Kansas City Dental Implant Blog
Wouldn't a bridge just be easier? Wouldn’t my insurance cover more on the bridge than the implant? I hear this question asked on an almost daily basis. My answer is usually perhaps or perhaps not. Sure, in most instances preparing the teeth on either side of a missing tooth for a bridge is less invasive than surgically placing an implant, waiting for it to osseointegrate, uncovering it and restoring it….and your insurance may pay more on the bridge…sometimes.
It is also true that in the course of traditional dental implant treatment we remove a tooth, let the bone heal, place the implant then let that heal, then finally we can add the crown. But what if the bad tooth isn't missing yet but still needs to be extracted? In many instances, we can place an implant at the same appointment we remove the tooth. Even better, in some cases, typically in front teeth, we can place a temporary crown on the implant at the same appointment we place the implant. Now this is easier than extracting a tooth, waiting for the gums to heal and subsequently fabricating a bridge.
Even if a bridge is easier and maybe cheaper, what if the bridge has to be remade? According to many studies, the average life span of a bridge is only about 10-15 years, while implants last more than 25 years on average. There are other factors to consider. In individuals who have a high decay rate (those who get a lot of cavities) there is a strong likelihood the bridge will decay at the margin, especially if it is in the back of the mouth. Bridges also tend to increase the risk of one or more of the abutment teeth requiring a root canal after the bridge is installed. Sometimes the bridge and abutment teeth are lost not long after the bridge is placed. I’m certainly not advocating bridges should never be used. Rather, when implants cannot be placed bridges often offer us a great tooth replacement restorative option.
Why do we still see so many bridges compared to implants? My conclusion is this occurs partly for financial reasons. Financial reasons related to the patient and dentist. The bridge may be cheaper than implant to the patient, though I generally charge less for an implant abutment and crown than I do a three unit bridge. More interesting, dentists who do not surgically place implants are forced to refer the implant to a specialist (generally an oral surgeon or periodontist). Thus the dentist earns nothing on the implant placement. When the implant heals, the patient then has a crown made by the dentist. On average, a general dentist makes at least twice as much on a bridge than they do just restoring an implant. This, I believe, is one of the reasons some general dentists rarely even offer dental implants as a treatment option. Fortunately, it seems many of the younger dentists are taking it upon themselves to learn to place dental implants themselves. This should continue to increase the popularity of dental implants.