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Dental Bridges

A dental bridge is a prosthetic composed of a false tooth known as a pontic and two anchoring dental crowns, or abutments. The crowns are secured to the teeth on either side of a gap, anchoring the pontic in place of the missing tooth. The dental bridge is so called because it “bridges” this gap; though the pontic is secured with dental cement to prevent bacterial buildup between the prosthetic and the gums, there is no physical connection between the false tooth and the jawbone. Though bridges can be made from a variety of materials, including silver amalgam or gold, they are commonly made from porcelain for aesthetic considerations.

Placing a Dental Bridge – The Procedure

Dental Bridge Procedure

There is a multi-step process for placing dental bridges. If you are missing one or more teeth and are considering a solution, dental bridges may be right for you. However, you should be willing to commit to the following procedure:

Step 1 – Preparation of the Teeth: A dental bridge is anchored to existing teeth on either side of the gap being treated. These teeth must be prepared so that they can receive the abutment crowns. In order to provide space for the crowns – which are tooth-shaped prosthetics that fully encapsulate existing teeth – and to ensure a suitable bonding surface, the teeth on either side of the gap must be resized. This step is permanent; though the crowns can be replaced if necessary, they cannot be removed.

Step 2 – Taking an Impression of the Teeth: Once the surrounding teeth have been sufficiently modified so that the crowns can be placed over them, an impression will be made. The impression can be either digital or accomplished through the use of traditional dental putty; the method that is employed will depend on your dentist. Once this impression has been taken, it will be used to design and fabricate your dental bridge. Your prosthetic can be fabricated in a dental laboratory by trained ceramists or in-house through the use of a computerized milling machine. As with your impression, the technology that is employed will depend on the dentist.

Step 3 – Placing a Temporary Bridge: While your permanent bridge is being fabricated, a temporary bridge will be put in its place to serve as a placeholder. This temporary bridge will provide you with the functionality and appearance of your permanent prosthetic, and help safeguard the teeth that have been reshaped against damage or decay.

Step 4 – Receiving Your Permanent Dental Bridge: Once your dental bridge has been fabricated (in the case of in-office design and fabrication, this can be accomplished in a single dental visit), you will return to your dentist’s office to have your temporary prosthetic removed and your permanent bridge placed. The crowns will be securely anchored to the teeth on either side of the gap with dental cement, and the pontic will be secured to the gum tissue to prevent bacterial incursion.

Candidates for Bridges

Anyone who is missing one or more teeth is a candidate for a dental bridge. The surrounding teeth and gum tissue should be in good overall health, as they will serve as the foundation for the replacement prosthetic. Though a dental implant can also be used to treat a missing tooth, individuals who are hesitant to undergo oral surgery may find that dental bridges better suit their needs, as unlike a dental implant, the placement of a bridge requires no oral surgery. Though the anchoring teeth are modified to receive the abutment crowns, no drilling of the gum or bone tissue is necessary for the placement of a bridge.

  • Before
  • After
Photo Credit: Laurel Dentists

Types of Dental Bridges

Dental bridges are safe and effective replacement solution for patients with missing teeth. There are several types of dental bridges that can be used in patients. Talk to your dentist to find out which dental bridge type is right for you.

Traditional Bridge

Two crowns that are placed on the teeth on either side of the gap left by missing teeth support this type of dental bridgework. The false tooth or span of up to three teeth is attached to the crowns to fill in the gap. Traditional bridges are the most common type of dental bridge, and are made of ceramic or porcelain fused to metal (PFM). If there are no surrounding teeth to support the crowns, dental implants can be used to fix the bridge in place.

Cantilever Bridge

This type of dental bridge is used when there are teeth on one side of the gap in the mouth. The replacement tooth or teeth are fused to two crowns that are attached to the patient's natural teeth on one side only.

Maryland Bonded Bridge

This type of dental bridge is made up of plastic teeth and gums supported by a metal framework. The metal framework, or wings, is bonded to the back of the adjacent teeth. The bonded dental bridge is generally lower in cost than other types of bridges and is the most simple to apply.

Types of Bridge Materials

The false tooth, or pontic, that is used to replace missing teeth can be made from different materials, including:

  • All porcelain: all porcelain bridges look the most natural, but do not provide as much strength as metal bridges; all porcelain bridges are best suited to replace front teeth.
  • Porcelain fused to metal: Porcelain fused to metal bridges are tooth colored restorations that provide more strength than all porcelain bridges; porcelain fused to metal bridges are typically used on back teeth when aesthetics are a big concern.
  • All gold, silver, and alloys: All metal bridges offer a better fit, and more strength and durability than any other type of dental bridge; however, they do not offer the natural appearance that many dental patients desire.

Alternatives – A Single, Implant-supported Dental Restoration

The most common alternative to a dental bridge is a single restoration supported by a dental implant. An implant is a titanium post that is drilled directly into the jawbone to serve as an artificial tooth root. With the help of an abutment, a dental prosthetic such as a crown or bridge can be secured to the implant to serve as an artificial tooth. Because the implant is secured into the jawbone itself, it can provide decades, and in some cases a lifetime, of support. In effect, the dental implant becomes a new tooth, helping to prevent bone reabsorbment in the affected area and allowing for a durable, long-lasting, stable solution to your missing tooth.

However, it should be noted that dental implants are more expensive than traditional bridges, and the placement process involves oral surgery and a long healing process. For these reasons and more, some individuals are hesitant to undergo dental implant surgery. Bridges are an effective solution for the treatment of one or more missing teeth, and for many men and women, are both more convenient and affordable.

Considerations: Weighing the Risks and Benefits

Many older dental patients have lost some of their teeth because dental care wasn't as widely available in the past as it is today. Missing teeth can cause additional dental problems as the teeth shift and move out of place. Fortunately, there are various tooth replacement options on the market, including the placement of dental bridges. Dental bridges are best suited to patients who are only missing some of their teeth, and whose remaining teeth and gums are in good health.

Benefits of Tooth Replacement Bridges

Missing teeth can cause cosmetic, functional, and health problems for patients. The benefits of tooth replacement options include:

  • Prevents movement of remaining teeth
  • Prevents TMJ disorder
  • Improves bite problems
  • Improves problems with speech
  • Reduces risk of bone loss
  • Reduces risk of periodontal disease
  • Reduces risk of tooth decay
  • Provides additional support for the facial structure
  • Provides the ability to chew the foods that you like
  • Increases stability as compared to partial dentures
  • Increases comfort
  • Improves appearance
  • Improves self-confidence
  • Typically last 10 years or more

Many patients prefer dental bridges to dental implants or dentures. Dental implants are the most expensive tooth replacement solution on the market, they are typically used to replace just one or two missing teeth, and the treatment generally takes a total of six months to complete. Dentures can be used to replace a few teeth, or a full set of dentures can be fabricated to replace all the teeth in your mouth. However, many patients feel that dentures do not provide stability or a comfortable fit.

Limitations of Dental Bridges

The dental bridges procedure is an excellent treatment option for patients that are missing teeth. However, there are some limitations, risks, and side effects associated with the procedure. If you are considering undergoing dental treatment to address missing teeth, talk to your dentist about the teeth replacement options available to you, including bridges, dental implants, and dentures.

Bridges are an alternative to dental implants and dentures. However, they have their limitations as well. In order to undergo the dental bridges procedure, patients must have natural teeth that are strong enough to support the bridge, in addition to healthy gums. Further, bridges can generally only be used to replace up to two to three teeth in a row.

Risks and Side Effects of Bridges

The risks and side effects of dental bridges include:

  • Bridges are not removable, making them more difficult to keep clean
  • Some of the natural surrounding teeth will need to be removed to prep them for placement of the dental crowns
  • If surrounding teeth are not strong enough to support it or the bridge span is too long, the restoration can collapse
  • Dental bridges eventually need to be replaced; they typically last for several years
  • Some patients experience tooth pain and sensitivity in the days following treatment

What Are the Costs Associated with Dental Bridges?

The cost of a dental bridge will depend on a variety of factors, including the materials used, whether the bridge is designed and fabricated in-office or in a dental laboratory, the complexity of the placement procedure, and on the dentist’s experience placing bridges. Typically, a bridge can range in cost from $500 per artificial tooth to as much as $1,200 per tooth. Thus, a bridge with only one pontic will cost less than a bridge with two or three pontics. The best way to determine the cost of a dental bridge is to consult with a qualified and experienced dentist.

Unlike many purely elective procedures, dental insurance may cover in full or subsidize the cost of dental bridge treatment, as a missing tooth can greatly impair a person’ s oral health. If there are out-of-pocket expenses, however, it may be possible to finance these through companies which specialize in financing of medical and dental procedures.

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