges, there's an initial appointment that takes between 2 to 3 hours, depending on the location and length of the bridge. There's an appointment 2 weeks later to cement the bridge. You'll have a temporary bridge in place while the permanent bridge is being made. At the cementation appointment, the temporary bridge will be removed, and the permanent bridge will be tried on, adjusted if necessary, and then cemented into place.
What is the process for getting a dental implant?
For implants, there's the initial placement appointment. This assumes there's no damaged or infected tooth that needs to be removed or cleaned up first. Assuming the tooth is missing or the space is present and the implant is ready to be placed, the implant will be placed.
The initial appointment takes about two hours per implant. There are follow-up appointments a week later, two weeks later, to check the healing. Then, nothing is done for about 3 to 4 months. At the 3 to 4 month mark, we check to ensure the implant is solid and integrated into the jawbone.
At that point, we start constructing and designing the tooth via a crown for that space. There's another appointment, about an hour, to take scans or impressions. Then the crown is made, and in two weeks, the permanent crown and tooth will be placed where the implant is, completing the process.
What maintenance is required for bridges, implants, and dentures?
All three options, bridges, implants, and dentures, require maintenance to keep them healthy. Dentures probably require the most maintenance because they need to be removed and cleaned. The teeth around them also need cleaning, which takes more work. Implants require the least maintenance because they are brushed and flossed like a regular tooth. Bridges are in the middle because it's hard to clean between them, requiring either cleaning above or below using a floss threader or a water pick. It can be done, but it takes more effort.
What are the costs of bridges, implants, and dentures?
In terms of cost, partials and dentures are the least expensive, unless you choose an implant-supported denture, which raises the cost. Bridges and implants, depending on how many you do, will be similar in price. A three-unit bridge, meaning it replaces one missing tooth with two anchor teeth, is comparable in price to a single tooth implant.
What should I consider when choosing a tooth replacement option?
It's important to look at what's important to you as the patient when considering tooth replacement options. At Crown Dentistry, if a patient needs to replace a missing tooth, we have a conversation with them. We discuss what's important to them, their budget, the pros and cons of each option, and determine which is the best fit. Some pros of one option might be important to you, while others might not matter. It's crucial to have a conversation, explore the available options, and decide which one aligns with your goals for your mouth.
If you're interested in replacing a tooth and have a missing tooth, please schedule an appointment for a consultation. The time to address this and figure out what's going on in your mouth is now. You don't want to leave a missing tooth longer than necessary because when teeth are missing, things in your mouth start to move.
Our mouths are made to have all teeth present to optimize eating and chewing, and help keep teeth in the right spot. Missing teeth compromise chewing and eating ability, leading to decreased health and appetite. It can also cause teeth to shift or move to unwanted places, potentially making straight teeth crooked or changing your bite, causing problems for your TMJ and other teeth. If you have missing teeth, the time to explore replacement options is now. If you're missing one or more teeth and want to explore other options, we're here to help.
If you’re ready to schedule an exam or would like to learn more about our services, we’d love to hear from you. Call us at (916) 848-2145 or email [email protected]. We look forward to caring for your smile.