Dental Implants…Why not have a bridge instead?

Dental Implants…Why not have a bridge instead?

Dental Implants…Why not have a bridge instead?

A traditional bridge involves grinding down adjacent teeth into pegs to support the bridge. It is a stable solution with average esthetics and function that is fairly easy to make. However, this alternative has two main disadvantages: continuous bone loss in the missing area, and sacrificing healthy teeth on behalf of the bridge.

The teeth that are ground down on each side are much more susceptible to cavities and root canals. The average bridge only lasts 7-10 years. Often when the bridge fails, one or both of the ground down teeth is lost.

The next time the bridge is made, another tooth may have to be ground down to a peg to support the new bridge. This is the most aggressive, but yet most common way a single tooth is replaced. Most patients that had their teeth ground for a bridge regret it later in life. A bridge and an implant are about the same cost. In the long-term the bridge will end up being replaced several times in your life.
Dental Implants…Why not have a bridge instead?

In this picture shown above, this patient is only missing two teeth!  So in order to replace just the two center teeth, four other teeth had to be ground down. Two implants to replace the front teeth would have avoided the need for involving any of the other teeth. A two tooth problem, is now a six tooth problem!
Here is another one:
Dental Implants…Why not have a bridge instead
Three teeth ground down to replace just one!


  1. Nadya

    Hello Dr. Amin,

    Thank you for your great blog! I’m 54 and due to childhood trauma, I ended up with 2 root canals #8, 9 and 4 crowns in the front. I’m in the process of replacing the crowns but #9 has too little tooth structure. I’ve been told I need to get an orthodontic extrusion which seems too lengthy, costly and extreme.
    Are there any other options?

    I found out about root banking, and

    but was hoping if the endodontist could just put a post and build up and cement it to a bridge for full support since the other surrounding teeth are already crowned.

    Your reply and help would be much appreciated!

    April 11, 2019 at 9:35 pm Reply
    1. RamseyAminDDS

      yes..banking a root is somthing I do in ‘some’ cases. I just did this on 4 patients this month alone!

      April 18, 2019 at 5:17 am Reply
  2. DW

    Is there a such thing as one piece dental implants where the tooth and the post that goes into the jawbone (root) are made as one piece and the whole unit is inserted in the jawbone like a natural tooth?

    October 2, 2018 at 6:17 pm Reply
    1. RamseyAminDDS

      yes but they have a lot of problems. Generally two piece implant has much more versatility rather than being locked in by a single piece with no abutment

      October 8, 2018 at 2:00 am Reply
  3. H

    First of all I would like to say fantastic blog!

    March 24, 2015 at 11:46 am Reply
  4. Aimee

    Hi there!

    I’m in need of some advice, and was recommended your site! I had a root canal at age 12 on on top left molar. At age 25, I had it re-done. I’m now 28, and after numerous infections on the tooth, have finally thrown in the towel – the re-treatment seems to have failed, and it looks like I’ll need to extract the tooth to stop these recurring infections.

    As to what to do after the extraction – I’m aware I have 2 real options; an implant or a bridge. I’ve read extensively here and elsewhere about the pros and cons of the implant, and that was my natural first choice. However, after some additional x-rays, it looks like the tooth roots are in my sinus and it will likely involve a sinus lift and/or bone graft.

    I went in search of a second opinion, and was told that perhaps in this case, a bridge would make more sense. The invasive surgery required to make an implant work may not just be worth it – essentially, that the tooth just wasn’t a great candidate for an implant. It COULD happen, with lots of finagling and bit and bobs and back and forths and months & months of procedures, but the risks of failure would be higher than a quick, traditional implant. As well, the two teeth adjacent to the affected tooth both have quite large fillings, which apparently make it an okay candidate for a bridge.

    I’m just wondering – does this all seem reasonable? I do understand that implants are almost always ideal, but what situations exist that would make them not good options?

    And – is this one of those situations, where a bridge may actually be a better option?

    Thanks so much for your thoughts!

    March 21, 2015 at 3:17 pm Reply
    1. Ramsey Amin DDS

      Hi Aimee,

      A bridge may very well be the best option for you but of course I have never seen or evaluated your unique situation. Some of the information you have been told may be based on that particular providers experience with dental implants. Meaning for some dentists, these procedures are so unusual that they cannot really tell you with any degree of certainty a success rate. In my practice doing a lateral window or internal sinus lift would be a daily event with a high degree of success and not lot of fanfare to make it work.

      Unless your case is very unique, a sinus lift is not an invasive procedure.

      Keep in mind that the teeth that are anchored to a dental bridge often end up with root canals and cracks. Usually within 7-10 years a bridge in the back of the mouth will fail from recurrent decay around the edges. At that point you may end up losing those teeth in having a more complex dental implant reconstruction then your even considering at this point.

      I would suggest a third opinion before you making any irreversible decisions. If the tooth is still present, a well done socket preservation bone graft at the time of extraction will help reduce the invasiveness of the sinus procedure that will be needed after the tooth is removed.

      I find that most patients that end up having Bridges done in the back of the mouth regret that they did not have an implant the first time.

      sinus bone graft basics

      3-D evaluation of sinus

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      March 22, 2015 at 9:37 pm Reply
  5. Nicolay

    Hi dear Dr. Ramsey A Amin,

    First of thank you for your helping all of us here.

    I’m planning to get a bridge to replace a recently missing front tooth. Side teeth are capped so already worked on.

    There is some bone missing on the base where this tooth was, on the front side.

    Can this missing bone be regrafted to mate with bridge? Otherwise the tooth would have to be unnatural long.

    Basically would this graft without placing a implant be possible?

    There is a

    March 4, 2015 at 1:22 pm Reply
    1. Ramsey Amin DDS

      hi Nicolay,

      YES…definitely. A connective tissue gum graft will help bulk out the missing tooth area for it to look very good. This will allow you to possibly have what we call an ovate pontic…. These look much better!!

      This attached link should help you:
      The Ovate Pontic – Ramsey Amin DDS of Burbank Explains This Dental Implant Bridge Detail

      Good luck!!

      Dr. Amin

      March 4, 2015 at 11:04 pm Reply
      1. Nicolay

        Yes. That is what i want.

        Is it basically the idea of pressing a egg shape with substantial force in the dome?

        Would this tight fit, from the egg in the dome over time not subside, i.e. gum retraction?

        Is it alsn necassary to completely fill the cavity from the former tooth rooth?

        Would this still require flossing on this interface?

        March 5, 2015 at 2:31 pm Reply
        1. Ramsey Amin DDS

          yes you have the idea. You can subside over time but typically if the graft is done with connective tissue they tend to be very good. Sometimes you need a combination of a bone graft plus a connective tissue gum graft in order to form the ovate pontic that we discussed before. Yes, you would need to floss on this interface using a floss threader. The design is the most key element after having plenty of gum and bone to do this.

          Dr. Amin

          March 8, 2015 at 5:35 pm Reply
  6. Kathryn Fricks

    Hello. I’m not sure if I should get implants or root canals. My top upper right molar has already be extracted. I need a root canal on molar 14, next to where the previous molar was. I also need a root canal on tooth 31 and a crown on 30. I’m currently being treated for an abscess on tooth 31 and on antibiotics. This molar had a cavity filled previously and I don’t believe there would be a substantial amount of tooth left to build on as it has already been drilled on. The cost for both root canals is around $5000. Would implants in these areas be more beneficial and cost friendly?

    February 11, 2015 at 7:09 am Reply
    1. Ramsey Amin DDS

      Hello Kathryn,

      Dental implants are a close second placed your natural teeth.

      If the teeth can be predictably restored with a good long-term prognosis than I would suggest you keep them. If the prognosis is questionable at 10 years post treatment, you may consider extraction and replacement with a dental implant. Be sure to see a very skilled and knowledgeable dentist that has your best interest in mind for a good long-term outcome. You can also have these teeth evaluated by 3-D scan which will help make the decision easier.

      Dental Implant or Root Canal – Cost and Value Comparison
      3D Scan

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      February 15, 2015 at 1:36 am Reply
  7. Irene Cardito

    Dear Dr. Ramsey A. Amin, D.D.S,
    My mom (73) is in need of “new” permanent dentures. The old ones are being replaced due to infections, and bone loss. Her dentist had to, unfortunately, remove the “permanents”, which was a task and clean up the mess. In order to accomplish this procedure, she had much needed bone graphing.
    She really didn’t have good dental hygiene as a child.

    Anyway, she now has the renewed choice of making a decision to go with a locator denture or a fixed implant bridge.

    What do you recommend for her?

    Irene Cardito

    February 5, 2015 at 9:10 pm Reply
    1. Ramsey Amin DDS


      I like the way that you put the word new in quotations….. Permanent is a very strong word!! The other keyword that you used is “dentures”. There is no such thing as “permanent dentures.”

      Overdentures and “permanent dentures” are all made of plastic. They wear out and need to be replaced. They often trap a lot of plaque which leads to bone loss. My suggestion would be to have a fixed dental implant bridge such as the Prettau which is NOT plastic acrylic.

      This solution is as close to “permanent” as it can be as long as the dental implant and the bone are in excellent condition.
      A plastic over denture will also wear out is often replaced after 7-10 years. Sometimes it is a personal decision or a financial decision to do an overdenture rather than fixed dental implants though.

      Fixed implant steps

      Prettau Dental Implant Full Mouth Bridge


      Dr. Amin 😉

      February 16, 2015 at 5:13 am Reply
  8. I have a top and bottom partial but my other teeth are bad due to medications. I think I can deal with a full top denture, buy my lower has been a nightmare and I suspect even worse when I get the denture.
    Am I understanding that Dr. Amin is saying that there is an alternative to try prior to going the implant route. Sorry but I couldn’t understand if they were two separate or one procedure.
    I am in Texas and would definitely prefer you to work on me. A few years ago I was commuting to Burbank to tape a TV chat show for a new network. One day while taping I lost a front cap. Your office fit me in and was in and out within two hours and able to continue taping. The entire staff loved you …the crew because they were only slightly late and the executives who were going to have to pay a ton of overtime.
    I will always appreciate that.

    November 13, 2014 at 1:51 am Reply
    1. Ramsey Amin DDS

      Hello Jack,

      Thank you for your very kind words…. The show must go on!!! 😉

      You must determine if your lower teeth are savable by predictable methods and that they will last more than 5-10 years using conventional treatment such as root canals and crowns. Oftentimes the teeth have been restored and re-restored so many times that there is very little tooth structure left and there is bone missing. If there are other areas of missing teeth in the same arch, it may be more cost effective and yield a more cosmetic and long lasting result to extract and replace all the teeth on the lower.

      Each situation is very unique in must be evaluated carefully. Many patients and my office opt to have a Prettau dental implant bridge. This must be extremely carefully planned and executed for it to turn out right. Do not be fooled by imitations or people claiming they can do the same for a very low price. You would not imagine how many times a have to redo this procedure for patients who already have spent thousands of dollars.

      Prettau Dental Implant Full Mouth Bridge

      Call my office and let me know when you will be in town. Give us as much notice possible to try to accommodate your time schedule. The holidays are always busy.

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, CA

      November 17, 2014 at 12:29 am Reply
  9. M J Borer md

    Where can I get a copy of The fellows of the American Academy of implant dentistry here in San Diego ZIP Code 92128 or close by North County In land or North County coastal San Diego thank you. Mike. Borer

    August 31, 2014 at 9:18 pm Reply
    1. Ramsey Amin DDS

      Hello MJ,

      You will find some very skilled dentists here:

      Some dentists are dual certified by the American Board of Oral Implantology also.

      Very respectfully,

      Ramsey A. Amin, D.D.S.

      September 2, 2014 at 7:28 pm Reply
  10. My mouth looks very similar to the picture showing 2 missing teeth with 4 others ground down. In my case, only one eye tooth is ground down and the other is fine. Can/should 1 permanent implant be joined/abutted to my 2 eye teeth?

    July 16, 2014 at 1:46 am Reply
    1. Ramsey Amin DDS

      Hello Janice,

      Connecting a dental implant to a natural tooth is almost never a good idea. The dental implant and the natural tooth move it to different rates and dimensions. As they move, the seal is broken on the natural tooth and bacteria get under the margin.

      The bottom line is that the teeth and up getting cavities because of a difference in this movement. Connecting dental implants to dental implants is fine, just tried to avoid connecting a dental implant to your own tooth. It is done in very rare instances and used to be done more in the 1970s but there were so many failures, that most people don’t do it anymore.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      July 18, 2014 at 1:28 am Reply
      1. Liz Shaw

        could you give me the names of qualified dentists to do implants in San Francisco, Calif.

        September 10, 2014 at 6:42 am Reply
        1. Ramsey Amin DDS

          Find The Dental Implant Experts — Ideally find someone who has both the ‘F’ and ‘D’ status described below!

          How to Choose an Implant Dentist

          American Academy of Implant Dentistry Credentialed Members

          Find an experienced and credentialed dental professional in your area. AAID credentialed members are actively engaged in active practice incorporating dental implants. Following are explanations of the credentials:

          Associate Fellows (AF) have been certified by their peers and have met national standards of education and practice in oral implantology.

          Academic Associate Fellows (AAF) are dentists who are employed as faculty or administrators by accredited dental schools on a full time basis and who are involved in the discipline of implant dentistry.

          Fellows (F) have been certified by their peers and have met national standards of education and practice in oral implantology. Due to the more extensive experiential requirements for Fellow Membership, Fellows are required to demonstrate advanced knowledge and experience in implant dentistry.

          Diplomates (D) are AAID members who have become Diplomates of the American Board of Oral Implantology/Implant Dentistry (ABOI/ID). The ABOI/ID is a certification agency that serves independently to protect members of the public who seek dental implant care. The designation signifies that these dentists have met the highest criterions in oral implantology – they have met educational and experiential standards; and, they have reached an in-depth level of knowledge and acquired a proficient level of skill and ability.

          September 10, 2014 at 5:30 pm Reply
  11. mel Niser

    I live in Tamarac, Fl, (Fort. Lauderdale,FL). Learned a lot about implants and bridges. Thanks.

    June 7, 2013 at 7:56 pm Reply
    1. Catherine Yanuric

      Please answer my question. What would be the best option? Dental bridge or implant? I already have a bridge but I’m planning to replace it because it appears so big and bulky and I’m not satisfied with the outcome. Please reply

      August 21, 2017 at 4:52 am Reply
      1. RamseyAminDDS

        There is not enough information to answer that but the dental implants are not likely to be smaller if a bridge that is on natural teeth is too big.

        August 26, 2017 at 5:35 am Reply
      2. RamseyAminDDS

        Too vague to answer

        August 26, 2017 at 5:35 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!