Bridges

A bridge is an alternative to an implant or a denture designed to replace one or more missing teeth. If a tooth is lost, it is important to replace it with an artificial tooth as soon as possible to prevent the remaining teeth from tipping or drifting out of line. The imbalance caused by missing teeth can lead to bite disorders, predispose to jaw joint (TMJ) problems or gum disease. Missing back teeth can create or exacerbate a “deep bite” leading to collapse of the bite and lower face, giving a more aged appearance. An early loss of front teeth affects facial esthetics, speech, and often has social implications.

A bridge spans the space where the teeth are missing. A bridge is cemented to the natural teeth or implants surrounding the gap, so called the abutments. A replacement tooth, called a pontic, is attached to the crowns (“caps”) that cover the abutments.

There are other types of bridges available as well. An inlay bridge is supported by inlay(s) rather than by crowns. A cantilever bridge is supported by one or more crowns on only one side of the space where the tooth is missing. A bonded bridge consists of a replacement tooth with “wings” bonded on both sides of the gap to the inside of your existing teeth. In general, such bridges are not as durable as traditional ones, and tend to come loose or fall out.

As with crowns, there is a wide choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth/teeth, its function, esthetic considerations and cost.

There are some disadvantages of placing a tooth-supported bridge. Bridgework compromises the integrity of the supporting teeth, both by reducing their size to place the bridge, and by causing more pressure and stress on them. This can cause the supporting teeth to degrade or fail in the future. As there is no root in the bone or supporting the gums at the site of the missing tooth/teeth, the gums and bone will recede over time. This can cause other teeth to fail, sunken looking spots in the jaw, and necessitate bone grafts should you want implants in the future. Bridges are also not considered permanent solution – they can require replacement after 10-15 years, especially if bone has resorbed or if the gum line has recessed.

You will receive detailed care instructions at the conclusion of your treatment. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. The most important step you can take to ensure the longevity of your bridge is to maintain good oral hygiene (brushing with fluoride toothpaste twice a day and flossing daily) and to visit your dentist and hygienist regularly for check-ups and professional cleanings.