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Dentistry
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Malocclusion
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A dental bridge is a fixed (permanent) restoration that replaces one or more missing teeth. 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 bridges. This is called "full mouth rehabilitation." If you have a lot of missing teeth, your dentist may recommend dentures instead.
Most dental bridges are made of porcelain. They are attached to a metal structure for support.
Other bridges are made of all-ceramic, which is a combination of porcelain and other materials that are similar in appearance.
Before placement, a dentist or prosthodontist will also remove some structure from the abutment teeth. These are the supporting teeth on each side of the bridge.
The amount of tooth structure removal required is the same for both the front and back teeth.
Almost 70 percent of adults (35-44) have lost at least one tooth to gum disease, an injury, decay, or a failed root canal.
Most dentists recommend bridges over implants if you already have existing dental crowns on the abutment (supporting) teeth. They may also recommend a bridge if you can't get implants for medical reasons.
You may need a bridge if you lost a tooth or teeth to:
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, called a pontic. A dental crown holds it in place on each side.
During the 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. They typically only restore back teeth (premolars and molars).
Cantilever bridges are similar to traditional bridges. They are made of porcelain fused to metal. To support a cantilever bridge, you must have one natural tooth remaining 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).
Maryland bridges, also called adhesive bridges, are less invasive than traditional bridges. They have a pontic (fake tooth) that is supported by a metal framework.
Maryland bridges are made of porcelain. This material is nearly the same color as your natural teeth.
These bridges have “wings” that bond to the adjacent teeth, which keeps them stable. Today, the wings are usually made of porcelain instead of metal (pictured above).
Less tooth removal is necessary for Maryland bridges because they attach to the backside of your 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.
Implant-supported bridges are supported entirely by dental implants, instead of a metal framework or dental crowns. This type of bridge restores premolars and molars.
Implant bridges are ideal for patients who have at least three missing molars in a row.
Bridge placement is separated into two appointments:
During the first appointment, a local anesthetic is administered. This ensures comfort and reduces pain during the procedure.
Your dentist will then shape and file the abutment teeth. All abutment teeth (supporting teeth) 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, your 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).
Once the permanent bridge is ready, you'll return for the second appointment.
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.
Here are some tips for keeping your dental bridge in great shape:
The aftercare routine for bridges and crowns is similar.
However, extra oral hygiene techniques are necessary after a permanent bridge is placed. The area where the pontic (fake tooth) rests on the gums is difficult to clean, which can result in plaque buildup.
Rinse with mouthwash often, brush at least twice a day, and regularly floss underneath the bridge. These practices reduce inflammation and help prevent cavities at the edge of the bridge.
Flossing between a bridge also requires additional tools like floss threaders, super floss, or a water flosser.
Traditional, Maryland, and cantilever bridges are relatively painless procedures.
Some people experience gum swelling or tenderness. Dentists recommend taking over-the-counter pain medications like 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.
While your permanent bridge is being made, your dentist will place a temporary bridge to protect the newly shaped teeth.
During this transition period, avoid eating or chewing:
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. You can eat normally after this period.
A dental implant is an artificial tooth root. It's a popular tooth replacement option for a missing tooth caused by an injury, decay, or extraction.
Implants are surgically inserted into the jawbone and mirror the shape of a screw. They bond with your natural bone. Dental crowns (artificial tooth crowns) sit on top of implants.
A single implant is a great option if you have one missing tooth. However, if you have more than one missing tooth, a bridge or denture may be needed.
Dental implants and dental bridges both replace missing teeth. Although similar, the costs and outcomes of the procedures vary.
The cost of a dental bridge depends on the type chosen, the crown, and if you have insurance.
Insurance may cover up to 50 percent of the total cost of a bridge.
| Traditional or cantilever bridge | $2,000 to $5,000 — includes one pontic and two dental crowns |
| Maryland bridge | $1,500 to $2,500 — includes one pontic and the framework |
| Implant-supported bridge | $2,500 to $6,500 — per implant |
A dental bridge can last between 5 and 15 years (sometimes longer) with proper care.
If you maintain great oral hygiene and visit your dentist for regular cleanings, your bridge can last for many years.
A dental bridge procedure is relatively painless because your dentist will use a numbing agent before the surgery.
However, you'll likely feel some minor discomfort after the numbing wears off.
It depends.
An implant is a great option if you have just one missing tooth. It's also more natural-looking.
A bridge is a better option if you have more than one missing tooth. It's also typically less expensive than an implant.
Most people pay between $300 and $1,000 for a single tooth bridge.
Dental bridges don't make it more difficult to eat. But fixed bridges often provide better chewing function than removable bridges.
Temporary speech impairment may occur with a new bridge. This will resolve within a few days to weeks.
If you take care of your teeth and bridge, the risk of complications is low.
However, a bridge can fail if the surrounding teeth or dental cement deteriorate. If your surrounding teeth are healthy, and the bridge loosens, your dentist can likely re-cement it.
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