When you lose a tooth, the dentist presents two options. A bridge costs £595-£800. An implant costs £2,600. The choice seems obvious until you realize the bridge comes back to haunt you in about 10 years.
The thing about dental bridges that nobody mentions upfront is that they're not a permanent solution disguised as one. They're a temporary fix with a permanent price tag. Your neighboring teeth get filed down to support the bridge, weakening them forever. The bone under your missing tooth continues deteriorating because nothing's stimulating it. And in 10-15 years, you're back in the dental chair replacing the bridge, except now those supporting teeth might need work too.
Dental implants cost more initially because they actually solve the problem. The titanium post integrates with your jawbone, preventing bone loss. Your neighboring teeth stay intact. And that £2,600 you spent? It's the only time you'll spend it, because implants last 25+ years, often a lifetime.
Here's what actually happens with each option over time.
What You're Actually Buying
A dental bridge is three crowns fused together. The two outer crowns cement onto your neighboring teeth after your dentist files them down. The middle crown fills the gap where your tooth used to be. The entire structure sits on top of your gums, supported by those adjacent teeth.
Your dentist takes impressions, sends them to a lab, and you come back a few weeks later to have the bridge cemented in place. Two appointments, maybe three weeks total. You walk out with a tooth that looks normal and works reasonably well.
A dental implant is a titanium screw surgically placed into your jawbone where the tooth root used to be. After 3-6 months of healing (where the bone grows around the titanium), your dentist attaches an abutment and crown on top. The implant becomes part of your jaw structure, functioning like a natural tooth root.
The process takes longer. Surgery, healing period, another appointment for the abutment, another for the crown. Four to six months from start to finish. Multiple appointments. More invasive. But once it's done, it's done.
The Real Cost Difference
The upfront costs tell you nothing useful about the actual financial commitment.
A standard 3-unit dental bridge (replacing one tooth) costs £595-£800 at most UK practices. Maryland bridges using a metal framework bonded to adjacent teeth cost £350-£1,000. The treatment is finished in two appointments. You're out the door with a working tooth replacement for under a grand.
A single dental implant runs £2,000-£2,600 for the complete treatment (implant post, abutment, and crown). Some practices charge £3,000-£4,000 depending on complexity and materials used. The treatment takes months and requires minor surgery. You're spending 3-4x what the bridge costs. Learn more about dental implants and what's involved in the treatment process.
That's the comparison everyone makes. Bridge: cheaper and faster. Implant: expensive and slow. Decision made, right?
Except dental bridges last 7-15 years. The average is about 10 years. Then you need a new one. And when that bridge fails, your supporting teeth have been weakened from years of extra stress. They might need crowns. They might need root canals. One of them might be so damaged it needs extraction.
Meanwhile, your implant is still working perfectly after 10 years. After 15 years. After 25 years. The titanium post lasts a lifetime. The crown on top might need replacing after 15-20 years (another £500-£650), but that's minor compared to replacing an entire bridge plus fixing damaged support teeth.
The 15-year cost comparison is more accurate. One bridge replaced once costs £1,200-£1,600 minimum. Two bridges (if you're unlucky) cost £1,800-£3,200. Add potential crown work on supporting teeth (£500-£650 each), and you're looking at £2,300-£4,500 over 15 years. The implant cost £2,600 once, and you're done.
Over 25 years, the financial advantage of implants becomes overwhelming. You might have replaced that bridge three times (£2,400-£4,800), dealt with numerous complications on supporting teeth (£1,000-£3,000+), and potentially lost one of those supporting teeth entirely (another £2,600 for an implant, or another bridge compromising two more teeth). Meanwhile, the implant had one crown replacement (£650) and continues working perfectly.
The bridge only wins financially if you never need to replace it and nothing goes wrong with the supporting teeth. That never happens.
What Happens to Your Other Teeth
This is where bridges reveal their fundamental problem.
To place a bridge, your dentist files down the two teeth adjacent to the gap. They remove significant amounts of enamel to create room for the crowns that will support the bridge. Those teeth are permanently altered. They can never be "just teeth" again. They're now structural supports for your bridge.
Healthy teeth, sacrificed to replace one tooth.
The bridge puts extra force on those supporting teeth every time you chew. They're holding up a structure that spans three teeth, but they're only two teeth doing the work. The mechanical stress accumulates over years. Studies show that 15-20% of bridge abutment teeth develop problems requiring additional treatment within 10 years.
Common problems include root canal infections (because the teeth were filed down and crowned), fractures (from excess stress), and decay at the margins where the crown meets the tooth (because that junction is hard to clean properly). When an abutment tooth fails, the entire bridge fails. Now you're not just replacing the bridge, you're also fixing or extracting a natural tooth that was healthy before the bridge was placed.
Dental implants don't touch your neighboring teeth. The implant goes where the missing tooth root was. Your adjacent teeth remain completely unmodified. They keep their enamel, their structure, their health. They continue functioning as normal teeth, not as bridge supports. For more details about treatment options, visit our treatments page.
The long-term preservation of neighboring teeth is worth noting. When those teeth stay healthy, you avoid the cascade of problems that bridges create. No extra stress, no altered structure, no decay at crown margins, no need for future work beyond normal maintenance.
The Bone Loss Problem
Under every dental bridge, your jawbone is slowly disappearing.
Tooth roots stimulate jawbone when you chew. The pressure signals your body to maintain bone density in that area. When you lose a tooth, that stimulation stops. Your body decides the bone isn't needed anymore and gradually resorbs it. This process continues for life unless something replaces the tooth root.
Dental bridges sit on top of your gums. They replace the visible part of the tooth, but there's nothing in the bone where the root used to be. The bone underneath continues deteriorating at a rate of about 25% in the first year, with additional bone loss every year after.
This creates several problems over time. Your gums recede as the bone shrinks away, making the bridge look unnatural. Food gets trapped under the bridge more easily as the gap widens. The bridge becomes less stable as the bone it's resting on disappears. After 10-15 years, there might not be enough bone left to support another bridge in the same location, forcing more complex solutions.
Dental implants prevent bone loss. The titanium post acts like a tooth root, transmitting force into the jawbone when you chew. Your body maintains the bone around the implant the same way it maintains bone around natural teeth. The bone density stays stable for decades.
This preservation matters more than most people realize. When you eventually need other dental work (crowns, bridges, or implants for other teeth), having healthy bone density throughout your jaw means those treatments are simpler and more successful. Low bone density from years of wearing bridges makes future implants require bone grafting (additional £595-£795 per area), adding time and cost to treatments.
Living With Each Option
The day-to-day experience differs in ways that aren't obvious until you've lived with one or the other.
Dental bridges feel close to normal teeth. They're solid, they don't move, you can bite and chew relatively normally. But cleaning them is harder. The fake tooth in the middle (the pontic) has space underneath it where food gets trapped. You need special floss threaders or interdental brushes to clean under there properly. Regular floss doesn't work because the three crowns are fused together.
Miss that cleaning, and bacteria accumulate. The margins where the bridge crowns meet your natural teeth become decay hotspots. This is how bridges fail most commonly: decay on the supporting teeth that compromises their ability to hold the bridge. Good hygiene extends bridge lifespan significantly, but it requires more effort than cleaning natural teeth.
Some people report that bridges feel slightly "different" when eating. Not uncomfortable, just not quite the same as a natural tooth. The sensation is subtle, but it's there. You adapt to it quickly.
Dental implants feel exactly like natural teeth. The crown attached to the implant looks, feels, and functions identically to the tooth that was there before. You clean it like a normal tooth: regular brushing and flossing. No special equipment, no difficulty accessing hard-to-reach areas. The implant crown has its own space with gum around it, just like a natural tooth.
The only potential issue is that implants lack the periodontal ligament that natural teeth have (the cushioning tissue between tooth root and bone). This means they don't have quite the same sensation when you bite down. The difference is minor enough that most people don't notice it after the initial adjustment period.
The Treatment Timeline Reality
Getting a bridge is quick. Getting an implant takes months. This timeline difference matters when making decisions, but it's worth understanding what's actually happening during those timelines.
For a bridge, your first appointment involves numbing the area, filing down the adjacent teeth, taking impressions, and placing a temporary bridge. Two weeks later, the permanent bridge comes back from the lab, and your dentist cements it in place. Total active treatment time: about 3-4 hours across two appointments. You have a functioning tooth replacement within a month.
For an implant, the surgery takes about an hour under local anesthetic. Then you wait 3-6 months while the bone grows around the titanium post (osseointegration). During this healing period, you might wear a temporary tooth replacement (partial denture or temporary bridge). After healing, you return for the abutment placement (30 minutes), heal for 2 weeks, then return for the crown (another hour). Total active treatment time: about 2.5 hours across four appointments, spread over 4-6 months.
The waiting isn't wasted time, it's necessary healing. The bone integration is what makes implants successful long-term. Rushing that process leads to implant failure.
For some people, the bridge timeline is legitimately better. If you need a replacement tooth immediately for work or social reasons, waiting 6 months for an implant isn't practical. If you have a medical condition that makes surgery risky, the non-surgical bridge approach makes sense. If you're elderly and unlikely to outlive a well-made bridge's 10-15 year lifespan, paying extra for an implant's 25+ year lifespan provides no benefit.
But for most people under 60, the implant timeline is just something you deal with once, rather than the bridge timeline you'll deal with repeatedly every 10-15 years.
When Bridges Make Sense
Bridges aren't always the wrong choice.
If you're replacing multiple adjacent teeth, implant-supported bridges become the better option. Placing 3-4 individual implants costs £7,800-£10,400, while placing two implants with a bridge spanning them costs £3,500-£5,000. The bridge is faster, less invasive, and significantly cheaper in this scenario.
If you have insufficient bone density and don't want bone grafting surgery, bridges don't require much bone to work. They rest on neighboring teeth for support. Implants need healthy bone to integrate properly, and building up that bone adds months of treatment time plus £595-£795 per grafting site.
If you have medical conditions that make surgery risky (uncontrolled diabetes, heavy smoking, certain medications that interfere with healing), the non-surgical bridge placement becomes the safer option. Implant surgery isn't major surgery, but it's still surgery, and healing complications in high-risk patients can lead to implant failure.
If you're over 75 and the bridge will likely outlive you, the implant's superior longevity provides no practical advantage. A well-made bridge lasting 12-15 years serves its purpose perfectly well without the surgical procedure and 6-month waiting period.
If cost is genuinely prohibitive and financing isn't available, a bridge provides a functional solution now rather than waiting years to save up for an implant. Having some tooth replacement is better than having none, and the cascade of dental problems from long-term gaps (shifting teeth, bite problems, additional tooth loss) costs far more than either option.
The Supporting Teeth Lottery
Whether a bridge works out well comes down to the health of your supporting teeth.
Some people have strong neighboring teeth that handle the extra stress without problems. The bridge lasts 15+ years. The supporting teeth remain healthy throughout. When the bridge eventually needs replacing, those teeth are still solid enough to support another bridge. This is the best-case scenario, and it happens maybe 40-50% of the time.
Other people have neighboring teeth with existing fillings, previous root canals, or borderline health. The extra stress from supporting a bridge accelerates problems that were going to happen anyway. The bridge lasts 7-10 years before one of the supporting teeth fails. Now you're dealing with root canal treatment or extraction on what was supposed to be a stable support tooth. This happens 30-40% of the time.
Worst case, one of the supporting teeth develops a fracture or severe decay within a few years. The bridge fails early. The damaged tooth needs extraction. You've lost two teeth instead of one, and now you need either a longer bridge (compromising two more teeth) or implants (which you should have gotten initially). This happens 10-20% of the time, and it's financially devastating.
With implants, there's no lottery. Your neighboring teeth aren't involved. They remain healthy regardless of how the implant performs. If the implant fails (5-10% chance), it fails alone. You replace the failed implant without affecting anything else in your mouth.
How This Decision Gets Made
Most people choose bridges because the initial cost feels manageable.
£650 fits in most budgets. £2,600 doesn't, not without payment plans or saving up. The dentist presents both options, mentions that implants are "better" but bridges "work fine," and leaves the decision to you. You see the price difference, think "the bridge sounds good enough," and book the treatment.
This decision would be fine if bridges came with clear warnings about the 10-15 year replacement cycle and the risk to supporting teeth. But those warnings are often minimized. "Bridges can last 15 years or more" sounds great until you realize it means they usually last 10 years, and "more" is just occasional cases with perfect conditions.
The better approach is to consider the 20-year cost. If you're 35 years old, that tooth you're replacing needs to last another 50+ years. How many bridge replacements is that? Three? Four? How many supporting teeth will develop problems over that time? Will you eventually need implants anyway after those supporting teeth fail?
For younger patients, implants almost always make more financial sense long-term. The higher upfront cost is offset by zero replacement costs and zero complications on adjacent teeth. For older patients (65+), bridges make more sense because one bridge will likely suffice for the remainder of their life.
The Truth About Implant "Complications"
Implant failure happens. Not often, but it happens.
Success rates are 95-98% over 10 years. That means 2-5% of implants fail within the first decade. Most failures happen in the first year (failure to osseointegrate), with very few failures after year three once the bone integration is established.
Risk factors include smoking (reduces blood flow, impairs healing), diabetes (slows healing, increases infection risk), poor oral hygiene (bacteria can cause peri-implantitis, which is like gum disease around implants), teeth grinding (puts excessive stress on the implant), and insufficient bone density (implant doesn't have enough support).
When an implant fails early, it's usually obvious within 3-6 months. The implant feels loose or causes pain. Your dentist removes it, lets the area heal, and places a new implant. The second attempt has a much higher success rate because the problem is usually related to the specific placement or initial healing, not fundamental unsuitability for implants.
Late failures (after year three) are rare and usually related to neglect. Peri-implantitis from poor hygiene, excessive forces from teeth grinding, or bone loss from systemic health problems. These complications are preventable with proper care and regular dental checkups.
Compare this to bridge complications, which increase over time rather than decrease. The longer a bridge is in place, the more likely it is to develop problems. Ten-year survival rates for bridges are 79-94% depending on design, with most falling in the 85-90% range. That's good, but not as good as implants, and the failure rate keeps increasing after year ten.
What Actually Determines Longevity
Both bridges and implants last longer with proper care.
For bridges, longevity depends mostly on the health of supporting teeth. Strong abutment teeth with minimal existing dental work last longer. Teeth that already have large fillings or root canals are more likely to develop problems under bridge stress. Your dentist can predict bridge success reasonably well by evaluating those adjacent teeth before placement.
Oral hygiene matters enormously. Bridges that get cleaned properly (including the space underneath the pontic) last years longer than bridges where food and bacteria accumulate. The margins where crowns meet natural teeth need particular attention because decay at those junctions is the primary cause of bridge failure.
Material quality affects both aesthetics and durability. Porcelain-fused-to-metal bridges are strong but can chip. All-ceramic or zirconia bridges look better but cost more. Metal bridges (rarely used now) are extremely durable but look terrible. Most UK practices use zirconia for posterior teeth and all-ceramic for visible areas.
For implants, the titanium post lasts essentially forever if osseointegration succeeds. The crown on top experiences normal wear and might need replacing after 15-20 years (some last 30+ years). The main longevity concerns are peri-implantitis (preventable with good hygiene) and mechanical stress from grinding (manageable with a night guard).
Your bone quality and quantity matter for initial success, but once the implant is integrated, bone health stays stable as long as you maintain the implant properly. This is the fundamental advantage: implants preserve bone, while bridges allow bone loss, so implant success is self-reinforcing while bridge success gradually undermines itself.
The Economics of Multiple Missing Teeth
The cost equation changes when you're replacing several teeth.
One missing tooth: Implant wins financially over time (£2,600 once vs £1,200-£1,600 every 10-15 years).
Two adjacent missing teeth: Implant-supported bridge costs £3,500-£5,000 (two implants, 3-unit bridge), vs traditional bridge £1,000-£1,600 (4-unit bridge). The implant option is more expensive upfront but preserves neighboring teeth and never needs replacing.
Three adjacent missing teeth: Individual implants cost £7,800-£10,400, implant-supported bridge costs £4,500-£6,500 (two implants, 4-unit bridge), traditional bridge costs £1,500-£2,400 (5-unit bridge). The traditional bridge is significantly cheaper, but you're now compromising four healthy teeth to replace three missing ones. The long-term complications risk increases with the number of supporting teeth involved.
Four or more adjacent missing teeth: Individual implants become impractical (£10,400-£15,600+). Implant-supported bridge remains reasonable (£5,000-£7,500). Traditional bridge pushes the limits of what's mechanically sound (£2,000-£3,500). At this span length, partial dentures (£599-£699) become a viable alternative that doesn't compromise remaining teeth.
For extensive tooth loss (6+ missing teeth), implant-supported dentures or All-on-4 treatment (entire arch on four implants, around £8,000-£12,000) become the most practical solutions. Traditional bridgework at this scale is rarely recommended because it compromises too many healthy teeth and creates excessive mechanical stress.
Making Your Decision
The choice between bridge and implant comes down to three factors: age, budget, and time.
If you're under 50, implants make more financial sense unless budget constraints are severe. You'll need that tooth replacement for 40+ years. One implant at £2,600 beats three bridge replacements at £1,800-£2,400 plus complications on supporting teeth.
If you're 65+, a well-made bridge will likely last the rest of your life. The implant's superior longevity provides no practical advantage. Save the money, avoid the surgery, get the bridge.
If you need the tooth replaced immediately for work or social reasons, bridges provide a working solution in weeks. Implants take months. Sometimes timing matters more than long-term optimization.
If your budget is constrained and you can't finance treatment, a bridge at £650 is achievable where an implant at £2,600 isn't. Having some tooth replacement beats having none. The dental problems from long-term gaps cost far more than either option.
If your neighboring teeth are already heavily restored (large fillings, root canals, existing crowns), they're already compromised. Using them to support a bridge matters less because they're not pristine teeth anymore. The implant advantage of "preserving healthy teeth" means less when those teeth aren't very healthy to begin with.
If you smoke heavily or have uncontrolled diabetes, implant success rates drop significantly. Bridges become the more reliable option in these cases. Fix the health problems first if possible, but if not, don't pay £2,600 for an implant that has a 30-40% failure rate.
The decision isn't always obvious. But it's worth understanding what you're actually choosing between: a solution that weakens your neighboring teeth and needs replacing every decade, versus a solution that preserves your dental health and lasts indefinitely.