Dental Bridge vs. Implant: Replacing Missing Teeth

A dental bridge and a dental implant both replace missing teeth with fixed teeth that you don't take out. A bridge is supported by crowns on the teeth on either side of the gap. An implant is anchored in the jawbone and doesn't rely on the neighboring teeth. Which one fits you depends on the health of those neighboring teeth, the bone where the tooth is missing, your medical history, your timeline and your budget.

How does a dental bridge work?

A bridge literally spans the gap left by one or more missing teeth. It is made as one piece:

• Abutments are crowns on the teeth on either side of the space. They hold the bridge in place.

• Pontics are the replacement teeth that sit over the gap and are attached to the crowns.

Bridges are commonly made of ceramic, porcelain fused to metal, or metal alloys such as gold. For front teeth, appearance usually guides the choice. For back teeth, strength and the bite play a larger role.

To place a traditional bridge, the supporting teeth are shaped for crowns. That is the main trade-off: two teeth are reshaped to replace one.

How does an implant replace a tooth?

A dental implant is a small post placed in the jawbone where the tooth is missing. After the bone heals around it, a crown is attached. The neighboring teeth are left alone. Several missing teeth in a row can also be replaced with a bridge supported by implants instead of natural teeth.

Our dental implants page and our article on how dental implants work explain the steps in more detail.

When might a bridge make sense?

• The teeth beside the gap already have large fillings or crowns and would benefit from new crowns anyway.

• The bone where the tooth is missing isn't suitable for an implant, or building it up isn't something you want to do.

• A health condition or medication makes implant surgery less advisable. For example, some bone-strengthening medicines affect how the jaw heals (see our page on osteoporosis medications and your dental health).

• You want the replacement finished in a shorter time. A bridge usually takes a few weeks, while an implant needs months for healing.

When might an implant make sense?

• The teeth beside the gap are healthy and unrestored, and you'd rather not reshape them.

• There is enough healthy bone, or it can be rebuilt.

• You want each tooth to stand on its own so you can floss normally around it.

How long do bridges and implants last?

Both have good track records, and neither is permanent. A systematic review of tooth-supported bridges found that about 94 percent of metal-ceramic bridges were still in place after five years. A separate review of single implant crowns found about 96 percent of the crowns still in service after five years and about 89 percent after ten. That review also noted that complications such as loose screws and gum problems around the implant were fairly common.

These figures come from different groups of patients, so they aren't a direct contest between the two. How long your restoration lasts depends more on your gums, home care, bite and regular checkups.

Why replace a missing tooth at all?

A gap does more than change your smile. Replacing a missing tooth can help you:

• Chew and speak comfortably

• Keep neighboring and opposing teeth from drifting or tipping into the space

• Spread biting forces more evenly across your teeth

Not every missing tooth must be replaced. A missing back tooth sometimes causes no problems, and leaving the space can be a reasonable choice. We'll talk through that option too.

How do you care for a bridge or implant?

• Bridge: Clean under the replacement tooth every day with a floss threader, super floss or a small brush. Decay on the supporting teeth is a common reason bridges fail.

• Implant: Brush and floss around it like a natural tooth. Gum inflammation around an implant can lead to bone loss, so regular cleanings matter.

• Both: If you clench or grind, ask about a night guard.

Talk about replacing a missing tooth in Jacksonville

The right choice starts with an examination of the teeth next to the gap, the bone and your bite. Dr. CJ Henley sees patients at 3675 Hendricks Avenue in San Marco. Contact the office or call 904-398-1549 to schedule a visit.

Sources

1. Pjetursson BE, Sailer I, Makarov NA, Zwahlen M, Thoma DS. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs. Dent Mater. 2015;31(6):624-639. doi:10.1016/j.dental.2015.02.013 (retrieved via PubMed)

2. Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res. 2012;23 Suppl 6:2-21. doi:10.1111/j.1600-0501.2012.02547.x (retrieved via PubMed)

About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.

Can Gum Disease Affect Your Overall Health?

Gum disease is linked with several conditions elsewhere in the body, including heart disease, diabetes, some cancers and Alzheimer's disease. For most of these, the research shows the conditions tend to occur together, not that gum disease causes them. Diabetes is the clearest two-way relationship. For the others, the honest answer is that we don't yet know whether treating your gums changes your risk, so treat gum disease because it damages your mouth, and keep up your medical care for everything else.

What is gum disease?

Gum disease begins as gingivitis: gums that are red, puffy and bleed when you brush. If plaque stays under the gumline, it can progress to periodontitis, a long-term infection and inflammation that destroys the bone holding the teeth. About 4 in 10 US adults aged 30 and older have some level of periodontitis. Smoking and diabetes are two of the strongest risk factors. [1]

Because inflamed gums bleed easily, mouth bacteria can enter the bloodstream briefly during brushing or chewing. That, along with long-term inflammation, is why researchers have looked for connections between oral health and overall health.

Is gum disease linked to heart disease?

People with gum disease have higher rates of heart attack, stroke and other atherosclerotic disease. In 2012, the American Heart Association reviewed the evidence and concluded that the association is real and holds up after accounting for known shared risk factors. It also concluded that the evidence does not show that gum disease causes heart disease, and that there is no evidence gum treatment prevents heart disease or changes its outcome. [2]

Smoking, age and diabetes raise the risk of both conditions, which explains part of the overlap. The practical message from the AHA statement is to treat gum disease for its own sake and not to treat it as a heart-disease prevention strategy.

What about diabetes?

This is the strongest connection. High blood sugar makes gum disease more likely and more severe, and severe gum disease can make blood sugar harder to control. [3] A large Korean study also found that people who brushed three or more times a day were somewhat less likely to develop diabetes over ten years. [6] Read more in our post on brushing your teeth and diabetes risk.

Is gum disease linked to cancer?

Several large studies have found modest links between a history of gum disease and certain cancers.

• Pancreatic cancer. A Harvard study of more than 51,000 men found about 64% higher pancreatic cancer risk in men who reported gum disease. The authors said the finding needed confirmation. [4]

• Cancer in older women. A study of nearly 66,000 postmenopausal women found about 14% higher overall cancer risk. See gum disease and cancer risk in older women.

• Stomach and esophageal cancer. See gum disease and stomach or esophageal cancer.

All of these are observational studies. None shows that treating gum disease lowers cancer risk.

Is gum disease linked to Alzheimer's disease?

Researchers have found the gum-disease bacterium Porphyromonas gingivalis and its enzymes in brain tissue from some people with Alzheimer's disease, and mouse studies suggest the bacterium can reach the brain. [5] This is early-stage research. It has not been shown that gum disease causes Alzheimer's or that gum treatment prevents it.

How can you protect your gums?

• Brush twice a day with fluoride toothpaste and clean between your teeth once a day.

• Don't smoke or vape.

• If you have diabetes, work with your physician to keep blood sugar in your target range.

• See a dentist regularly. Gum disease is usually painless until it is advanced, so a professional exam is how it is found.

• Tell your dentist about your health conditions and medications.

Where can you get your gums checked in Jacksonville?

A comprehensive dental exam at our office includes measuring the gum pockets around each tooth and reviewing your medical history. Contact us or call 904-398-1549 to schedule.

Sources

1. Centers for Disease Control and Prevention. Gum (periodontal) disease. Retrieved October 6, 2026.

2. Lockhart PB, Bolger AF, Papapanou PN, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012;125(20):2520-2544. doi:10.1161/CIR.0b013e31825719f3 (retrieved via PubMed)

3. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes, gum disease and other dental problems.

4. Michaud DS, Joshipura K, Giovannucci E, Fuchs CS. A prospective study of periodontal disease and pancreatic cancer in US male health professionals. J Natl Cancer Inst. 2007;99(2):171-175. doi:10.1093/jnci/djk021 (retrieved via PubMed)

5. Dominy SS, Lynch C, Ermini F, et al. Porphyromonas gingivalis in Alzheimer's disease brains: evidence for disease causation and treatment with small-molecule inhibitors. Sci Adv. 2019;5(1):eaau3333. doi:10.1126/sciadv.aau3333 (retrieved via PubMed)

6. Chang Y, Lee JS, Lee KJ, Woo HG, Song TJ. Improved oral hygiene is associated with decreased risk of new-onset diabetes: a nationwide population-based cohort study. Diabetologia. 2020;63(5):924-933. doi:10.1007/s00125-020-05112-9 (retrieved via PubMed)

About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.