Types of Dental Bridges & Procedure Steps

What is a Dental Bridge?

A dental bridge is a fixed (permanent) restoration that replaces one or more missing teeth in your mouth. Dental bridges mimic the look, shape, and function of natural teeth. They are also custom-made for every patient.

In more serious cases, a patient may need multiple dental bridges. This is called "full mouth rehabilitation." If you have a lot of teeth missing, your dentist may recommend dentures instead.

Most dental bridges are made of porcelain. They are attached to a metal structure for support. Other dental bridges are made of “all-ceramic,” which is a combination of porcelain and other materials that are similar in appearance.

Before dental bridge placement, your dentist will remove a certain amount of tooth structure from the abutment teeth. Abutment teeth refer to the teeth supporting the dental bridge on each side. The amount of tooth structure removal required for dental bridges is the same for both the front and back teeth.

In a survey by the American Academy of Cosmetic Dentistry (AACD), dental bridges were the sixth most common dental procedure patients received in 2013 (28 percent). Participants could select as many procedures as applicable.

Dental Bridge vs. Dental Implant

Dental implants and dental bridges both replace missing teeth. Although, the cost, look, and outcome of the procedures vary.

When is a Dental Bridge Necessary?

Most dentists recommend bridges over implants if the patient already has existing dental crowns on the abutment (supporting) teeth. They may also recommend a dental bridge if you cannot get implants for medical reasons.

Similar to dental implants, patients may need a dental bridge after a tooth extraction or tooth loss, typically due to:

• Severe tooth decay
• Trauma or injury
• Periodontal disease
• Medications
• Old age

Almost 70 percent of adults between 35 and 44 years of age have lost at least one tooth from gum disease, an injury, tooth decay, or a failed root canal.

4 Types of Dental Bridges

There are four types of dental bridges, including:

1. Traditional Bridges

Traditional dental bridges are the most common type of dental bridge. They consist of ceramic, porcelain fused to metal, or all-metal like gold.

These bridges have one fake tooth, also called a pontic, that a dental crown holds in place on each side.

During a traditional dental bridge procedure, your dentist will shape and file the two teeth next to the fake tooth. This ensures the two dental crowns fit correctly. Traditional bridges are durable, strong, and last a long time with proper care.

Traditional bridges are typically used to restore posterior (back) teeth, such as premolars and molars.

2. Cantilever Bridges

Cantilever bridges are similar to traditional bridges because they are made of porcelain fused to metal.

However, to support a cantilever bridge, a patient must have one natural tooth next to the missing tooth.

In a cantilever dental bridge, a dental crown (artificial tooth) is placed over the unhealthy tooth on either side. This type of bridge is typically used to restore front teeth. Cantilever bridges aren’t strong enough to support molars (back teeth).

3. Maryland Bridges

Maryland bridges, also called adhesive bridges, are less invasive than traditional dental bridges.

They consist of a pontic (fake tooth) that is supported by a metal framework.

Maryland bridges are made of porcelain. They also have “wings” that bond to the adjacent teeth, which keeps the bridge stable. Today, most Maryland bridges have porcelain wings, instead of metal wings (pictured above). Porcelain looks almost identical to the color of your natural teeth.

Less tooth removal is necessary for Maryland bridges because they attach to the backside of the front teeth next to the missing tooth. Other types of dental bridges require more tooth structure removal before placement.

Maryland dental bridges are used to restore incisors (front teeth). They are rarely used to restore missing molars or canines. This is because canines are very important to your bite and Maryland bridges can shift or loosen easily.

4. Implant-Supported Bridges

Implant-supported bridges are supported entirely by dental implants, instead of a metal framework or dental crowns.

This type of bridge is typically used to restore back teeth, such as premolars and molars.

Implant bridges are ideal for patients who have at least three missing teeth (back molars) in a row.

Dental Bridge Procedure: Step-By-Step

Dental bridge procedures are separated into two appointments:

First Visit — Tooth Preparation and Temporary Bridge

During the first appointment, a local anesthetic is administered to ensure you are comfortable and do not feel any pain during the procedure.

Then, your dentist will shape and file the abutment teeth. All abutment teeth (teeth supporting the bridge) are prepared like a dental crown. This means all of the enamel and any additional tooth structure is removed to create a clear path to the other tooth.

After the teeth are shaped, impressions are made and sent to a dental laboratory. This is where your custom dental bridge is created.

While the permanent bridge is being made, the dentist will place a temporary bridge over the newly shaped teeth and gap. If the surrounding teeth are not strong enough to support a bridge, dental implants will be placed into your jawbone (implant-supported bridge).

Second Visit — Permanent Bridge Placement

Once the permanent bridge is ready for placement, you will return for the second appointment.

First, your dentist will remove the temporary bridge and clean your teeth. If there is any sensitivity or pain, a local anesthetic will be administered before removing the temporary bridge.

Your dentist will also take x-rays of the bridge to ensure it fits properly. Then, the bridge and teeth are bonded together using special dental cement.

Dental Bridge Aftercare

Oral Hygiene Tips

The aftercare routine for dental bridges and dental crowns is similar. Although, extra oral hygiene techniques are necessary after a permanent bridge is placed. This is because the area where the pontic (fake tooth) rests on the gums is difficult to clean, which can result in plaque buildup.

Patients should rinse with mouthwash often, brush at least twice a day, and regularly floss underneath the bridge. Doing so helps reduce inflammation and prevent cavities at the edge of the bridge.

Flossing between a dental bridge requires additional tools, such as floss threaders, super floss, or water flossers.

Pain Maintenance

Traditional, Maryland, and cantilever bridges are relatively painless procedures. Some patients may experience gum swelling or tenderness. Dentists recommend taking over-the-counter pain medications, such as ibuprofen, to manage the pain.

Implant-supported bridges require minor surgery, which may result in tooth sensitivity, gum tenderness, and jaw swelling for the first few days after surgery.

Food: What Not To Eat

While your permanent bridge is being made, your dentist will place a temporary bridge in your mouth to protect the newly shaped teeth. During this transition period, avoid eating or chewing:

• Sticky or chewy foods, such as gum and candy
• Hard foods, such as nuts and chips
• Ice cubes

It is also essential to chew on the opposite side of your mouth while the temporary bridge is in place. After the permanent bridge is applied, you should still avoid eating sticky and hard foods for 24 hours after the procedure. You can return to normal eating habits after this period.