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Tooth Has Fractured: Should I Get an Implant or Bridge?

Last Updated: Nov 11, 2015

Amanda asks:Hello. I am 24 years old and facing a bridge or an dental implant. I’m really struggling with the decision.
One of my molars (second from the back, with no wisdom teeth, left side, lower jaw–number 19, if I’ve interpreted the chart correctly) is fractured, and the fracture extends below the gumline. I’ve been told the tooth must be extracted, and have finally accepted that. The fracture actually occurred maybe eight years ago, and aside from when it happened, I hadn’t been to the dentist in over ten years until recently. The fracture was not treated at all when it occurred. It was simply examined and options discussed. I was always deeply disappointed when I had a cavity as a child (which didn’t happen much), and am now devastated to be facing the permanent loss of one of my teeth at such a young age.However, I’ve discussed it with a friend who is a dental hygienist, and she warned me of the risks of an implant. She said that if an implant fails it is practically impossible to replace it. (My dentist said the same.) I’ve read, also, about nerve damage and improperly placed implants that fail quickly or get infected and cause bone loss or adjacent tooth loss. As devastated as I am to lose one tooth, I certainly don’t want to face losing another in the near future!The alternative is a bridge. Less risky, but by its nature, damaging to an otherwise healthy tooth. I cringe at the thought of what they’ll have to do to my healthy tooth to prepare it for a bridge. I understand, also, that a failed bridge can be replaced by another bridge or implant(s), but a failed implant cannot be replaced by a bridge.What should I do?

1 Comments on Tooth Has Fractured: Should I Get an Implant or Bridge?

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Dr. Carlos Boudet

11/11/2015

From what you describe, you try to keep your mouth in good shape and have to decide between a bridge and an implant.First, let me tell you that the art and science of dental implantology has advanced a lot since it started becoming popular many decades ago.If it was my own mouth, I would choose a dental implant over a bridge for the following reasons:If my molars have an occlusal filling (a small filling on top of the molar) I would not want to condemn the teeth adjacent to the missing molar to a crown for the rest of my life. The crown has a margin where your molar can get additional decay if it is not done with precision, and insurance companies approve payment to replace a bridge after 5 to 7 years, which means that they see that bridges have to be replaced throughout your lifetime.Also very important is the fact that after your molar is removed, the bone begins to atrophy or shrink and if you do not put a dental implant in the bone to keep from loosing it(the first year you loose 25% of the bone), after a few years you may not have enough bone to put an implant without a bone graft.When the dentist follows proper treatment planning and procedures, the incidence of all those things like an implant in the wrong position or angle, nerve damage, and implant failure are pretty much a rare occurrence, and not something that happens when properly trained, experienced practitioners handle your dental implant treatment.Hope this helps.Carlos Boudet, DDS

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