Let's Bridge That Gap!
Before dental implants, when there was a missing tooth that needed to be replaced, a dental bridge was generally the preference over a small denture. A bridge is essentially 1 or more crowns joined together to replace 1 or more missing teeth. Unlike a denture which is removable, a bridge is permanently fixed to the teeth. It is the stronger, longer term option.
A bridge uses the adjacent teeth next to a missing tooth to replace it. Just like a bridge crossing a river from where it gets its name has vertical supports either side of the river, a dental bridge requires a tooth on either side of the missing tooth to support its replacement. Basically, a crown is placed on each tooth either side of the missing one and a third crown called a pontic is joined to these other 2 crowns to form 1 strong unit. The pontic rests on the gum tissue where the tooth is missing, making it look like a tooth is coming out of the gum like a normal tooth.
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One Bridge, Two Gaps.
This same principle can be applied to 2 missing teeth next to each other. In this case, you would have a crown on either side of the 2 missing teeth connecting 2 crowns in the middle to replace the 2 missing teeth. For strength, you usually wouldn’t want your bridge to be any longer than this. Typically, 1 missing tooth and 2 support teeth is the ideal arrangement.
It is also possible to hang 1 pontic off a single crown. This is called a cantilever bridge as there is only support for the pontic on 1 side. This is obviously not ideal and can only be done where the support tooth is strong enough and usually bigger than the missing tooth the pontic has to replace. This may occur at the back of the mouth where there may be no teeth behind the 1 that needs to be replaced. It is also done to be conservative and not crown another tooth if this is not needed for support. In front teeth cases where the forces on the teeth may be less, a cantilever bridge may be sufficient for strength.
Do I Need To Build A Bridge?
When you have a missing tooth or a tooth that needs to be extracted, you have the option of a dental implant, a bridge or a denture to replace the tooth. You may opt for a bridge for the following reasons:
- You want a strong long term option
- Adjacent teeth would benefit from crowns
- You want a fixed option rather than a removable denture
- You prefer a non-surgical option
- There is lack of bone or other issues preventing implant option
That's A Strong Foundation!
A bridge is cemented in place, is very strong and durable long term and cannot be removed. It is a good option if the teeth adjacent to the missing one have large fillings which would benefit from crowns. Because all 3 teeth are now joined together, there needs to be an adjustment in flossing technique to clean under the pontic. Also if something happens to 1 of the teeth (e.g. 2 supports and 1 pontic) that make up the bridge, the whole bridge may need to be replaced as all three teeth are now linked together.
With the development of dental implants, there are now less applications for the traditional dental bridge. Bridges still have their advantages though. In many instances, a dental bridge can still treat 3 teeth for less than the price of a single dental implant. After the dental implant, you may still need to crown the adjacent teeth at an additional cost if they are also problematic. In a case like this, a bridge may be more cost-effective.