What is a dental bridge? Types and procedure

Nichole McKenna

Written by Nichole McKenna DDS, Jack Lawrence DMD

Dental bridges are fixed tooth restorations mounted on adjacent dentition. The supporting teeth are called abutments and the fake tooth is referred to as a pontic. The aim is to blend in with the smile, making it easier to speak, eat, and laugh.

They may be used as an alternative to implants or partial dentures. It all depends on what the patient is comfortable with and what a dental professional recommends.

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Who benefits from a dental bridge?

Dental bridges are a great choice for patients with missing teeth and some healthy neighboring dentition left for support. Among other advantages, such a restoration can prevent tooth movement and facial sagging.

Nichole McKenna

Nichole McKenna, DDS

For patients that have supporting teeth that do not require any dental work, implants may be recommended instead. This is to preserve the healthy tooth structure of these teeth.

This option is not suitable for those who need a full mouth restoration or who have bite issues. A dental bridge requires your arches to fit together properly, otherwise it might come loose or fall out.

There are 4 popular categories of tooth bridges. They work very similarly and the procedure is almost the same. The type is usually chosen on the basis of the condition of the patient’s mouth as well as the cost of the dental bridge.

Traditional dental bridge

Traditional dental bridge

Picture by Authority Dental under CC 2.0 license

Dentists mount traditional bridges on two teeth that are adjacent to the gap you need to fill. These healthy teeth must be on either side. Crowns go on top of the abutment teeth and fake ones are placed in the middle.

This type of bridge is often quite small and lightweight. At the same time it offers a lot of chewing comfort. The pressure from your jaws is evenly distributed and complete breakage is unlikely and rare. Traditional bridges can last for up to 15 years.

The most common material is porcelain fused to metal, which does not have the great aesthetics of some full-porcelain restorations. However, these bridges are strong enough to replace back teeth, including molars.

Cantilever bridge

Cantilever tooth bridge

Picture by Authority Dental under CC 2.0 license

A cantilever bridge needs only one abutment tooth. This means that a dental crown is attached to an adjacent tooth, filling the gap next to it with another one.

It doesn’t provide enough support for molars, so it is only recommended for front tooth restorations. The Journal of American Science reports a higher incidence of complications such as fractures or loose crowns than with traditional bridges.

Cantilever bridges can be manufactured from porcelain-fused-to-metal, porcelain on its own, and zirconia. They last for up to 10 years.

Maryland bridge

Maryland dental bridge

Picture by Authority Dental under CC 2.0 license

Maryland bridges are similar to traditional ones, except they are reinforced with a metal framework. Two abutment teeth are necessary, but they don’t have to be fitted with crowns. This means a Maryland bridge is a reversible procedure.

Otherwise called a resin bonded bridge, they have plastic teeth and gum-like material. The metal parts are on the back, so they aren’t visible when you speak or smile. The condition is that your bite has to be very well aligned.

The metal attachments may discolor abutment teeth. This is why Maryland bridges are usually deemed temporary. They are commonly installed while patients are awaiting their implants to heal. If you take good care of it, however, they may serve around 10 years.

Maryland bridges are great at replacing front teeth. They are not strong or durable enough for back tooth replacement.

Implant-supported bridge

Implant supported dental bridge

Picture by Authority Dental under CC 2.0 license

Dental bridges can also be supported on dental implants. This may be an option for patients whose adjacent teeth are not strong enough to hold up the restoration, or are missing many back teeth. Small titanium posts are embedded in the jaw. A bridge, usually PFM, is seated on the posts once they have healed.

The biggest benefit of an implant-supported bridge is that it doesn’t need abutment teeth. This means that no dentition is damaged during the process. The implant also stimulates the bone, preventing resorption.

On the other hand, this type of bridge requires surgery and is a lot more expensive. Nonetheless, if you have several neighboring teeth missing, such an investment can make sense. A bridge supported by 2 implants is more cost-efficient than single rods. It is also more durable than a traditional bridge.

Dental bridge procedure

Dental bridges can often be installed in just 2 appointments. It all depends on the situation in your mouth and the type of bridge you need.

The first step is an exam of your mouth to make sure a bridge is the best option for you. Your dentist will inspect your teeth and check for signs of decay and gum disease. If you do have any such issues, they will be targeted beforehand. This visit is likely to include dental X-rays.

If the tooth that the bridge is supposed to replace is still in your mouth, it will be extracted about 2 weeks earlier. The soft tissues in your mouth must heal before anything else is done.

The abutment tooth or teeth will be filed down to accommodate the crowns. This happens under a local anesthetic to ease your discomfort. The dentist will take dental impressions and possibly a digital scan of your mouth. Those are sent off to a lab where your bridge will be made.

A temporary bridge will be fitted to protect the exposed teeth and gums. You’ll have to wear it until your restoration is ready to land in your mouth. This is usually made from temporary materials such as composite.

The next time you visit the office, the temporary bridge will be removed and the teeth underneath will be thoroughly cleaned.

Your permanent bridge will be cemented onto your abutment teeth. This may also require some kind of numbing agent, though it is not as invasive as the first step. You’ll be able to see the final result at this stage.

The dentist will ask you to bite down gently to make sure it all fits properly. This may feel a bit odd, but you will quickly get used to the change. If any adjustments are necessary, the dentist will do them right away.

It’s a good idea to visit your dentist once more after about 4 weeks to make sure you are taking care of your bridge properly. Aftercare is an important step. If you adhere to the instructions, your bridge can serve you for many years. A good idea is to invest in a floss threader to properly clean underneath the bridge.

Dental bridge near me

In order to avoid having your bridge come loose or fall out, it needs to be meticulously designed. Make sure you find the right professional to do the job. They must be experienced, skilled, and, ideally, affordable.

Authority Dental can help you find the best dentist near you. We have a huge network of specialists who all get great reviews. An appointment can be made for you whenever it’s convenient. The matching service is free.

We’ll take into account your insurance plan and preferred payment method. There are also financing options if you need them. We're available 24/7. Get started here.

FAQ

A dental bridge may be completed in as little as 2 appointments. They may each take about 2 hours. The visits are usually 2 weeks apart.

As with any dental restoration, it may take some time. The bridge will feel large and bulky at first, but you shouldn't have any trouble speaking, chewing, or sensing taste, as happens with dentures.

Most patients get used to having a dental bridge in their mouths after about 2 weeks.

Proper oral hygiene is the most important aspect of care. This goes for both your dental work as well as the remaining dentition. If the teeth that are supporting your bridge become damaged or infected, you may have to have a new one fitted.

Brush and floss your teeth and restoration every day. Gently move the string between the bridge and your gum to remove any food remains. Make sure to clean under your dental bridge and between the abutment and neighboring teeth too. Keep up with regular check-up appointments and professional cleanings. If anything is amiss, it’s best to catch it early on.

With proper care, dental bridges can last up to 15 years.

The biggest factor when comparing a dental bridge vs. implants is the price. Implants are a lot more expensive. Nonetheless, dentists may recommend an implant to patients considering replacement of a single tooth. Those are more durable and provide more comfort. They can be used and cared for as if they were natural teeth.

The downsides include the price and the fact that they take a long time to be completed. In some cases, the process can last up to 2 years including all healing periods. Additional procedures such as bone grafting may be necessary. What’s more, implants always require surgery.

References

  1. The Impact of Edentulism on Oral and General Health - NCBI
  2. Misaligned teeth and jaws: Overview - NCBI
  3. The Effect Of Different Preparation Designs And Cement Type On The Fracture Resistance Of All-Ceramic Cantilever Anterior Fixed Partial Dentures - ResearchGate