Dental Bridge
A dental bridge is a dental treatment for replacing a missing tooth.  A bridge can sometimes be used to replace more than one missing tooth. It is a requirement that the tooth/teeth being replaced has at least one tooth behind it and one tooth in front of it.
Let’s say for instance that a patient is going to lose their first molar and decides to have a bridge made to replace the tooth.  Typically, the tooth is extracted and given time to heal.  Once the site has healed sufficiently, the tooth in front of the missing space and behind the missing space are prepared in the same manner they would be for a dental crown.  These teeth are considered the “abutments” of the bridge.  After impressions are taken and models are made, a dental lab fabricates a bridge.  A bridge is essentially two (or more) crowns connected, and the connection, called the “pontic”, is what replaces the missing tooth.  The pontic is made to adapt to the gum tissue that has heeled after the extraction.
The preferred material for making dental bridges has changed a lot over the years.  Nowadays, there are tooth colored metals that can be utilized to make amazingly strong bridges.  When superior esthetics are necessary, like for front teeth, ceramic can be layered on top of metals to make them appear more realistic.
For a very long time, dental bridges were “state of the art” dental treatment for patients that did not want to have removable partial dentures.  As dental implants became more and more predictable, bridges began to fall out of favor in dentistry.  As implants became more and more cost effective, bridges are getting closer and closer to be a thing of the past in dentistry.  In most cases where a dental bridge is an option, a dental implant is a better option.

Dental Bridge or Dental Implant?

Why are implants usually better?  When an implant is placed, there is no need to prepare the adjacent teeth for crowns.  Preparing teeth for crowns unnecessarily increases the chance that they will require root canal treatment in the future.  Bridges are also hard to clean and require special tools to adequately clean under them.  If a patient is at high risk for cavities and gets a cavity on one of the teeth involved in the bridge, it is most likely the case that the entire bridge will have to be replaced.  After a bridge is placed, the bone and tissue under it will still resorb over time.  Very old bridges on patients typically no longer adapt to the gums anymore, leaving large gaps that trap food.  Implants maintain and support the bone and don’t experience the same type of recession.
Having said that, bridges are still a preferred option for patients in some unique situations.  Here are just a few examples:
  1. Patient is not a candidate for surgery.  If medical reasons prevent a patient from having implant surgery but they still want to replace a missing tooth with a fixed restoration, a bridge can be an excellent choice.
  2. The space where an implant could/would go would require multiple surgeries that the patient is unwilling to have.  In cases where a tooth has been missing for a long time, the bone and tissue may no longer have what it takes to support an implant without one or two preliminary surgeries.  Some patients are hesitant to go through all of this and prefer the bridge for simplicity’s sake.
  3. The adjacent teeth need crowns anyway.  There are times when it seems justifiable to make a bridge for a patient when the teeth on either side of the space missing the tooth need crowns anyway.  Whether a bridge is a good choice or not in a case like this all depends on why the patient needs the crowns in the first place.  Does the patient get cavities easily?  Do they have trouble keeping their teeth clean?  A bridge may or may not be a good choice for the patient.  If the risk of cavities is high, an implant might still be a better option, but the patient might still prefer a bridge for the sake of short term simplicity.
In summary, bridges were once a workhorse in dentistry for replacing missing teeth, but nowadays implants have replaced them for the most part when it comes to predictability, esthetics, and long term success.  Bridges are still useful in certain clinical situations, especially when the patient is not a candidate for surgery or the surgery is determined to be too difficult by either the doctor or the patient.
Every situation is different.  If you’re missing teeth and are debating between a bridge or implants come and see me and I will give you honest advice.  There are typically many directions any case can go in, and I enjoy helping patients decide what is best for them.