It’s as Good as New

If you lose a tooth, a dental bridge or implant can fill the gap. Here’s what to know about both options.

By: Dana Schwartz

Nora McCarthy had had her dental bridges only five years when she found out that they needed to be replaced. Hers was a common problem: Bridges, which fill the gap caused by a missing tooth, often last only seven to nine years.

It was not the first time she’d needed to replace a bridge. This time, McCarthy, 60, of Fort Washington, decided on a different option: implants.

“After years of dental work and bridges, I like my implants so much more,” she says.

McCarthy has had 14 implants put in by DC oral surgeon Steven Guttenberg. McCarthy was a good candidate because she had adequate bone in her jaw.

“Implants can replace almost any tooth,” Guttenberg says. “An implant actually helps to maintain the bone and the strength of the jaw.”

An implant, which is placed in the jaw like the root of a tooth, is made of titanium. It’s topped with a crown, which acts as the tooth. After an implant is positioned, the bone needs time to heal around the implant before a crown can be attached. Bethesda oral surgeon David Ross says that the entire process—placement of an implant and a crown—takes three months for the lower jaw and up to five for the upper.

During this time the dentist can place a temporary device, called a flipper, which flips in and out to fill the empty space. Or a temporary tooth can be bonded to the surrounding teeth until the bone is ready for the permanent crown.

Guttenberg says it can take as little as ten minutes to place an implant: An oral surgeon makes an incision in the gum, drills a hole into the jaw, then screws in the implant. Guttenberg performs the procedure under intravenous sedation so that the patient does not hear the drilling. If a patient prefers, he will use a local anesthetic. He says patients tell him that having an implant placed is less painful than having a tooth extracted.

Implants cost $1,500 to $3,000 each. A crown, which is then placed by a general dentist, costs $1,400 to $2,000.

Bridges cost $4,000 to $5,000, and getting a bridge requires that the two healthy teeth on either side of the missing one be carved down to have crowns put on them. These teeth act as an anchor for the replacement tooth. Implants do not require sacrificing of other teeth.

Guttenberg says that isn’t the only plus of an implant. In a bridge, he says, “not only are you exposing the crowned teeth to decay because the enamel that protects the teeth is shaved away, but those two healthy teeth are now doing the work of three.”

Ross says implants have a success rate of 98 percent. In some cases an implant comes loose because there is a buildup of soft tissue and the bone was not given a chance to heal. When an implant does fail, it can be replaced.

This article first appeared in the December 2008 issue of The Washingtonian. For more articles from that issue, click here