If you have a missing tooth or teeth, then one way to fill this gap is a fixed bridge. It can restore appearance, function, chewing and help stabilize the bite.
A bridge is a type of false tooth that is fixed to one or more teeth on either side of the gap. There are two main types of bridges, the first is commonly known as a conventional bridge, while the second type is known as an adhesive bridge (sometimes also known as a ‘resin-retained’ or ‘Maryland’ bridge).
What are the differences between the different types of bridges?
A conventional bridge is made by drilling the adjacent tooth (or teeth) down to a peg and a crown is made, which fits over this prepared tooth. A false tooth is connected to this crown (or crowns if there are two supporting teeth), which then fills the gap left by the missing tooth. This can alter the shape and appearance of the adjacent teeth to match the new false tooth. However, a conventional bridge can be destructive to the supporting teeth and can affect the nerve of the tooth.
In a small percentage of cases (upto 10-15%), the nerve of the supporting tooth will be irreversibly damaged and the tooth may get infected. This tooth may then need root canal treatment.
A conventional bridge can be more secure than adhesive bridges and is usually advised if the supporting tooth (or teeth) are already crowned or have large fillings.
An adhesive bridge is made by sticking a small metal wing to the back of an adjacent tooth which supports the false tooth. This requires very little or no drilling of the adjacent tooth, but can sometimes cause the supporting tooth to look slightly greyer. For an adhesive bridge, the tooth is prepared (if necessary) and an impression (mould) of your teeth is made. A dental technician will then make the bridge in our laboratory, to fit the supporting tooth very accurately.
At your next visit, the dentist will try the bridge in place, and may fit it at that visit or a subsequent visit (if modifications are necessary). Between visits, a removable denture may be needed.
How successful will my bridge be?
Bridges, (both conventional and adhesive) are generally very successful. 80% of conventional bridges will last for 10 years or longer with relatively minor complications. However, 10-15% of supporting teeth may eventually need root canal treatment due to the nerve inside the tooth dying off. A small proportion of supporting teeth may also develop decay along the margin of the bridge and/or gum disease around the supporting teeth.
Adhesive bridges can be slightly less successful, with around 80% lasting for 5 years or longer. However, complications with adhesive bridges are relatively less complex and easier to manage. The most common complication with adhesive bridges is failure of the cement holding the bridge in place (i.e. the bridge may fall off). This is usually easily rectified by cleaning any remaining cement from the tooth and resticking the bridge.
Brush your bridge as normal and when you floss, you should remember to sweep the floss under the false tooth along the gum line – your dentist or hygienist will show you how. This is very important to keep your gums and teeth healthy and help the bridge last longer.
I do not like the idea of a bridge, what options do I have?
A bridge is one of many options available to replace missing teeth. If you do not wish to have a bridge, then consider the following:
1. Leave the gap
- If you are happy with your dental appearance and the gap does not affect eating or socializing, then you may choose to leave the gap as it is. This carries a small risk of the teeth around the gap drifting into the space, making it more difficult to fit a bridge if you change your mind in the future.
2. Denture
- This is a false tooth attached to a removable plate, which must be removed from the mouth at night and for regular cleaning. It is usually recommended when multiple teeth are missing.
3. Dental Implants
- This is a false tooth attached to a titanium implant surgically placed into your jawbone. In some cases, this may give you very good function and appearance. However, this may not be possible for a number of reasons. Speak to your dentist for further details about this option.