Alternatives to Dental Implants: Bridges, Dentures and More

The main alternatives to dental implants are bridges, partial or complete dentures, and, in some cases, leaving the gap. Bridges and dentures are available on the NHS as Band 3 treatments, while implants are usually private.

Implants get a lot of attention, but they are not the only way to replace missing teeth, and they are not right for everyone. Bone loss, health conditions, cost or simply not wanting surgery can all point towards another option. This overview sets the choices side by side so you can have a more informed conversation with your dentist.

What are the alternatives to dental implants?

NHS England’s band guide lists bridges and both plastic and metal dentures under Band 3, currently £332.10. The NHS describes implants as usually only available privately, though sometimes provided on the NHS for patients who cannot wear dentures for certain reasons.

When is a bridge a good alternative?

The Oral Health Foundation describes a bridge as a fixed device that replaces one or more missing teeth, anchored to neighbouring teeth or implants. A traditional bridge uses crowns on the teeth either side of the gap; an adhesive bridge is bonded to the back of nearby teeth and is often used for front teeth. With good care, the Foundation says, a bridge can last many years.

The trade-off is the neighbouring teeth. Guy’s and St Thomas’ NHS Foundation Trust notes that implants are used when a dentist does not want to put crowns on healthy teeth, which is exactly what a traditional bridge needs. If the teeth next to the gap already have large fillings or crowns, that matters less.

When are dentures a good alternative?

Dentures can replace one tooth or a whole arch. The NHS says complete dentures replace all upper or lower teeth and partial dentures replace one or more, and that it can take a few weeks to get used to them. Cleveland Clinic lists improved chewing, speech and appearance among the benefits, but notes traditional dentures can shift or slip, and that bone loss after tooth loss can change the shape of the face over time.

Dentures don’t involve implant surgery, and Guy’s and St Thomas’ lists a different denture design as one of the alternatives to implants. The NHS adds that dentures can last for years with proper care, though they may loosen as gums and jawbone change with age.

Is leaving a gap an option?

Guy’s and St Thomas’ includes no treatment among the alternatives to implants. Whether that is sensible depends on where the gap is and how it affects chewing, appearance and the surrounding teeth, so it is a question to discuss with your dentist rather than decide alone.

How do you choose between them?

1. Health of the neighbouring teeth. Healthy teeth either side may push towards an adhesive bridge or an implant rather than crowning them.
2. Number and position of missing teeth. Bridges replace one or more teeth in a gap; dentures can replace a few teeth or a whole arch.
3. Bone and gum health. Implants need enough healthy jawbone, or a bone graft first.
4. General health and smoking. Guy’s and St Thomas’ says smokers have a higher risk of implants not joining with the bone.
5. Budget and NHS eligibility. Bridges and dentures are Band 3 on the NHS; implants are usually private.
6. Preference for fixed or removable. Some people strongly prefer teeth that don’t come out.

For detailed head-to-head comparisons, read dental implants vs bridges and dental implants vs dentures.

Sources

• NHS, Dental treatments
• NHS, What is included in each NHS dental band charge?
• NHS, Dentures (false teeth)
• Oral Health Foundation, Bridges
• Guy’s and St Thomas’ NHS Foundation Trust, Dental implants
• Cleveland Clinic, Dentures

This article is general information and is not a substitute for advice from your own dentist.