Dental bridges: what to expect, aftercare and FAQs

What is a dental bridge?

Cleveland Clinic says a bridge replaces one tooth or a row of missing teeth. It uses crowns on the natural teeth beside the gap and artificial teeth to bridge the gap in your smile, and dentists can match the shade of your natural teeth. The supporting structures are called abutments, either natural teeth or small connector posts on implants, and the artificial teeth that fill the gap are pontics.

What are the types of dental bridge?

Cleveland Clinic lists four. A traditional bridge has crowns on both sides with artificial teeth between, and is used when healthy natural teeth flank the gap. A cantilever bridge has a crown on one side only, used when natural teeth are on just one side, and is less strong. A Maryland, or resin-bonded, bridge uses metal wings bonded to the backs of neighbouring teeth, typically for front teeth, since it cannot handle back-tooth chewing forces. An implant-supported bridge rests on dental implants, which must fuse to the jawbone first, usually 3 to 6 months, and is used when three or more teeth in a row are missing.

What does a dental bridge look like?

A bridge is designed to look like your natural teeth. Cleveland Clinic says dentists can match the shade of your natural teeth, and describes the crowns and the artificial teeth between them. The page has a diagram of the four types but little detail on appearance beyond color matching. Ask your dentist for before-and-after examples of similar cases, which is general advice and flagged.

How is a bridge placed?

For a traditional or cantilever bridge, Cleveland Clinic says the dentist numbs the area, reshapes the abutment teeth, which removes enamel and is irreversible, and takes impressions that go to a lab. You wear a temporary bridge while the lab works, usually 2 to 4 weeks. At the second visit the temporary is removed and the final bridge is checked for fit and cemented. Some offices mill the bridge on site the same day. A Maryland bridge involves preparing the teeth and bonding the wings with resin cement. An implant-supported bridge needs surgery, a healing period of about 3 to 6 months, then the bridge is attached with cement or tiny screws.

How long does a dental bridge last?

Cleveland Clinic's bridge page says about 5 to 15 years on average, sometimes longer with good care. Its separate page comparing bridges with implants says bridges often need replacement after roughly five to seven years, according to the American Dental Association. The two pages differ, and we report both. How long yours lasts depends on how well you clean it and the health of the supporting teeth.

Are dental bridges permanent?

Cleveland Clinic says dentists call them permanent bridges because only a dentist can remove them, and that they still wear out and need replacement. A loose bridge is usually easy to remove and recement, it says, but if it must be removed for another reason, such as treating gum disease or decay, it may break during removal and need replacing.

How do you clean under a bridge?

Cleveland Clinic says to brush and floss daily using a nonabrasive fluoride toothpaste, clean under the bridge daily with floss threaders or interproximal brushes, avoid very hard or chewy foods, and not chew ice, pens, pencils or fingernails, and to keep up regular check-ups and cleanings. Poor cleaning can lead to plaque, gum inflammation and cavities, it says. Our flossing guides cover cleaning between teeth.

Is a bridge or an implant better?

Cleveland Clinic says neither is universally better. Implants generally last longer and help preserve bone, and implants can last a lifetime though the crowns on them generally last about 15 years. Bridges require reshaping and capping adjacent teeth that may otherwise be healthy, while implants do not involve neighbouring teeth. A bridge usually takes two visits over a couple of weeks, while an implant can take up to six months and several visits. Implants generally are not recommended for people under 18. The choice depends on how much treatment you will tolerate, how quickly you want results, comfort with surgery, cleaning effort and cost, and your dentist's view of your anatomy.

What are the risks of a bridge?

Cleveland Clinic lists decay or trauma to the abutment teeth weakening the bridge, abutment teeth that cannot support it fracturing, and poor cleaning leading to plaque, gum inflammation and cavities. The benefits it lists are a natural look, restored chewing and speech, and preventing neighbouring teeth from shifting into the gap.

Questions to ask your dentist

Take these to your consultation.

• Which type of bridge suits my missing tooth?
• Would an implant be better for me?
• How much of my healthy teeth will you reshape?
• How long should it last, and how do I clean it?
• What happens if it comes loose?

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