Short answer: A dental bridge is a fixed prosthesis in which one or more missing teeth are replaced with artificial teeth attached to the teeth on either side of the gap, which are prepared for crowns. It is cemented in the mouth and is not removed by the patient. It is usually completed in a few sessions, after impression and try-in stages. It offers a quick solution that requires no surgery; however, it requires reducing the supporting teeth. The decision between an implant, a bridge and other options is made after an examination.
Losing a tooth does not just leave an aesthetic gap; it reduces chewing efficiency and can cause the neighboring teeth to tilt into the gap over time and the opposing tooth in the other jaw to overerupt. One of the methods used to replace missing teeth is the dental bridge, which has been widely used for many years. In this article we look at what a dental bridge is, how it is made, its advantages and disadvantages, how it compares with an implant, why pain can occur under a bridge and how to care for a bridge.
What is a dental bridge?
A dental bridge is a prosthesis that stays fixed in the mouth, consisting of crowns made for the teeth on either side of the missing tooth and one or more artificial teeth attached to those crowns. It is also called a crown and bridge prosthesis. The supporting teeth next to the gap are called “abutments,” and the artificial tooth in between is called the “pontic.” The bridge is secured to the supporting teeth with a special cement and is not removed by the patient.
Bridges can be made from different materials. Porcelain-fused-to-metal bridges are a durable option that has been in use for a long time. Bridges with a zirconia framework or made entirely of ceramic contain no metal, so they let light through more naturally and offer an aesthetic advantage, especially in the front of the mouth. The choice of material is made by the dentist according to the bridge's position in the mouth, its length, the biting forces and aesthetic expectations.
Besides the classic bridge, there are also some special types of bridges. Resin-bonded (Maryland) bridges are held in place by wings bonded to the back surfaces of the neighboring teeth and require less tooth reduction; they are generally used in selected cases of a single missing tooth in the front of the mouth. Implant-supported bridges, on the other hand, are supported by implants instead of natural teeth.
How is a dental bridge made?
A dental bridge is usually made through a process completed over a few appointments, consisting of examination, preparation of the supporting teeth, impression, try-in and cementation.
- Examination and planning: The health of the teeth and gums that will provide support, the bone support and the bite are evaluated, and X-rays are taken. If the supporting teeth need treatment for decay or a root canal, this is completed first.
- Preparing the supporting teeth: Under local anesthesia, enough material is removed from around the supporting teeth for the crown to fit.
- Impression or digital scan: An impression of the prepared teeth and the opposing jaw is taken, the bite is recorded and the shade is selected.
- Temporary bridge: While the permanent bridge is being made in the laboratory, a temporary bridge is placed to protect the prepared teeth and maintain appearance.
- Try-in: At the framework and/or porcelain stage, the bridge is tried in the mouth; fit, bite and color are checked.
- Cementation: After the final checks, the bridge is permanently cemented, and instructions for use and cleaning are given.
The total time varies with the size of the bridge, the material and any preliminary treatments; in most cases it is completed within a few weeks.
What are the advantages and disadvantages of a dental bridge?
A dental bridge makes it possible to replace missing teeth in a fixed and relatively quick way; however, it also has an important disadvantage, the need to reduce the supporting teeth.
Advantages
- It is a fixed prosthesis; it does not need to be put in and taken out and feels close to a natural tooth.
- It requires no surgery; it can be an option for health conditions that rule out implants or where bone is insufficient.
- In most cases, treatment time is shorter than for an implant.
- It restores chewing function and appearance and prevents neighboring teeth from shifting into the gap.
- If the supporting teeth already have large fillings or need crowns, it also protects those teeth.
Disadvantages
- Material has to be removed from healthy supporting teeth; this cannot be undone.
- Decay or nerve problems may develop in the supporting teeth over time.
- Because there is no tooth root, the bone under the pontic may continue to shrink over time.
- Cleaning under the bridge requires special tools.
- If a problem develops in one of the supporting teeth, the whole bridge often needs to be replaced.
How does a dental bridge compare with an implant?
A bridge and an implant are two different approaches to replacing a missing tooth, and which one is more suitable varies from person to person. An implant is a structure placed in the jawbone, similar to the root of the lost tooth, with a crown made on top; it functions on its own without touching the neighboring teeth. This means healthy neighboring teeth do not need to be reduced, and the load on the bone is carried more evenly.
On the other hand, an implant requires a surgical procedure, the bone needs to be sufficient or bone augmentation may be required, and treatment takes longer because of the healing period. Conditions such as uncontrolled diabetes, certain medications or heavy smoking can affect implant planning. A bridge, meanwhile, can be a sensible option especially when the neighboring teeth already need crowns, or when surgery is not wanted or not suitable. Cost is also part of the decision; the cost of both options is provided in writing after the examination and planning.
In some cases, the gap of a missing tooth can be closed by moving the neighboring teeth into the gap with orthodontic treatment, or the teeth may need to be brought into the right position before a prosthesis. We discuss this option in our article on clear aligner treatment for missing teeth.
What causes pain under a bridge?
The most common causes of pain felt under a bridge or in the supporting teeth are decay in a supporting tooth, nerve inflammation, gum problems and a bite that is too high. A clinical examination and X-rays are needed to find the source of the pain. Possible causes are:
- Decay in a supporting tooth: Decay starting at the edge of the crown can progress over time and cause sensitivity and pain.
- Nerve problems: In some vital supporting teeth from which material was removed during preparation, nerve inflammation can develop over time; in this case, root canal treatment may be needed.
- Gum inflammation: Plaque that builds up under the pontic or at the crown edges can cause inflammation, bleeding and tenderness of the gums.
- High bite: If the bridge makes early contact when you bite, pressure and pain can develop in the supporting teeth; this is usually corrected with a simple adjustment.
- Cement washing out: If the bridge loosens from one support, bacteria leaking underneath can lead to decay and a bad smell.
- Root fracture or gum recession: Although less common, these can cause pain in the supporting teeth.
There may be mild sensitivity in the first days after cementation, which usually passes quickly. However, if you notice ongoing or increasing pain or pain that becomes noticeable when chewing, a feeling of movement in the bridge or a bad smell, you should go for a checkup without waiting.
How should you care for a dental bridge, and how long does it last?
A well cared for dental bridge can be used for many years; the lifespan of a bridge depends largely on the supporting teeth and gums staying healthy. In daily care, pay attention to the following:
- Brushing twice a day with fluoride toothpaste and a soft brush, paying special attention to the crown edges
- Cleaning under the pontic every day with bridge floss (floss with a stiff end), an interdental brush or a water flosser
- Not biting very hard foods or things like ice with the bridge
- Wearing the night guard your dentist recommends if you clench
- Having checkups and professional cleaning every six months to once a year
When should you get an examination in Ankara for a missing tooth?
If you have lost a tooth, it is helpful not to delay an evaluation, because the longer the gap remains, the more the neighboring teeth may shift and the bone may shrink, which can narrow your options. If you notice pain, a bad smell or movement in your existing bridge, a checkup is also needed. At our clinic in Oran, we evaluate bridge, implant and orthodontic options together according to the condition of your mouth and explain the plan that suits you.
Frequently asked questions
How long does it take to make a dental bridge?
When no preliminary treatment is needed, a dental bridge is usually completed in a few appointments over a few weeks. If the supporting teeth need root canal treatment or gum treatment, it may take longer.
Are the teeth made smaller when a bridge is made?
With a classic bridge, enough material is removed from around the supporting teeth for the crown to fit. This is done under local anesthesia. With some options, such as a resin-bonded bridge, the amount of reduction is smaller.
What causes a smell under a bridge?
Food debris building up under the pontic, insufficient cleaning or the bridge loosening from one of its supports can cause a bad smell. Regular cleaning with bridge floss and an interdental brush is important. If the smell continues, a checkup by your dentist is needed.
Which is better, a bridge or an implant?
Both methods have advantages and limitations. An implant is placed without touching the neighboring teeth; a bridge requires no surgery and is completed in a shorter time. The decision is made individually after evaluating the teeth, the bone and general health.
