Dental bridges are similar to partial dentures in that they are used to fill spaces with missing teeth. A dental bridge is an effective dental treatment that comprises a false tooth, referred to as a pontic, with dental crowns or abutments acting as props. The crowns are fixed to the tooth on both sides of the gap, attaching the pontic firmly in place of the absent tooth.
Generally, any person with one or several missing teeth can opt for a bridge, though the surrounding teeth and gum tissue must be in good health, because they form the foundation for the replacement prosthetic. Bridges do not require oral surgery, which makes them a great alternative for individuals who are afraid of going through oral surgery in dental implant procedures. While the supporting teeth are adjusted to receive abutment crowns, no gum or bone tissue drilling is necessary for bridge placement.
Before and after dental bridge procedure (Source: Austin Cosmetic)
Reasons to get Dental Bridges
Missing teeth can have a huge impact on the functionality and appearance of your smile. Without something to fill the gaps, remaining teeth can easily shift their position and alter your occlusion or bite, resulting in jaw pain, speech impediment, temporomandibular joint disorder (TMJ), increased susceptibility to periodontal disease, and frequent headaches.
There are many reasons why you should fill spaces between your teeth. To begin with, a gap can interfere with your bite because the teeth adjacent to the space can lean into the gap, altering the way the upper and lower teeth bite together. This can in turn cause food to get packed into the gap, resulting in both decay and gum disease. So, a dental bridge can prevent the teeth adjacent to the gap from drifting out of position and reduce the risk of tooth decay and periodontal disease. Other benefits include:
So, bridges help to:
- Restore a healthy bite for proper chewing
- Reduce strain on remaining teeth due to misaligned bite
- To distribute the forces in your bite proportionally
- Prevent gum disease and tooth decay because of food accumulating in the gap
- Maintain facial contours and preserve the shape of your face
- Improve your smile and appearance
- Restore self-confidence after an injury or accident
4 types of dental bridges
There are several types of bridges that patients can choose from, though it is best to ask your dentist to help you find the right one for you.
- Traditional Fixed Bridge: it is the most popularly type of bridge, and comprises two prosthetic crowns, anchored on adjacent teeth or implants, on both sides of the pontic, to support the dental bridgework.
- Maryland Bonded Bridge or resin-bonded bridges: These comprise plastic teeth and gums held in place by wings or a metal framework, which is then bonded to the back of neighboring teeth using resin. This bridge is used when there is a gap in the front teeth, or in instances where the teeth adjacent to the gap are healthy and strong.
- Cantilever Bridges: as the name suggests, they false tooth is supported by one or several adjacent teeth on only one side. They are used in areas that are susceptible to low stress, with teeth on one side of the gap.
- Implant-supported bridges: They are anchored to implanted teeth instead of a natural teeth.
Dental materials for bridgework
Different materials can be used to fabricate the pontic, including:
- All porcelain for a natural look, though they are not very strong, which makes them ideal for front teeth replacements.
- Porcelain fused to metal, offer more strength, are colored, and typically used on back teeth.
- Gold, silver and alloys offer a great fit, more strength, and durability than the others, though they do not offer that natural appearance.
Dental bridge versus partial denture
The method that you use to replace missing teeth depends on:
- Number of missing teeth
- Position in your mouth
- Condition of other teeth
A fixed bridge is used when there are few teeth that need replacing, or when the gaps are on only side of the mouth. Otherwise, a partial denture – removable prosthetic tooth – is used.
Risks and complications of dental bridges
Although dental bridgework are a popular and highly successful tooth replacement option, there is always the danger of issues that necessitate the removal or replacement of a bridge. Some of the risks that your dentist will discuss with you include:
- An incorrect or ill-fitting bridge — an improper or loose fitting bridge can cause tooth decay to form on the adjacent healthy teeth beneath the crowns. These teeth are more susceptible to decay because the dentist must file down the natural teeth adjacent to the gap in order to implant the crown. Decay in the supporting teeth can in turn lead to tooth injury and bridge instability.
- Damage to adjoining teeth – Dental bridges can develop rough spots over time. These rough patches can wear away natural tooth enamel on healthy teeth if they come into contact with adjacent teeth.
- Gum disease risk is increased – Tooth appliances, such as a dental bridge, can make you more susceptible to gum disease. But this risk can be greatly reduced by practicing proper oral hygiene practices at home, including flossing and brushing your teeth on a regular basis, as well as getting regular dental cleanings. Regular dental appointments enable your dentist to detect any early signs of gum disease and treat it before it causes permanent damage.
- Fractures to the pontic or crowns – Although these dental appliances are fabricated from strong dental materials, and can sustain chewing forces as good as your natural tooth enamel, they can still be fragile. Chewing or biting on hard foods can crack or fracture the surface, create a chip, or completely damage the bridge. Though your dentist can repair small chips and cracks, larger fractures may require bridge replacement.
Causes of dental bridge failure
Dental bridgework is a long-lasting tooth replacement option. But like any other treatment, there is a risk of failure. In such cases, your dentist may need to remove, repair, or replace your dental bridge to restore the optimal function and aesthetic of your mouth. Some possible causes of bridge failure include:
- Improper Oral Hygiene – This is the leading cause of bridge failure. Bridge failure can occur when decay accumulates around and under the crown, causing harm to the adjacent anchoring teeth.
- Fragile Abutment Support – Changes to the supporting teeth might make a dental bridge less stable. Instability or a loss of support from these teeth might cause an unequal distribution of pressure on the bridge, leading to collapse.
- Bad Habits – Teeth clenching or grinding at night, biting your nails, eating hard foods like nuts, chewing on your pen and other hard substances, and similar behaviors can damage your bridge’s crowns or pontic.
- Missing your dentist appointments – Maintaining the life of your bridge requires both proper dental hygiene at home and regular visits to your dentist. Regular dental checkups can help to detect any possible issues with your bridge before they become serious enough to cause it to collapse.
Dental bridge infection symptoms
The symptoms of an infected dental bridge restoration are similar to those of any other kind of dental infections. In addition to loosening of the bridgework, you may also notice:
- Throbbing pain in the infected tooth or jawbone, ear or neck (on the same side as the tooth pain)
- Severity of pain increases when you lie down
- Sensitivity to pressure in the mouth
- Sensitivity to hot or cold foods and drinks
- Swelling of the cheek
- Tender or swollen lymph nodes in the neck
- Bad breath
- Unpleasant taste in mouth
My dental bridge fell out. What should I do?
There are a number of possible causes for your bridge to become loose and possibly fall out, including the following:
- Oral trauma – If you’ve recently had a hit to the head, face, or mouth, your bridge may start to feel loose
- The teeth that support it have been severely injured
- Abutment tooth decay — poor oral hygiene may cause the underlying “abutment” to rot and cause the pontic to loosen
This procedure uses the term “bridge” because the pontic is secured using dental cement to prevent the buildup of bacteria between the prosthetic and gums, yet there is no physical connection between the jawbone and the false tooth. But over time, the dental cement may deteriorate and cause the bridgework to become loose. Trauma may also cause the connection to loosen and the tooth to the fall off.
If the supporting teeth are still in good shape, a damaged dental bridge can sometimes be removed and re-cemented in place. However, the bridge or crown may need to be replaced if the supporting teeth have become severely deteriorated over time. This is because supporting teeth that are showing indications of deterioration may no longer fit precisely with the existing bridge’s contour.
Can a dental bridge be removed and recemented?
How a dentist removes a damaged bridge depends on a variety of different factors. Loose bridges can often be easily removed and repaired, allowing your dentist to recement the bridge into place.
However, the cement used to bond a bridge in place is designed to last for many years and it is not always possible to remove a bridge without causing damage to the support of surrounding teeth.
Your dentist can try to tap off the bridge, but this can often injure and even fracture the support teeth. In these cases, the dentist will need to drill off the bridge and create a new one.
What your dentist chooses to do will depend on the cause of the bridge failure, how strong the current bridge bond is, the integrity of the supporting teeth, and the desired result.
How much does a dental bridge cost with insurance?
The cost of various types of dental bridges varies considerably. It is anticipated to cost between $1,500 and $5,000, depending on:
- The type of dental bridge used
- Number of teeth to be replaced
- Material used for fabrication of the pontic and abutment
- Location of your dentist
The following are some of the dental bridge costs:
- A typical dental bridge costs between $2,000 and $5,000. Each abutment tooth has a pontic and a crown.
- Maryland tooth bridges with one pontic cost between $1,500 and $2,500.
- A cantilever bridge will cost between $2000 and $2700.
- An implant-supported bridge, which spans three or four teeth and is supported by two dental implants, costs $5,000 to $15,000.
When you have dental insurance, you can save money by having tooth bridges and other particular dental treatment options covered.