A dental bridge is a treatment for replacing a missing tooth or multiple missing teeth. It is a requirement that the tooth (or teeth) being replaced have at least one tooth behind it and one tooth on either side 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, we prepare the tooth in front of the missing space and behind the missing space as they would be for a dental crown. These teeth are considered the “abutments” of the bridge.
Dental Bridge or Dental Implant?
Why are implants usually better? First, when placing an implant, 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.
When a Dental Bridge is the Better Choice
- The 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.
- 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.
- The adjacent teeth need crowns. Sometimes it seems justifiable to make a bridge for a patient when the teeth on either side of the missing tooth need crowns, anyway. Whether a bridge is a good choice in a case like this 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.
Dental Bridge Process and Materials
After the dentist takes impressions and makes the models, a dental lab fabricates a bridge. A bridge is essentially two (or more) crowns connected, and the connection — called the “pontic” — replaces the missing tooth or teeth. The pontic adapts to the gum tissue that has healed after the extraction.
The preferred material for making dental bridges has changed a lot over the years. Nowadays, we can use tooth-colored metals to make amazingly strong bridges. When superior esthetics are necessary, like on front teeth, we can layer ceramic on top of metals to make them appear more realistic.
For a long time, dental bridges were state-of-the-art dental treatments for patients who did not want to have removable partial dentures. However, as dental implants became more and more predictable, bridges fell out of favor in dentistry. Additionally, as implants have become more cost-effective, bridges are getting closer to being a thing of the past in dentistry. In most cases where a dental bridge is an option, a dental implant is a better option.
Is a Dental Bridge Right for You?
Bridges were once a workhorse in dentistry for replacing missing teeth, but nowadays implants have mostly replaced them for predictability, esthetics, and long-term success. However, dental 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 unique. So, if you are missing teeth and are debating between a bridge or implants, come and see us. Our highly trained, caring, and experienced dental team will give you honest advice. There are typically many directions any case can go in, and we enjoy helping patients decide what is best for them.