What types of dental bridges are available in London and which is best?
A patient came to us not that long ago – mid-40s, missing a lower molar after a failed root canal, already been quoted for an implant somewhere else but wasn’t a candidate because of bone loss. The implant clinic handed her a leaflet and basically wished her luck. She showed up at Islington Smiles with a printout, three completely contradictory opinions from Reddit threads, and genuinely no idea what the difference was between a cantilever and a Maryland bridge.
That’s so common it’s almost its own diagnosis. And honestly, that’s exactly why I’m writing this. Bridges aren’t a one-size-fits-all thing. What works depends on where the gap is, what shape the surrounding teeth are in, how hard you bite, what you care about aesthetically, and what you can actually afford. So let me try to cut through the noise a bit.
The Four Main Types of Dental Bridges
Traditional fixed bridges
are the most common a crown on each tooth either side of the gap (those are the abutment teeth), with a false tooth suspended in between (the pontic, if you want the technical term). They’re reliable, they’re well-researched, they can last 10–15 years with decent care. But here’s what most people don’t sit with long enough before deciding: you’re permanently altering two healthy teeth to support one missing one. That’s a real trade-off. Not a dealbreaker, but worth actually thinking about.
only use one abutment tooth instead of two, which sounds great until you realise why that matters. They’re fine in lower-stress spots – front teeth, for instance – but from what I’ve seen, cantilever bridges on molar sites cause fracturing of the supporting tooth over time, and that’s not a small problem. Bite force on back teeth can exceed 200 lbs per square inch. A single crown anchor genuinely wasn’t built for that.
use a metal or porcelain framework bonded to the backs of adjacent teeth – no crowning involved, which is the whole appeal. They’re minimally invasive and often £400–£700 cheaper per unit than a traditional bridge in London. Here’s the thing though: they debond. Longevity and strength just aren’t where you need them to be for every situation. For a front tooth with healthy neighbours? A Maryland bridge is genuinely elegant. For back teeth? We don’t recommend them as a first choice.
Implant-supported bridges
are where the field has been moving for a while now – implants placed at either end of the gap (or at intervals along a longer span), bridge attaches to those, no healthy teeth get touched. The longevity data is strong, like 20+ years isn’t unusually strong. Cost in London typically runs £4,500–£7,500+ depending on how many implants and how long the span is. Not accessible for everyone, and I want to be honest about that. But structurally, it’s the most sound option available right now.
The Honest Opinion Most Clinics Won’t Give You
OK so this is where conventional advice really falls down, and it drives me a bit mad when I see it repeated everywhere without nuance.
Most “bridge vs implant” comparisons assume the patient has a clean binary choice and perfectly healthy teeth on either side of the gap. But a lot of patients presenting with missing teeth also have compromised adjacent teeth – old fillings, early decay, crowns that are already there. In those cases, a traditional bridge isn’t “damaging a healthy tooth” at all… you’re placing crowns on teeth that need work anyway. That completely changes how you should be thinking about it.
At Islington Smiles, we’ve found that roughly 30–35% of patients referred for dental bridges actually benefit most from the traditional fixed approach – precisely because their adjacent teeth need restoration regardless. The bridge becomes efficient in that context, not destructive.
This is where most people get it wrong, by the way. They hear “a bridge means grinding down healthy teeth” and assume that applies to them. It might not.
Decision Debrief: Choosing Between Traditional and Implant-Supported for a Patient with Three Missing Teeth
The situation: A patient in her early 50s, three consecutive missing upper premolars. Options were a three-unit traditional bridge using the canine and first molar as anchors, or two implants supporting a three-unit implant bridge.
What we chose: Implant-supported.
Why: The canine – one of the proposed abutment teeth – was structurally solid with zero existing restorations. Grinding it down to support a bridge felt, honestly, indefensible. The molar on the other end had a large amalgam filling but was otherwise fine. Budget was a real factor – the implant route was about £3,200 more – but she had private dental cover that contributed £1,500. Once that narrowed the gap, she chose implants.
What surprised us: The healing. We expected clean osseointegration at the 12-week mark. One implant site integrated slower than expected – she’s a smoker (disclosed at consultation, though she’d “mostly quit,” which… okay that’s not quite right, but we work with what patients tell us). We extended the timeline by six weeks. The final result was excellent. But it reminded us – again – that disclosed risk factors change treatment timelines, not just outcomes. Every time.
Location of the Gap Matters More Than People Think
Aesthetics drive front-tooth decisions. Function drives back-to-tooth decisions. These are not the same problem and shouldn’t be treated like they are.
A missing upper lateral incisor is almost always better served by a Maryland or implant bridge because traditional bridges in that zone mean grinding down perfectly good canines – cosmetically unnecessary and structurally overkill. A missing second molar is a completely different conversation, because bite load is higher, implant placement is trickier back there, and second molars aren’t exactly on display when you smile. A traditional bridge in that spot is often a sensible, cost-effective call.
What Does a Bridge Actually Cost in London?
Rough figures for 2026, private treatment:
- Traditional 3-unit bridge: £1,800–£3,500
- Maryland bridge: £900–£1,800
- Cantilever bridge: £1,200–£2,200
- Implant-supported bridge (2 implants, 3 units): £4,500–£7,500+
NHS treatment covers basic bridgework under Band 3 – currently £319.10 – but material choices are limited and waiting times vary a lot across London boroughs. Worth knowing before you assume it’s a straightforward option.
So Which Is Actually “Best”?
Implant-supported bridges win on longevity and structural integrity. Full stop. But they’re not always the right answer and I think it’s important to say that clearly rather than just defaulting to “implants are best” every time.
If bone volume isn’t there, if health conditions mean surgery isn’t appropriate, or if budget is a genuine constraint and not just a preference, a well-placed traditional bridge from someone who knows what they’re doing will serve you for over a decade. That’s not a consolation prize. That’s a real outcome.
At Islington Smiles, our approach is to put the full picture on the table – trade-offs included and let patients actually decide, rather than steering anyone toward the most expensive thing. If you’ve been handed a leaflet and pointed at the door, or if you’ve got conflicting opinions and no idea how to weigh them up, come in and talk it through properly.
I’m still not 100% sold on every new technique that gets announced in the field, tbh – there’s always something being hyped. But the genuinely exciting stuff right now is zirconia materials, digital scanning that produces better-fitting pontics, and implant techniques that are getting more predictable year on year. What hasn’t changed is that the decision still comes down to your specific anatomy, your budget, and what you’re actually willing to live with long-term.
FAQs
How long does a dental bridge last?
Traditional bridges typically last 10–15 years with good oral hygiene. Implant-supported bridges often go past 20 years. How long yours lasts depends a lot on how well you look after the surrounding gum tissue and whether you clench or grind, which loads the whole thing differently than normal biting does.
Does getting a dental bridge hurt?
It’s done under local anaesthetic, so during the actual procedure, discomfort is minimal. Some sensitivity and mild soreness in the days after prep is normal, but most patients get through it fine with over-the-counter pain relief. Nothing dramatic.
Can you get a dental bridge on the NHS in London?
Yes — basic bridgework is covered under Band 3, which is currently £319.10. The trade-off is limited material options and variable waiting times depending on which borough you’re in. If aesthetics or material quality matter to you, it’s worth at least getting a private quote for comparison before committing.
How do you clean under a dental bridge?
Normal brushing won’t reach under the pontic, so floss threaders or interdental brushes are essential. Some patients do well with a water flosser. This isn’t optional maintenance – plaque build-up under the bridge is one of the main reasons bridges fail early, and it’s entirely preventable with the right tools and a bit of routine.
Is a dental bridge better than a denture for a single missing tooth?
In most cases, yes. A bridge is fixed in place, feels more like a natural tooth, and doesn’t need to be removed for cleaning. Partial dentures are removable and can feel less stable, though they’re sometimes the right call when multiple teeth are missing or when surgery isn’t an option. For a single gap with healthy adjacent teeth, a bridge – or an implant – is almost always preferable to a denture from a functional standpoint.
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