Bridge or Implant After a Tooth Extraction? What to Do With the Space
Updated: 5 days ago
After a tooth extraction, the space can be filled with a dental implant or a bridge, or sometimes simply left alone, and the right choice depends mostly on what each one asks of your healthy teeth. An implant is a small post, usually titanium, placed in the jawbone to act as a new root, with a crown on top. A bridge is a false tooth held in place by crowns on the teeth either side of the space.
Hmm. So a couple of months ago I had this tooth taken out, and now I'm thinking, what do I do with the space? Do I go with the bridge, or a dental implant? Or do I just leave it? It is something we hear all the time. It is a conversation we have multiple times a day here, so let me tell you more about these options. My name is Dr. Kevin Zhang. This is Meraki Dental in South Surrey.
The short version
• Leaving the space is a real option for some gaps, usually at the back, but over years the neighbours can tilt and the bone shrinks.
• An implant replaces the root and leaves the teeth beside it alone. It needs a small surgery and a couple of months of healing.
• A bridge is quicker with no surgery, but the teeth either side are shaped down for crowns, and that enamel does not grow back.
• Both are good options, just different. A free 60-minute implant consultation tells you which fits.
Written from Dr. Kevin Zhang's own explanation. Dr. Kevin is a general dentist and co-owner at Meraki Dental in South Surrey. Reviewed against the sources listed below on 2 October 2026.
Do I need to replace a missing tooth?
Not always, and I would rather tell you that up front. Whether a space needs filling depends on where it is, what it does to your bite, and what you want from it.
If the missing tooth was at the very end of the row, a wisdom tooth or sometimes a second molar, many people chew perfectly well without it and nothing much changes. If the space is further forward, if it shows when you smile, or if you notice yourself chewing on one side, it is usually worth replacing. The teeth in front of and behind a space have nothing to lean on, and the tooth above or below it has nothing to bite against. That is where the slow changes start.
So leaving the space is a legitimate choice. It just should not be an accidental one. If you decide to leave it, we look at it at your check-ups, with an x-ray now and then, so that if something starts to move, you hear about it early.
What happens to the gap if you leave it?
Three things, and mostly slowly. Here they are with what the research actually found, because the internet tends to make this sound faster and scarier than it is.
The neighbours tilt. The teeth either side lean into the space. A study that followed 116 untreated back-tooth spaces on x-rays found the gap closed by less than 1 mm on average in the first year, and after the first two years the movement was usually gradual and minor (Gragg and colleagues, 2001).
The opposite tooth drifts. A tooth with nothing to bite against slowly creeps out of its socket, which dentists call over-eruption. One study found it in 92% of back teeth left without a partner, by 1.68 mm on average (Craddock and colleagues, 2007). That sounds small, but it can be enough to make a later bridge or implant harder to fit.
The bone shrinks. Once the root is gone, the ridge of bone that held it shrinks. A systematic review found the ridge lost 29 to 63% of its width and 11 to 22% of its height in the six months after an extraction, with the fastest change in the first three to six months (Tan and colleagues, 2012).
What a space can do over time, if it is left. The same information is written out above.
One more, from a study that followed teeth for ten years. Teeth next to an untreated space survived less often (81%) than teeth next to a space filled with a bridge (92%) (Aquilino and colleagues, 2001). That study looked back at records rather than running a trial, so I treat it as a signal, not a verdict. But it is the honest reason I do not tell people that leaving a space costs nothing.
What is the difference between a bridge and an implant?
Where the support comes from. An implant brings its own. A bridge borrows it from the teeth beside the space.
The implant. Let's say this is your space, the tooth came out a couple of months ago, and everything is all healed up. A dental implant goes into the jaw, and it's kind of like growing the root of a tooth. We place it, let everything heal, and then a tooth goes on top of the implant. It feels and functions just like a natural tooth.
We don't need to touch, or worry about, any of the surrounding teeth. It can function by itself.
The bridge. A bridge is three teeth joined together: a false tooth in the middle, held by crowns on the supporting teeth on both sides. It is an easy process to make, and there is no surgery. The only downside is that we have to prepare the teeth on either side to support it. Prepare means shaping them down so a crown fits over each one. In a lab study that weighed teeth before and after, a full crown preparation removed roughly two-thirds to three-quarters of the visible part of the tooth (Edelhoff and Sorensen, 2002).
If those teeth already have big fillings or old crowns, that matters less, because they may need crowns anyway. If they are untouched, healthy teeth, that is the real cost of a bridge, and the enamel does not grow back. To be fair to bridges, the technology has moved on for them too. Where a bonded design suits, usually for a front tooth, a thin wing is bonded to the back of the neighbouring teeth instead, and the same lab study found those designs removed far less tooth.
Bridge or implant: which is better?
Neither, in general. Both are good options. They are just different. Which one is better for you depends on the teeth beside the space, the bone under it, your general health, and how you feel about a small surgery. Here they are side by side, in order of what they ask of your healthy teeth. The first one is doing nothing.
Three options, in order of what they ask of your healthy teeth. The same information is in the table below.
Option | What it asks of your healthy teeth | Surgery and time |
Leave the space | Nothing today. Over years, the neighbours can tilt and the opposite tooth can drift. Fine for some back spaces, and we watch it at your check-ups | No surgery. Check-ups only |
Implant | Nothing. The teeth either side are not touched. It needs enough bone, and sometimes a graft first | A small surgery, planned in advance, then a couple of months of healing before the crown |
Bridge | The two teeth either side are shaped down for crowns, and that enamel does not grow back. A floss threader keeps it clean underneath | No surgery. Usually two visits |
Neither the implant nor the bridge is covered by the CDCP. More on that below.
How long they last is closer than people expect. A systematic review of implants carrying a single crown found 97.2% of the implants still in place after 5 years and 95.2% after 10. The crowns on top did a little less well, 96.3% at 5 years and 89.4% at 10, because a crown can chip or loosen and need redoing even when the implant underneath is fine (Jung and colleagues, 2012). For bridges held by natural teeth, a systematic review found 89.1% still in place after 10 years (Tan and colleagues, 2004). Both last a long time if you look after them. Neither lasts for life.
A few honest rules of thumb from my side of the chair:
If the teeth either side are healthy and untouched, an implant is the option that leaves them that way.
If the teeth either side already need crowns, a bridge can solve more than one problem at once.
If surgery is not right for you at the moment, for health reasons or simply because you would rather not, a bridge or a removable partial denture still replaces the tooth.
If the space is at the very back and does not bother you, leaving it and watching it is fine.
Not sure which one suits your space?
60 minutes, at no cost. We talk through all three options, not just the implant.
How long after an extraction can I get an implant?
Sometimes the same day. It depends on how the site heals, not on a fixed date on the calendar. The International Team for Implantology describes four timings: placing the implant at the same visit as the extraction; once the gum has healed over but before the socket fills with bone; once the socket has filled with bone; or into a fully healed site. Which one fits depends on the bone and gum around that particular tooth.
What I tell people is this: talk to us before the tooth comes out if you can, or soon after. The bone shrinks fastest in the first three to six months, so a plan made early has more options in it. If it has already been a while, that is fine too. Often it just means a bone graft first, and at Meraki we are equipped to place, graft and restore most implants in-house.
Once the implant is in, we let it heal for a couple of months. Then the tooth goes on top of it, and the dental implant is complete.
Does getting a dental implant hurt?
Usually much less than people expect. Nowadays we do everything pre-planned, and everything is very precision driven. The implant is placed into the jawbone under freezing, with minimal trauma, and honestly, the healing is usually a couple of days of sore gum, and that's about it. If you are anxious, tell us when you book. We offer oral sedation, and we will plan around you.
Afterwards, an implant will feel and chew and function just like a natural tooth. We still need to brush it and floss it. Otherwise, it will serve you for a long, long time.
Is an implant expensive, and does the CDCP cover it?
Yes, it does cost a little bit, and no, the CDCP does not cover implants or bridges. I will not quote a price here, because the real number depends on whether you need a graft and what goes on top, and a number without your x-ray is a guess. You get the numbers in writing before anything starts.
The way I think about it, we are very much investing in the long-term future. Spread over the years an implant serves you, the cost compares well to suffering with a missing tooth and not being able to enjoy the food and the lifestyle that you deserve.
On coverage: the Canadian Dental Care Plan excludes implants, anything that sits on an implant, bone grafts and bridges. A partial denture is covered once the plan approves it first, so if you are on the CDCP, that is worth knowing before you choose. Our guide to what the CDCP covers walks through it. Private plans vary a lot on implants. We help you find out what yours will cover beforehand, and we bill your insurer directly.
Want to know what your own space needs?
When should I call about the space?
Most of the time, there is no rush. A healed space is not an emergency. These are the situations that should not wait:
What you notice | What it can mean | What to do |
A healed space at the back, no pain, and chewing is fine | Nothing urgent | Bring it up at your next check-up |
A tooth is about to come out, or just has | The best time to plan | Ask about an implant now, while every option is still open |
Food packing into the space, or a neighbour sore when you bite | A neighbour starting to tilt, or a gum pocket | Book a check-up in the next few weeks |
Pain getting worse a few days after an extraction, or a bad taste | A dry socket or an infection | Call us today |
Swelling in the face, or a fever | Infection | Call us today. If swelling makes it hard to swallow or breathe, go to the emergency department |
A bridge that feels loose, or a bad taste around it | Cement washing out, or decay underneath | Call us this week |
If you need us today, we keep time for emergency exams Tuesday to Saturday, and you can book an emergency exam online.
Bridges and implants at Meraki Dental in South Surrey
Meraki Dental, South Surrey.
A few practical things, since people ask them at the front desk:
A free implant consultation, and a proper one. It runs 60 minutes. We look at the space, the bone and the teeth either side, and talk through all three options, including leaving it. You request a time online, and our front desk confirms it with you.
Implants done in-house. I place implants at Meraki, and we are equipped to place, graft and restore most implants here, so most cases stay with the same team from start to finish. There is more on our dental implants in South Surrey page.
Days and languages. I am in on Wednesdays and Saturdays. Dr. Vivian Huang is in on Tuesdays and Thursdays, and Dr. Rupi Dhami on Fridays and Saturdays. Between us you can be seen in English, Mandarin or Punjabi. Meet the team.
Open Tuesday to Saturday, 9am to 5pm. 2940 King George Blvd, Unit 100, Surrey, with free parking on site and on the street.
Rated 4.9 on Google from 142 reviews, at the time of writing. And if you come in on a day Dr. Vivian is working, you may meet Jasper, the small dog who comes to work with her.
Frequently asked questions
Is it better to get a bridge or an implant?
Neither is better for everyone. An implant replaces the root and leaves the teeth either side untouched, but it needs a small surgery and a couple of months of healing. A bridge needs no surgery and is quicker, but the teeth either side are shaped down for crowns. If those teeth are healthy, an implant usually makes more sense. If they already need crowns, a bridge can be a good fit.
What happens if you don't replace a missing tooth?
Often not much at first. Over months and years, the teeth either side can tilt into the space, the tooth opposite can drift out of its socket, and the bone under the space shrinks, fastest in the first three to six months. For some back spaces that is acceptable, and leaving it is a fair choice. A dentist should check it at your regular visits so any change is caught early.
How long after a tooth extraction can you get an implant?
Sometimes the same day as the extraction, and sometimes weeks or months later, once the gum or the bone has healed. It depends on the bone and gum around that tooth, not on a fixed date. The bone shrinks fastest in the first few months, so it helps to plan before or soon after the extraction. Waiting longer is still possible, but it can mean a bone graft first.
Do I need to replace a missing back tooth?
Not always. If the missing tooth was at the very end of the row, many people chew well without it, and leaving the space is reasonable. If it is further forward, if you find yourself chewing on one side, or if the tooth opposite has nothing to bite against, replacing it is usually worth considering. A check-up with an x-ray tells you which group you are in.
Does a dental implant hurt?
Most people find it much easier than they expected. The implant is placed under freezing, and the procedure is planned in advance so it is precise and gentle on the gum and bone. Afterwards, the healing is usually a couple of days of sore gum. Oral sedation is available at Meraki Dental if you are anxious. Tell us when you book and we will plan around you.
Does the CDCP cover dental implants or bridges?
No. The Canadian Dental Care Plan excludes dental implants, anything that sits on an implant, bone grafts and bridges. It does cover partial dentures once the plan approves them first, which is another way to replace a missing tooth. Private insurance varies a lot for implants. Meraki Dental can help you check what your plan covers before treatment, and bills insurers directly.
How long do dental implants and bridges last?
A long time, for both. A 2012 systematic review found 95.2% of implants carrying a single crown still in place after 10 years, and 89.4% of the crowns on top still in place. A 2004 systematic review found 89.1% of bridges held by natural teeth still in place after 10 years. Brushing, flossing and regular check-ups matter for both, and neither lasts for life.
Book an implant consultation in South Surrey
So, bridge, implant, or leave the space? The two fixed options are both good. They are just different, and the right one is the one that fits your teeth. Come in and let's have a chat. It takes 60 minutes, it costs you nothing, and you are not committing to anything by coming in. We're a fun and casual bunch. We do take our work very seriously, though. We look forward to meeting you!
Or call 604-385-1823. Meraki Dental, 2940 King George Blvd, Unit 100, Surrey, BC V4P 0E4. Tuesday to Saturday, 9am to 5pm. Rated 4.9 from 142 Google reviews at the time of writing.
Sources: Gragg KL, Shugars DA and colleagues, Movement of teeth adjacent to posterior bounded edentulous spaces, Journal of Dental Research, 2001. Craddock HL and colleagues, Occlusal changes following posterior tooth loss in adults, Part 1, Journal of Prosthodontics, 2007 and Part 2. Tan WL, Wong TL, Wong MC, Lang NP, A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans, Clinical Oral Implants Research, 2012. Aquilino SA, Shugars DA and colleagues, Ten-year survival rates of teeth adjacent to treated and untreated posterior bounded edentulous spaces, Journal of Prosthetic Dentistry, 2001. Jung RE and colleagues, Survival of single crowns on implants, a systematic review, Clinical Oral Implants Research, 2012. Tan K, Pjetursson BE, Lang NP, Chan ES, Survival and complication rates of fixed partial dentures, Clinical Oral Implants Research, 2004. Edelhoff D, Sorensen JA, Tooth structure removal associated with various preparation designs, anterior teeth, Journal of Prosthetic Dentistry, 2002 and posterior teeth, International Journal of Periodontics and Restorative Dentistry, 2002. International Team for Implantology, consensus statements on implants in post-extraction sites. Government of Canada, what the Canadian Dental Care Plan covers. Review count from Google, 2 October 2026.
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