What a bridge does
A bridge is made of a replacement tooth, called a pontic, joined to supports on one or both sides of the gap. The supports are known as abutments, and they can be natural teeth or dental implants.
Filling a gap isn’t always essential, but it can help. Over time the teeth beside a space may tilt into it, and the tooth opposite can drift down or up because it has nothing to bite against. A gap can also make chewing harder on that side, change how some words sound or simply bother you when you smile. Your dentist will help you decide whether replacing the tooth is worthwhile for you.
Conventional bridges
In a conventional bridge, the teeth on each side of the gap are shaped for crowns, and the replacement tooth is joined between those crowns as a single piece. Once cemented, it is fixed and isn’t removed for cleaning. It can be made from porcelain or porcelain-fused‑to‑metal, depending on the position and the forces on that part of your mouth.
This design tends to suit gaps where the neighbouring teeth already have large fillings or crowns, because those teeth would benefit from being covered anyway. If the neighbours are healthy and unfilled, shaping them means removing sound enamel, and that is a real trade‑off to weigh up.
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Bonded (Maryland) bridges
A bonded bridge, sometimes called a Maryland bridge, has a replacement tooth attached to a thin metal or ceramic wing. The wing is bonded to the back of a neighbouring tooth, so that tooth needs little or no shaping.
Bonded bridges are often used to replace a single front tooth, where biting forces are lighter. Because they are held by bonding rather than a crown, they can come unstuck, and they may need re‑bonding from time to time. They are less often suitable for back teeth or for people who grind heavily.
For teenagers and young adults who have lost a front tooth, a bonded bridge is sometimes used as an interim option, because implants are usually placed only once jaw growth has finished.
Implant-supported bridges
When several teeth in a row are missing, two or more dental implants can support a bridge across the space. Because the implants carry the load, the remaining natural teeth don’t need to be shaped or relied on.
This option involves surgery to place the implants and a healing period before the bridge is fitted, and it depends on having enough bone and healthy gums. Our dental implants page explains how implants work and who may be suitable.
What happens to the teeth either side
With a conventional bridge, the supporting teeth do the work of their own and the missing tooth. Shaping them for crowns is irreversible, and like any crowned tooth they can develop decay at the crown edge or, in some cases, need root canal treatment later if the nerve becomes inflamed.
Because the units are joined, a problem with one supporting tooth can mean the whole bridge needs to be removed and remade. The gum and bone under the replacement tooth also change shape over the years after a tooth is lost, which can leave a small space under the pontic where food collects. None of this means a bridge is a poor choice, but these are the reasons good cleaning and regular checks matter so much.
Cleaning under a bridge
Ordinary flossing doesn’t work under a bridge, because the teeth are joined and the floss can’t pass down between them. Plaque that builds up beneath the replacement tooth and around the supporting crowns is a common cause of decay and gum problems around bridges.
At your fitting visit we will show you which of these tools suits the shape of your bridge, and check how you are going at your hygiene appointments:
- Floss threaders: a stiff loop that guides ordinary floss under the bridge so you can clean each side of the supporting teeth
- Thicker floss with a stiffened end, made for bridges and wider spaces
- Interdental brushes, sized to slide under the pontic and between the teeth
- A soft brush angled along the gum line on both the cheek and tongue sides
Bridge, implant or partial denture
There are three main ways to replace a missing tooth, along with leaving the gap. The right choice depends on the health of the neighbouring teeth, your bone and gums, your general health, your budget and how you feel about surgery or a removable appliance.
Questions worth asking include how each option affects the teeth you still have, how long treatment takes from start to finish and what upkeep it needs year to year.
- Bridge: fixed, usually completed within a few weeks and no surgery, but conventional bridges involve shaping the neighbouring teeth
- Implant: replaces the tooth without involving its neighbours, but needs surgery, healing time of several months and suitable bone, and smoking or some health conditions can affect success
- Partial denture: removable, the least invasive option and usually the lowest cost, and it can replace several teeth in different places, though some people find it takes time to get used to
What affects the cost of a bridge
Bridges are priced by the unit, so each supporting crown and each replacement tooth is counted separately, and the material and type of bridge change the fee. Health funds generally treat bridges as major dental, and because each unit has its own item number, your estimate will show how the total is built up.
Dental bridges, step by step
Questions about dental bridges
How many teeth can a bridge replace?
Most bridges supported by natural teeth replace one or two missing teeth, because longer spans put a lot of strain on the supports. Where more teeth are missing, an implant-supported bridge or a partial denture is often more suitable.
Why does food get stuck under my bridge?
The gum under a missing tooth gradually shrinks after the tooth is lost, which can leave a small space beneath the pontic. Cleaning daily with a threader or interdental brush usually manages it. If it is getting worse, ask us to take a look.
What should I do if my bonded bridge comes loose?
Keep the bridge somewhere clean and call us. Bonded bridges can often be cleaned and re‑bonded if the wing and the tooth are undamaged. Don’t try to glue it back yourself, as that can make re‑bonding harder.
Can the teeth next to the gap support a bridge if they have fillings?
Often, yes, and teeth with large fillings can be good candidates, since covering them with crowns may help protect them. Your dentist will check that each supporting tooth has a healthy nerve, strong roots and healthy gum before recommending it.
Will a bridge feel like my own teeth?
Most people adjust within a few days. The bridge may feel slightly unfamiliar to your tongue at first, and you will need to change how you clean that area, but you chew on it much like natural teeth.
Do I need to replace a missing back tooth at all?
Not always. Some people manage well with a gap, particularly right at the back of the mouth. Your dentist will look at whether the neighbouring and opposing teeth are likely to drift and how well you can chew before giving advice.
Can a bridge be fixed if it chips or breaks?
Minor porcelain damage may be polished out or repaired with tooth-coloured composite in the chair. Because a bridge is made as one piece, larger breaks usually mean it needs to be remade.