How do Bridges Work?

A bridge may be recommended if you're missing one or more teeth. If you are missing one or more teeth, the gap in your smile can cause many other problems, including additional decay, sensitivity, tooth drift, gum disease, and a change in your bite. . Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and in many cases, too, a missing tooth can cause the temporomandibular joint, or TMJ, to become misaligned, a condition referred to as TMD.

A bridge is a restoration designed to fill the gap caused by a missing tooth and prevent additional dental problems. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.


Many people who lose one or more back teeth are often inclined to do nothing to replace them. Unfortunately, losing a tooth can start a vicious cycle of destruction. In a normal, healthy mouth, your teeth have a natural balance. Each upper tooth contacts the corresponding lower tooth, allowing for a well-balanced chewing function. Losing a tooth quickly destroys this balance.A functional mouth has 28 teeth (14 upper and 14 lower - excluding wisdom teeth). They work as a team. Each tooth has three companion teeth: the two adjacent teeth and the opposing tooth. These companion teeth provide support and stability. Drifting, shifting, periodontal disease, and abnormal decay areas are some of the problems that can occur when your tooth loses the support of a companion. The adjacent teeth shift inward toward the missing space. This causes open spaces between the adjacent teeth and their companion. The opposing tooth will drift down into the space left behind by the missing tooth. This causes interferences which will affect eating and talking. As the opposing tooth drifts out of its socket, the bone support is lost and the tooth will inevitably be lost as well. This cycle is a domino effect which will lead to the loss of many otherwise healthy and vital teeth. In the picture below, a lower molar has been lost. Its neighbours and biting partners are jeopardized. This is what happens:

  • The opposing molar will super-erupt.

  • The unprotected ridge is subject to trauma.

  • The neighbor teeth tilt, destroying proper functional balance.

  • Shifting teeth create spaces which food will become trapped and lead to decay and periodontal disease.

  • Bone is destroyed as teeth drift and tip.


A fixed bridge will accomplish the following:

  • Replace missing teeth.

  • Help balance and restore a normal bite.

  • Help prevent unnatural stress on the dental ridge.

  • Prevent over-eruption of opposing teeth.

  • Prevent shift and tilt of adjacent teeth.

  • Help prevent formation of decay in abnormal areas.

  • Help retard the onset of periodontal disease.

Procedure in Making Dental Bridge

We prepare your teeth on either side of the space for the false tooth. Teeth on either side of the space are prepared to accommodate for the thickness of the crown. We will then make an impression, which will serve as the model from which the dental laboratory will be make the bridge (false tooth and crowns). A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums. On your second appointment, the temporary bridge will be removed. Your new permanent bridge will be fitted and checked and adjusted for any bite discrepancies. Your new bridge will then be cemented to your teeth.

There are three types of dental bridges:

1. Traditional Fixed Bridge -- Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures. A fixed dental bridge has a false tooth, known as a pontic, which is fused between two porcelain crowns to fill the area left by a missing tooth. These two crowns are held in place because they are attached onto your teeth on each side of the false tooth. This procedure is used to replace one or more missing teeth. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but can last as many ten years or more.

2. Resin Bonded Bridges -- The resin bonded is primarily used for your front teeth. Less expensive, this bridge is best used when the abutment teeth are healthy and don't have large fillings. The false tooth is fused to metal bands that are bonded to the abutment teeth with a resin, which is hidden from view. This type of bridge reduces the amount of preparation on the adjacent teeth. Resin bonded or "Maryland" bridge, primarily used for the front teeth.

3. Cantilever Bridges -- In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. This procedure involves anchoring the false tooth to one side over one or more natural and adjacent teeth.

Clasps and metal

If you are an appropriate candidate, a porcelain bridge can look as natural as (or in many cases better than) your own teeth, in color and shape, in proportion and alignment, with no clasps or metal appearance. Some bridges are designed with a metal support structure or a metal lining, covered with porcelain (porcelain-fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually can often look opaque or "flat" because they do not let light pass through like a natural tooth. There can also be a tell-tale dark band showing through the teeth or showing next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction). All-porcelain bridge restorations are what we chose to use unless there is a compelling reason otherwise. Again, when properly seated, they are virtually as strong or stronger than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency).

Alternative tooth replacement options

The two primary tooth replacement options in addition to bridges include:

  • Dental implants-A permanent, full tooth replacement option, dental implants provide the most complete and natural looking solution for tooth replacement.

  • Full or partial dentures-Dentures, either full or partial, offer a minimally invasive tooth replacement option for the visible or upper portion of the tooth. Unlike dental bridges, dentures are removable.

Caring For Your Dental Bridge

A dental bridge depends on the health of the adjacent teeth and gums for support. To care for your bridge, brush and floss normally after each meal.

Superfloss and floss threaders are effective tools for keeping the area under your bridge plaque-free. Superfloss has a stiff end that helps in threading it through tight areas and a fuzzy tufted segment that can remove plaque as you floss. Insert the superfloss under the bridge and use it to floss the sides of the teeth and under the bridge. Floss threaders also aid in removing plaque. Pull out about 18 inches of floss, insert it through the floss threader, and then use the threader to insert the floss under your bridge. Floss to remove food particles and plaque from the sides of the teeth and under the bridge. Use the same procedure to care for your temporary bridge, being careful not to dislodge it as you brush and floss. If it does come loose, gently re-attach it; call your dentist if your temporary bridge frequently comes loose.


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