Comparing Options for Replacing Missing Teeth
There are three common options for replacing missing teeth: dental implants, dental bridges, and dentures. Each approach can restore function and appearance, but they differ in how they are supported, how they affect surrounding teeth, and what kind of maintenance they require.
Understanding the differences can help patients prepare for more productive conversations with their dental team about which option may be most appropriate for their situation. For a closer look at implant varieties, see our guide to the types of dental implants available.
How Each Option Is Supported
Dental implants are anchored directly in the jawbone. A small post acts as an artificial tooth root, providing independent support for the restoration without relying on neighbouring teeth.
Dental bridges are supported by adjacent natural teeth. These teeth are usually reshaped to accommodate crowns that hold the replacement tooth or teeth in place between them.
Dentures rest on the gums and underlying bone. They may be full dentures, replacing all teeth in an arch, or partial dentures, which replace several teeth and clip onto remaining natural teeth for retention.
Upfront Cost vs Long-Term Value
Dental implants typically have a higher initial cost compared to bridges and dentures. However, the long-term economics of each option can differ significantly.
Bridges may require additional work if the supporting teeth develop problems over time. Dentures generally have the lowest entry cost but often need relines, adjustments, and eventual replacement as the jaw changes shape.
A consultation with a dental professional can help match the costs of each option to your specific clinical reality and long-term goals. The Ontario Dental Association also provides guidance on understanding dental costs in Ontario. For detailed pricing information, see our page on dental implant costs in Ontario.
Impact on Neighbouring Teeth
One of the key differences between these options is how they interact with remaining natural teeth.
- Implants stand alone and do not require alteration of adjacent healthy teeth.
- Bridges require the reshaping of healthy teeth on either side of the gap to serve as anchors for the prosthetic.
- Dentures can place forces on remaining natural teeth, particularly partial dentures that use clasps for retention.
Comfort, Stability, and Function
Implants are typically the most stable of the three because they are anchored directly in the jawbone. They function similarly to natural teeth for chewing and speaking.
Bridges are fixed in place and offer good stability, though their performance depends on the health and strength of the supporting teeth.
Dentures may shift during eating or speaking, particularly as the shape of the jaw changes over time. Implant-supported dentures offer a significant improvement in stability by anchoring the denture to implants placed in the jaw.
Bone Changes Over Time
When a tooth is lost, the jawbone in that area can begin to lose volume over time due to lack of stimulation.
Implants may help reduce bone loss because the implant fixture provides stimulation to the jawbone, similar to a natural tooth root.
Bridges do not stimulate the bone in the gap area beneath the replacement tooth, so some bone changes may occur in that region over time.
Dentures rest on the gum surface and do not provide direct bone stimulation. Over time, jaw changes can affect the fit of the denture, requiring adjustments or relines.
Maintenance Expectations
All tooth replacement options require ongoing maintenance to remain functional and healthy.
- Implants: Regular oral hygiene, professional cleanings, and periodic monitoring of the implant and restoration.
- Bridges: Careful cleaning under and around the bridge, including the use of floss threaders or interdental brushes.
- Dentures: Daily cleaning, overnight soaking, and periodic professional adjustments to maintain fit as the jaw changes.
Which Option Is Best?
The best option depends on the individual. There is no universally correct answer, and the right choice varies based on oral health, budget, lifestyle, and personal priorities.
- If preserving healthy adjacent teeth is a priority, implants may be the preferred option.
- If a quicker, less invasive restoration is needed, a bridge may be appropriate.
- If budget is the primary concern, dentures offer a more accessible entry point.
Consider your daily life, comfort expectations, cleaning habits, and how important long-term stability is to you. For a deeper look at the value question, see are dental implants worth it.
Frequently Asked Questions
What lasts longer: implants, bridges, or dentures?
In systematic reviews with at least ten years of follow-up, dental implants show survival of approximately 94 to 96 percent. Comparative reviews also report high long-term survival for conventional tooth-supported bridges, though complications become more frequent over time for both options. Removable dentures have no fixed lifespan and typically need relining or replacement as the jaw changes shape.
Which is cheaper: implants or bridges?
Bridges generally have a lower upfront cost than implants. However, when considering long-term value including durability and impact on neighbouring teeth, implants may offer better value over time.
Can you switch from dentures to implants?
Yes, many patients transition from traditional dentures to implant-supported dentures or full arch implants. A consultation can determine whether your bone and oral health support this transition.
References
- Moraschini V, Poubel LA, Ferreira VF, Barboza ES. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377-388.
- Howe MS, Keys W, Richards D. Long-term (10-year) dental implant survival: a systematic review and sensitivity meta-analysis. J Dent. 2019;84:9-21.
- Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res. 2007;18(Suppl 3):97-113.
- Feine JS, Carlsson GE, Awad MA, et al. The McGill consensus statement on overdentures: mandibular two-implant overdentures as first choice standard of care for edentulous patients. Int J Oral Maxillofac Implants. 2002;17(4):601-602.