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I'm trying to get a straight answer about the relative merits of implants vs. bridges. I am genetically missing my upper left lateral incisor, and have been told by a couple of dentists and orthodontists that my bone mass is good and I am a good candidate for an implant. However, I was recently told by a different dentist that implants were a radical procedure to replace only one tooth, and he suggested a bridge. My problem with a bridge is that it requires the shaving down of adjacent teeth, and I have few enough decent teeth already without carving away at them! Please just give me an objective opinion. The relative costs are not a factor; the long-term benefits are. Thanks!

The debate between dental implants and fixed bridgework is one of the hottest topics in dentistry today. For an accurate prognosis of the risks and benefits of both procedures, it is very important to visit a dentist who provides both services. If certain prerequisites are met (ie- minimal bone loss, non-smoker, good oral hygiene, and adequate space to place an implant), dental implants are an excellent choice. With this in mind, inherent risks are involved with any surgery. Nonetheless, implants have now proven to remain strong for 10+,15+ years and counting! Dental implants to replace a single front tooth also include the added challenge of tissue contouring. This means that it is important to account for the expected bone loss and changes in your gums which occur during healing. By monitoring the healing phase over several months, a completely natural appearance of your new tooth can be attained. Another possible option for replacing a missing lateral incisor is a restoration known as a 'Maryland Bridge'. This is essentially a bridge which requires only modest removal of the enamel on the lingual, or back side, of the adjacent teeth. This bridge is then bonded to the back side of your teeth, leaving the front of the teeth with their enamel intact! This option is certainly a quicker fix than an implant procedure, but also has its own drawbacks such as your loss of ability to floss between the involved teeth. Though this answer only scratches the surface of the many facets of this topic, I hope it helps you in your decision.

ps. Please visit http://www.seattle-dentist.com/cosmeticdentist.htm to see a photo of a 10+ year old dental implant in one of our patients. The implant is the patient's left incisor in the first example.