The best outcome for advanced tooth decay is the preservation of your tooth. This isn't always practical when the tooth's pulp has undergone necrosis (death of the nerve tissues) and when a significant amount of the tooth's physical structure has been destroyed. The tooth must be extracted and then replaced, leading to the question of what's the best option for you—a dental bridge or a dental implant?
There are three types of dental bridge: the traditional fixed bridge, wherein the prosthetic tooth is suspended between two hollow dental crowns fitted over the teeth on either side; the cantilever bridge, connected on one side only, like its large scale namesake; and the Maryland bonded bridge, featuring a false tooth fitted with small wings, which are bonded to the rears of the teeth on either side. However, bridges have drawbacks that dental implants do not.
Alveolar Bone Mass
The loss of a tooth triggers the loss of bone mass in the alveolar bone, which is the section of the jaw that holds the dental sockets. The alveolar bone loses 50% of its width within 12 months of tooth extraction (with 30% of this loss taking place in the first 12 weeks). This occurs because this section of bone is no longer being stimulated by pressure from the tooth. The nutrients that maintain bone density are no longer supplied to the empty socket.
Complications of Bone Loss
For some patients, loss of alveolar mass is sustainable, with few long-term adverse effects. For other patients, the loss of bone mass can be catastrophic, particularly when additional teeth (and therefore additional alveolar bone mass) are lost. Later in life, the onset of osteoporosis (or anything that affects bone density) can further accelerate the loss of bone mass. The jaw weakens, and the exterior of the face may visibly sag. Unfortunately, dental bridges (which sit on the gums) do nothing to prevent bone loss. Dental implant treatment has a different outcome.
A dental implant is placed in your alveolar ridge. It's a small titanium alloy screw, and the bone begins to heal around it after implantation. Once healing has been completed and the bone and implant have been integrated, a prosthetic dental crown is bonded to the tip of the implant, becoming a fully functional artificial tooth and tooth root. The dental crown experiences the compression bite force of a natural tooth, in turn stimulating the bone beneath it, meaning loss of bone mass does not occur.
A bridge makes an acceptable replacement for a tooth, but for your long-term dental health, you want to replicate the structure of a natural tooth as much as dental science can allow—meaning a dental implant is generally the better choice.