Replacing a Missing Tooth: Bridges, Dentures, and Implant-Supported Options Compared
There’s no universally correct answer here, which is worth remembering when a comparison article crowns a winner.
There are three options: a fixed bridge, a removable denture, or an implant restoration. Bridges are quicker and better covered, but require reshaping the two healthy teeth on either side. Dentures replace several or many teeth without surgery. Implants leave neighbouring teeth untouched and last longest, but take months and are excluded from the CDCP.
The right option depends on how many teeth are missing, where they are, what condition the neighbouring teeth are in, how much bone you have, and what your coverage will do.
Bridge, denture, or implant? The three approaches at a glance
| Fixed bridge | Removable denture | Implant restoration | |
|---|---|---|---|
| Best suited to | One or a few teeth in a row, with sound neighbours | Several or many missing teeth | One or a few teeth, with adequate bone |
| Fixed or removable | Fixed | Removable | Fixed |
| Affects other teeth | Yes — two are reshaped | No | No |
| Timeline | A few weeks | A few weeks | Several months |
| Surgery | No | No | Yes |
| Typical coverage | Major service, ~50% | Major service, ~50% | Rarely covered |
| CDCP | Not covered | Covered, preauth required | Excluded entirely |
How do fixed bridges work, and how long do they last?
A bridge spans a gap by anchoring a replacement tooth to the natural teeth on either side, which are crowned to act as supports.
The evidence: conventional bridges show around 93.8% survival at five years and 89.2% at ten. Worth separating from that: success — meaning still in place with no complications along the way — was only 71.1% at ten years. So roughly nine in ten bridges are still doing their job at a decade, but a meaningful minority needed intervention to get there.
Cantilever designs, supported on one side only, do worse: 81.8% survival at ten years, 63% success, and loss of pulp vitality in the supporting tooth in nearly a third of cases.
The trade-off is the one to think hardest about. Two healthy teeth get reduced to hold the bridge. If those teeth already need crowns, you’re giving up nothing you weren’t giving up anyway, and that’s when a bridge is at its most compelling. If they’re pristine, you’re permanently altering two sound teeth to solve a problem with a third.
Note that the CDCP doesn’t cover bridges at all, which matters if it’s your only coverage.
When is a denture the right choice?
Removable replacements: partial dentures fill gaps around remaining natural teeth, complete dentures replace a full arch.
The evidence: complete dentures average about 10.1 years of service life, better than the five-to-ten years usually quoted. Removable partials are shorter-lived — roughly 75% still in use at five years and 50% at ten — and around 18% of patients stop wearing a partial altogether.
Strengths: no surgery, nothing done to the remaining teeth, and the only practical approach when many teeth are missing. Covered by the CDCP with preauthorization.
Trade-offs: removable, requires an adjustment period, and lower dentures in particular can feel unstable because there’s less ridge to grip. The stop-wearing statistic for partials is the useful signal here: for some people the daily reality doesn’t work out, and that’s worth weighing in advance rather than discovering later.
How long do implant restorations last?
A titanium post is placed in the jaw and, after the bone integrates with it over several months, restored with a crown. It doesn’t involve the neighbouring teeth at all.
The evidence, with an important distinction. The implant itself does well: around 96% survival at ten years in pooled analyses, though that drops to roughly 93% once patients lost to follow-up are accounted for, and one real-world practice study found 82.9%.
But the restoration on top is a separate lifespan and it’s shorter. Implant-supported single crowns run at roughly 89% survival at ten years; implant-supported bridges at roughly 80%. Roughly one in five implant bridges needs replacing by year ten while the implant underneath still counts as a success. And only about 66% of patients are free of any complication at just five years. Peri-implantitis — inflammation with bone loss around the implant — affects around 22% of implant patients.
None of this argues against implants. They’re an excellent option and often the best one. What it argues against is the “place it and forget it for life” framing, and for taking the maintenance and hygiene requirements seriously.
One correction worth making, because it’s repeated almost universally: implants do not prevent jawbone loss across your jaw. Extraction causes real ridge resorption — roughly 3.8 mm of horizontal width in the first six months. But research from the group that established that finding also showed that placing an implant into a fresh extraction site failed to prevent the socket wall remodelling. Implants preserve bone locally, at the implant, and slow loss rather than stopping or reversing it. The benefit is genuine and it’s narrower than commonly advertised.
Implants are excluded from the CDCP entirely, including implant-supported crowns and bone grafts, and most basic private plans don’t cover the surgical portion either. Some enhanced plans contribute toward the crown.
How do the three compare on survival?
| Option | Ten-year figure |
|---|---|
| Conventional fixed bridge | ~89% survival, though only ~71% complication-free |
| Cantilever bridge | ~82% survival, ~63% complication-free |
| Removable partial denture | ~50% still in use |
| Complete denture | Mean service life 10.1 years |
| Implant post | ~93–96% survival |
| Implant-supported single crown | ~89% survival |
| Implant-supported bridge | ~80% survival |
Two things to read out of that table. Survival and complication-free success are different measures, and the gap between them is where the maintenance lives. And with implants, the post and the restoration on top have separate lifespans — the post commonly outlasts the crown attached to it.
How do you choose between them?
- How many teeth are missing, and where? One or a few with sound neighbours points toward a bridge or an implant. Many teeth, or a full arch, points toward a denture or an implant-supported overdenture.
- What condition are the adjacent teeth in? If they need crowns anyway, a bridge is efficient. If they’re untouched, that argues for an implant, which leaves them alone.
- Is there enough bone? Implants need adequate volume. Grafting is possible, and it adds time and steps.
- What will your plan cover? Often the deciding factor, and there’s no shame in that. Bridges and dentures usually get major-service coverage. Implants usually don’t, and the CDCP excludes them outright.
- Can you live with something removable? Some people never think about a partial denture again. Others never make peace with it. Answer this before treatment, not after.
- Do you smoke? It substantially raises implant complication risk and belongs in the decision explicitly.
What we handle at Mellow Family Dental Care
We provide crown and bridge work, both traditional and implant-supported. Dentures are assessed here and fabricated by a denturist we refer to, who has an in-house lab. Dr. Makhani will assess your situation, walk through which options genuinely apply to your mouth, and plan the restorative work. Where a case calls for surgical implant placement or bone grafting, we coordinate that portion with a specialist and handle the restoration on top.
We direct-bill all insurance companies, and can submit a predetermination so you know your share in writing before committing.
Common questions
Which option is best? There isn’t one. Implants perform best long-term for single teeth and leave neighbours untouched; bridges are quicker and better covered; dentures handle multiple missing teeth and require no surgery. Your specific mouth decides it.
Which lasts longest? Implants, on the evidence — but distinguish the implant from the crown on it. The post commonly lasts decades; the restoration typically needs attention sooner.
Which does insurance cover best? Bridges and dentures, usually as major services around 50%. The CDCP covers dentures but excludes both bridges and implants. More on insurance.
Can I change my mind later? Often, though some changes are easier than others. Moving from a denture to implants is common. Moving from implants back to a removable option is possible but means further treatment. Reversing a bridge is hardest, since the supporting teeth have already been reshaped.
What if I’m missing most of my teeth? A complete denture or an implant-supported overdenture is usually the practical answer. Overdentures address the stability problem that makes lower dentures frustrating.
Do I have to replace the tooth at all? Not always — it depends on which tooth and your circumstances. There’s reasonable evidence that not replacing a back tooth is an acceptable outcome for many people. For a visible tooth, or one affecting how you chew, replacement is a stronger recommendation. It’s worth an actual conversation rather than an automatic yes.
To talk through which option fits your situation, call Mellow Family Dental Care at 604.457.2273 or visit Unit 150–20528 Lougheed Highway in West Maple Ridge.
Sources: Pjetursson BE, et al. Systematic review of survival and complication rates of fixed dental prostheses. Link · Taylor M, et al. Longevity of complete dentures. J Prosthet Dent 2021;125(4):611–619. Link · Araújo M, Sukekava F, Wennström J, Lindhe J. Ridge alterations following implant placement in fresh extraction sockets. J Clin Periodontol 2005;32:645–652. · Derks J, Tomasi C. Peri-implant health and disease: a systematic review. Link · Pjetursson BE, et al. Comparison of survival and complication rates of tooth- and implant-supported prostheses. Link
This article is general information and does not replace an in-person dental exam.
