There is a gap, there are two quotes in front of you, and one of them is a good deal bigger than the other. The thing worth knowing before you pick is that money is only half of what each one costs you.
So what is a bridge actually doing?
Picture a footbridge over a stream. The span in the middle is the part you want, and the span is the easy bit. What makes a footbridge possible at all is the two banks it is built into, and you cannot build one without digging into both.
A dental bridge works in exactly that way. The false tooth in the middle floats over the gap, held there by crowns that sit over the teeth on either side, which means those two teeth have to be shaped to take a crown: a layer taken off all the way round, so the crown can slip over the top. A bridge replacing one tooth is usually three units, a crown on each neighbour and the false tooth between them, which is why your dentist counts units rather than teeth when working out your price.
Now, that shaping is the bit worth sitting with for a moment. Enamel never grows back. So if the two teeth either side of your gap are healthy and untouched and have never been filled, a bridge spends them in order to fill the space. You get one tooth back, and you commit three.
That is no reason to rule a bridge out. Hold that thought, because there is a common version of this where the sums flip and the bridge is plainly the better buy.
And what is an implant doing instead?
An implant leans on nothing. It is a small titanium post placed down into the jaw where the root of the missing tooth used to be, and over a few months the bone grows onto it and grips it. Then a crown made to match your other teeth goes on top. The teeth either side never get touched.
There is a second thing going on down there that people rarely hear about. Bone keeps itself where it is used, in the way a path across a field stays clear because people keep walking it. A root presses on the bone every time you chew, and once it has gone, that patch of jaw has nothing much to do. An implant gives it something to do again. A bridge, however well made, spans over the top and leaves the ground underneath quiet.
So here is the honest summary of the two. A bridge borrows strength from the teeth you still have. An implant brings its own.
Bridge or implant over ten years, side by side
Ten years is the right window for this, because a year is too short to tell you anything useful and a lifetime is longer than anyone can promise.
| A bridge | An implant | |
|---|---|---|
| What it is | A false tooth carried by crowns on the teeth either side | A titanium root in the jaw with its own crown on top |
| The teeth either side | Shaped all the way round to take crowns | Untouched |
| The bone under the gap | Spanned over, and left as it is | Loaded again by the new root |
| Time from start to finished tooth | Two visits, about a fortnight apart | Several months, while the bone fuses |
| What it feels like | Numb for the shaping, pressure rather than pain, tender to cold for a few days | Numb for the placement, pressure rather than pain, sore for a few days |
| Cleaning it | Floss threaded underneath the false tooth, every day | Brushed and flossed like your own tooth |
| How long it lasts | Ten years, often much longer | Decades with care |
| The price here | From £400 a unit, usually three units for one tooth | From £1,700 with the crown |
| When it is the right answer | The neighbours already need crowns, or an implant is ruled out | Healthy teeth either side, and bone enough to hold it |
What does each one actually cost?
Here is where most comparisons online quietly cheat, because they set a per-unit price against a whole-treatment price and let you draw the wrong conclusion.
A bridge is priced by the unit, from £400 each here, and one missing tooth usually needs three of them. A single implant, including the crown that goes on it, is from £1,700. Do that sum for your own gap before you decide the implant is in a different league altogether. The number that matters is always the total.
A few things can sit on the implant side of the ledger, and they belong there from the start. If the tooth has been gone a long while and the scan shows the bone has thinned, bone grafting starts from £350, and for an upper back tooth a sinus graft is £1,150. The CBCT scan the whole plan is built on is £125. If you would rather not be aware of it happening, sedation is £350 a session. The consultation itself is free, held with a refundable deposit, and the figure for your own mouth is written down once your scan has been read. Every other price sits on the fee guide in the open.
Then there is the ten-year half of it, which is really a question about what replacing each one looks like. A bridge commonly lasts ten years and often a great deal longer, and what wears one out is what wears teeth out: grinding, biting hard things, and gums left uncleaned around the edges. An implant lasts decades with care. The difference shows up on the day either of them needs attention. A bridge is one piece, so it comes off as one piece, and you are replacing three teeth of work rather than one. An implant crown, if it ever needs redoing, is a crown. The titanium underneath stays where it is.
When is a bridge the right answer?
Often, and this is the part the implant conversation tends to skate past.
If the teeth either side of your gap already have big fillings in them, or are cracked, or are already crowned, or have had root canals, then the shaping a bridge needs costs you nothing you had. Those two teeth were heading for crowns anyway. Put a bridge in and one piece of work does two jobs at once: the neighbours get the protection they needed, and the gap gets filled at the same time. When that is your mouth, a bridge is the correct treatment rather than the cheap one, and any dentist worth booking will say so out loud.
A bridge is also the answer when an implant is ruled out for you, and there are ordinary reasons why that happens. Too little bone and no wish to have it built up first. A health condition that slows healing. Or simply that you do not fancy months of waiting and a surgical appointment for the sake of one tooth. A bridge takes two visits about a fortnight apart, and you walk out of the second with the gap filled and the job done.
The single case where a bridge is the wrong call is the clean one: two perfectly healthy, untouched teeth either side of one gap, with bone enough underneath. That case belongs to the implant, and you deserve to be told so.
When is an implant worth the wait?
When those neighbours are in good shape and you would like to keep them that way. When you are planning in decades rather than ten-year stretches. And when a tooth you brush and floss like your own appeals more than threading floss under a false one every night.
Be clear-eyed about what you are signing up for, though. The placement is a short visit under local anaesthetic, the soreness afterwards is the kind ordinary painkillers handle, and you eat soft for the first week. The hard part is the waiting. Bone takes a few months to fuse to titanium, and there is nothing to do in that time except keep the area clean and come in for a check. You are not left with a hole in your smile, because a temporary tooth goes in where it shows, and even so, months are months.
An implant asks a few things of you as well. Healthy gums, because gum disease is treated before anything goes in. Enough bone, which the CBCT scan measures rather than guesses at. And no smoking around the treatment, because it is the habit that most lowers an implant’s chance of fusing and lasting. Once it is in, it wants the same care any tooth wants: gums left uncleaned around an implant become inflamed exactly as they do around a natural one. Nobody is handing you a tooth you can forget about.
What about a denture?
Worth saying plainly, because for plenty of people it is the right answer and it gets treated as the consolation prize.
A denture is removable, it leaves every other tooth untouched, and it is the lowest cost now: an acrylic one is from £332.10 a jaw here, and a cobalt chrome one, which is slimmer and grips more firmly, from £950 a jaw. Where it truly earns its place is when several teeth are missing rather than one, or when the gum is still healing after extractions, or when the number simply has to be smaller this year. It lasts years, and it is relined as the gum beneath it changes shape.
Here is the thing that surprises people. Implants and dentures are not rivals at all: two implants can hold a loose lower denture firm, which is often the answer for a full denture that will not stay put. If dentures are what you are weighing up, we have written about what dentures cost in the UK separately.
So which one is yours?
Honestly, a scan answers this faster than any article can, because the two things that decide it are both physical: the state of the teeth either side, and how much bone sits under the gap. Neither is a matter of opinion, which is rather a relief.
What you can do is turn up knowing what to ask. Ask what condition those two neighbouring teeth are genuinely in, and whether they would need crowns anyway. Ask what the scan says about the bone. And ask for both totals in writing, the bridge and the implant, so you are holding whole numbers next to each other. Any practice worth your time will give you all three without being chased.
At The Dental Barn in Balsall Common the implant consultation is free, held with a refundable deposit, and the scan and the written estimate come before you commit to anything. You can read the treatment through on the dental implants page, or the other side of it on crowns, bridges and dentures. And if you come out of that consultation with a bridge booked, because a bridge is the right answer for your mouth, that is a good result too.
