What a difference forty years can make: Dental bridges once occupied the top spot for choices to replace missing teeth until the arrival of dental implants in the 1980s. Today, dental implants are the gold standard for dental restoration.

But although bridgework may have lost “first chair” in the orchestra of restorations, it's still a viable option. In fact, it can be the best option in certain situations.

Bridges consist of a series of porcelain crowns fused together like fence pickets. The center crowns, known as the pontics, “bridge” the gap left by a missing tooth or teeth. The crowns on each end, the abutment teeth, crown the natural teeth on either side of the gap to support the bridge.

Bridges are effective and durable, but with a major downside: To accommodate the abutment crowns, we must reduce the size of the natural teeth to which they'll be attached. This alteration can weaken those teeth's structure and require them from then on to have some form of restoration. They're also at higher risk for tooth decay.

Implants, on the other hand, don't require this alteration, and may also be more durable than bridges. Why then consider a bridge?

Price can be a factor: Implants may be more expensive, especially involving multiple teeth. Keep in mind, though, that this only compares the initial cost: Because implants have a 95% or more ten-year success rate, with further evidence they could potentially last for decades, they may actually cost less in the long-run than bridge restorations that have a higher chance of being replaced sooner.

But the prime reason is that some dental situations aren't suitable for dental implants. For instance, implants require a certain amount of bone for proper placement, so people with extensive bone loss may not be able to acquire them. Health conditions like uncontrolled diabetes or a compromised immune system can also complicate implant installation. A bridge in these cases may represent a better alternative.

With the help of your dentist, you'll need to consider your individual situation, dental and financial, in deciding between an implant or a bridge. And, if a dental bridge is your best option, it will be a solid choice for restoring your missing teeth and your smile.

If you would like more information on various dental restoration methods, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”

Dental implants are all the rage—and for good reason: They’re incredibly “tooth-like,” both in appearance and function. They also have a stunningly high success rate: More than 95% of implants still function after ten years. This means out of thousands of implants installed each year, only a handful fail.

But although that’s an amazingly low number, they’re still failures for real people who’ve suffered a loss. If you’re considering dental implants the chances of that being your experience are quite low. But it could still happen.

Here’s a few things you can do to make sure your implants don’t fail.

Stop smoking. Of the small percentage of implant failures, an inordinate number are smokers. A smoker’s chances of implant failure are roughly double those of non-smokers. Smoking, and to some degree any tobacco use, can make your mouth an unhealthier place: Not only can it increase your dental disease risk, but it can interfere with the healing process after implant placement and increase the chances of early failure.

Manage your health. Diabetes and similar systemic conditions can interfere with the healing process too, which could impact your implant attachment to bone. Diabetics thus run a slight risk of implant failure—but actual failures mostly involve patients who don’t have good control of their symptoms. If you’re a diabetic, properly managing your condition will lower your risk of implant failure to nearly identical that of someone without diabetes.

Treat gum disease. Implants in themselves are immune to disease—but the underlying bone that supports them isn’t. A gum disease infection could eventually weaken and diminish the implant-bone attachment. If this happens around an implant, its stability can be severely compromised. The best strategy is to prevent gum disease through daily, thorough brushing and flossing to remove disease-causing dental plaque. And if you see any symptoms like gum swelling, redness or bleeding, see your dentist as soon as possible.

Your implants could serve you well for decades. Just be sure you’re doing the right things to ensure their longevity.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants: A Tooth-Replacement Method That Rarely Fails.”

Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants After Previous Tooth Loss.”