‘Is a bridge better than an implant ?’ was the gist of a question that a new patient asked me yesterday.
She came to me because she needed a “lot of work.” Her research into a dentist involved, at least partially, reading this column.
She understood from previous writings that our office had many choices to help patients restore their mouth to function and cosmetics. Based on this understanding, she came to see me.
A Myriad of Issues Affecting Her Smile
Complaints ranged from missing teeth to loose teeth. Spaces on the upper right impacted the smile. As we come out of COVID and mask-wearing, smiling became important again. She had done her research and did not want to lose any more teeth. Her goals were clear. Save my teeth and make me proud and happy to smile.
We Start With an Assessment
I proceeded to assess the number and health of her remaining teeth.
I did a visual exam as well as a radiographic, an x-ray, exam.
Missing Teeth, Considerable Bone Loss & a Destructive Pattern
Some of her teeth had a considerable amount of bone loss. When a tooth loses the supporting bone due to gum disease, the result is a wobbly tooth. As the tooth moves when the patient chews, the movement causes even more bone loss. Eventually, this destructive pattern results in an infection requiring tooth removal.
When I started in practice, the trend to treat loose teeth involved two aspects. Firstly, we addressed the source of the disease. Gum, or the technical term, periodontal disease, is a result of bacterial attacks.
Bacteria live in the soft and hard debris that accumulates on our teeth daily. Meticulous home care coupled with frequent cleanings will manage the problem and slow down or eliminate the cause of bone loss.
There is still a problem present even with the bacterial control with loose teeth. Tooth movement is destructive, as I mentioned before. How can I stop a loose tooth from moving?
Splinting Teeth Together to Control Tooth Movement
We employ a method to control tooth movement by connecting one tooth to another tooth or teeth. We call this approach splinting.
There are a variety of ways in which I can splint two teeth together.
1. I can bond teeth with a tooth-colored material.
2. A wire can be embedded in the bonding for more strength.
3. I could even use crowns to connect two teeth for the ultimate in structural integrity and low maintenance.
Perhaps an Implant is A Solution?
At this point in our discussion, the subject arose as to what is better. . . an implant or a bridge?
Both solutions will solve our missing tooth problem. The implant has nothing to do with the teeth on either side of the space. This is often a good thing. However, implants take more time from start to finish.
A bridge involves the side teeth but is a more expedient procedure. These choices usually are weighed against each other, and a decision is made.
A Bridge Will Give Added Life to Her Teeth
With our patient, there is another thing to consider. The mobility and looseness of her teeth are a factor. A bridge will solve this problem. There is nothing that an implant can do to help the teeth on either side of the implant. In her case, this may be our determining factor and motivate us to move forward with a bridge. In other words, a bridge will give added life to her teeth, whereas an implant will not.
Implant VS Bridge Is Never Black & White
Our original question of which is better for tooth replacement, an implant or a bridge, is not black and white. Every person and their oral condition requires a detailed exam and a weighing of all the factors. If you feel you need this type of approach, please call 440.951.7856, ask for Nikki or Cat and let them set up a time to talk with me. I look forward to meeting you.
Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.