What is a dental bridge?
A fixed bridge is one piece made of three or more teeth joined together. The teeth on each side of the gap are shaped and crowned, and the replacement tooth in the middle is attached to those crowns. The whole bridge is cemented in, and only a dentist can take it out.
Filling the gap matters more than it looks. When a tooth is missing, the teeth beside it tend to tip into the space, the tooth above or below drifts toward it, and chewing moves over to the other side. A bridge keeps the teeth around the gap where they belong.
Bridge, implant or partial denture?
There are three usual ways to replace one missing tooth, and none of them is right for everybody. If a bridge or a partial will serve you better than an implant, we would rather tell you that than sell you the more expensive option. The honest trade-offs:
- A bridge is fixed, feels much like your own teeth, and usually takes two appointments. The cost is that the teeth on either side have to be shaped for crowns. If they already have large fillings, that is a fair trade. If they are healthy and untouched, it is a real loss.
- A single-tooth implant replaces the root as well as the tooth and leaves the neighbors alone. It needs enough bone, and several months of healing while the bone fuses to the post.
- A partial denture clips onto the teeth you have and comes out to clean. It usually costs less than either and can replace teeth in more than one place, but it moves more than a fixed tooth, and some people do not get on with taking it in and out.
Implant-supported bridges for longer gaps
When several teeth in a row are missing, a regular bridge can run out of teeth to hold onto, or ask too much of the ones it has. Two implants can carry a bridge across a longer gap instead, without touching your natural teeth at all.
An implant-supported bridge depends on having enough bone where the implants would go, so that is checked before anything is planned.
What happens at the bridge appointments
At the first appointment, the teeth on either side of the gap are numbed and shaped. Then we scan them with a small digital wand, so there is no tray of impression putty to hold in your mouth. The scan goes to the dental lab that makes the bridge, and you leave with a temporary bridge protecting the shaped teeth.
At the second, the temporary comes off and the finished bridge is tried in. We check how it sits against the gum, how the color matches your other teeth and how your teeth meet, and we adjust it before it is cemented. If your bite feels off once the numbness wears off, call. A high spot does not settle by itself.
How do you clean under a bridge?
The replacement tooth sits on the gum rather than in it, and food and plaque collect underneath. Ordinary floss cannot pass down between teeth that are joined, so it has to go under the bridge instead. A floss threader, a floss with a stiff end made for bridges, or a water flosser all do the job, and we will show you whichever suits your hands.
The crowned teeth holding the bridge can still decay where the crown meets the tooth, and if one of them fails, the whole bridge is affected. Cleaning under it every day and keeping up your check-ups is what keeps a bridge going for many years.
What does a dental bridge cost?
The fee depends on how many teeth the bridge spans and what it is made of, so you get a written estimate before anything is scheduled. Most dental plans treat a bridge as major treatment and pay part of it, though some will not pay toward replacing a tooth that was already missing when you joined. For larger work we can send the insurer a pre-treatment estimate first. See how insurance works here.
No dental insurance? The Virginia Dental Club is a membership plan for people without it, and worth a look before you decide.
Questions patients ask
How long does a dental bridge last?
Commonly many years. What decides it is the health of the teeth holding it up, so cleaning under the bridge and along the edges of its crowns every day matters most. Check-ups catch trouble at those edges while it is still small.
Does getting a bridge hurt?
The teeth are numbed before they are shaped, so most people feel pressure rather than pain. They can be sensitive for a few days afterward, and the gum may be tender where the temporary sat.
Is a bridge better than an implant?
Neither is better for everyone. A bridge is finished sooner and involves no surgery, but it means shaping the neighboring teeth. An implant leaves those teeth alone and replaces the root, but it needs enough bone and several months of healing.
What if my bridge feels loose?
Call rather than waiting for it to come off. A loose bridge usually means the cement has washed out or a supporting tooth has a problem underneath, and both are easier to deal with early. If it does come out, keep it and bring it with you.