"My back tooth got extracted, what now?" I get this question every week. And most patients think there's only one option, an implant. But in Germany there are actually several options, and an implant isn't always the best choice.

I treat the way I'd want to be treated. That means laying out all the options, with real prices, timelines, and risks. Because the better a patient understands the choice, the better the decision they make.

A dental bridge (in German Brücke) is a fixed restoration made of several connected crowns. The outer crowns are fixed on abutment teeth or implants, and the middle part replaces the missing tooth. Unlike a removable denture, a bridge feels like your own teeth. Today we're going through when a bridge is the right choice, when an implant is, what it costs, and what GKV covers.

3 types of dental bridges

1. Traditional bridge on crowns

The most common option. The dentist trims two neighboring teeth (which may have had fillings or crowns before), takes impressions, and the lab makes three connected crowns. Two are cemented on the abutment teeth, the third "hangs" between them and replaces the missing tooth.

Pros: fast (2-3 visits over 2-3 weeks), no surgery, cheaper than an implant, well-proven technology.

Cons: need to trim neighboring healthy teeth. If they already had fillings, fine. If they're healthy, it's a shame.

2. Adhesive bridge (Maryland bridge, Klebebrücke)

The artificial tooth is held to neighboring teeth via thin metal or ceramic "wings" bonded to the back surface. The abutment teeth are minimally trimmed, just a thin layer of enamel on the back.

Pros: minimally invasive to healthy teeth, can be done quickly, cheaper than a traditional bridge.

Cons: doesn't hold as firmly. About 20-30% come loose within 5-10 years. Mostly suited for front teeth with low chewing load.

3. Implant-supported bridge

Instead of trimming neighboring teeth, 2 implants are placed, and a three-crown bridge is fixed on them. Suitable when 2-3 teeth in a row are missing and the neighbors are healthy.

Pros: preserves neighboring teeth, the most durable solution (15-25+ years).

Cons: more expensive, requires surgery, 4-6 months for osseointegration.

Bridge or single implant: when to choose what

I get this question weekly. My direct approach:

Bridge BETTER if:

  • Neighboring teeth already have large fillings or crowns (they need crowning anyway)
  • Insufficient bone for an implant and you don't want a bone graft
  • Bisphosphonates, severe diabetes, or other contraindications to implantation
  • You want a fast result (2-3 weeks instead of 4-6 months)
  • Limited budget (a bridge is 30-50% cheaper than an implant)

Implant BETTER if:

  • Neighboring teeth are completely healthy, no fillings
  • Enough bone, no systemic contraindications
  • You're younger (implant lasts for decades, bridge 10-15 years then redo)
  • You want a long-term solution
  • You're willing to invest in your teeth long term

How much a bridge costs in Hamburg

Real 2026 prices:

  • Traditional porcelain-fused-to-metal bridge (3 units): 1500-2500 euros total
  • All-ceramic bridge (zirconia): 2500-3500 euros
  • Adhesive bridge: 600-1000 euros
  • Bridge on 2 implants (3 units): 4500-6500 euros

With Festzuschuss, GKV covers part of the cost depending on your Bonusheft:

  • No Bonusheft: 60% of the basic Regelversorgung
  • 5-year Bonusheft: 70%
  • 10-year Bonusheft: 75%

Real out-of-pocket (Eigenanteil) for a traditional PFM bridge with a 10-year Bonusheft: 600-1100 euros. For all-ceramic: 1500-2200 euros. All-ceramic is only subsidized at the PFM level, you pay the difference.

How I place a bridge: process A to Z

Traditional PFM bridge, typical sequence:

Visit 1 (1.5 hours)

Exam, X-ray, discussion of options. Filling out Heil- und Kostenplan, submitting to Krankenkasse. If you plan to use the Bonusheft, you confirm it's properly stamped.

Wait for insurance approval (1-3 weeks)

The Kassa reviews the plan and approves the subsidy.

Visit 2 (2 hours)

Anesthesia. Trimming the 2 abutment teeth. Taking impressions. Fabricating a temporary plastic bridge for 2 weeks. You can live and eat with the temporary.

Lab work (2-3 weeks)

The lab makes the final bridge. If you're a private patient, CAD/CAM can deliver in 1 week.

Visit 3 (1 hour)

Removing the temporary. Trying in the permanent bridge, checking the bite. Cementing. Care instructions.

Total: 3 visits, 4-6 weeks from first appointment to finished bridge.

Caring for a bridge: making it last 15+ years

What to do every day

🧵 Superfloss. Has a stiff end, a soft thickened section, and a thread. You can't clean under the pontic without it. At least once a day.

🪥 Interdental brushes (Interdentalbürste). Size chosen by your dentist. Clean the crown margins.

👨‍⚕️ Professional cleaning every 6 months. A regular toothbrush can't reach all the areas under a bridge. Professional cleaning is essential.

🔍 Follow-up X-ray every 2-3 years. You won't see decay under the crown on an abutment tooth. The dentist sees it on the X-ray.

⚠️ If you notice any early signs of loosening (clicking sensation, bad smell, gum bleeding), go to the dentist right away. Waiting risks the abutment tooth under the crown getting destroyed.