When a tooth is lost, the resulting gap can affect chewing function, speech, and the alignment of surrounding teeth. Leaving this space open can cause neighboring teeth to drift, disrupting the bite and potentially leading to further dental complications. A fixed dental bridge is a common, non-removable prosthetic solution that restores this gap by permanently anchoring a replacement tooth to the adjacent natural teeth. This restoration maintains the correct spacing and structure of the mouth.
Defining the Fixed Dental Bridge
A fixed dental bridge functions by connecting an artificial tooth to the teeth on either side of the space, literally bridging the gap. The bridge consists of three main components that work together as a single unit. The replacement tooth, known as the pontic, sits directly over the missing tooth’s location.
The pontic is secured by crowns cemented onto the natural teeth adjacent to the space, which are referred to as the abutment teeth. These abutment teeth serve as the foundational anchors, supporting the prosthetic structure. The total number of units in a bridge is the sum of the pontics and the abutment crowns.
There are three primary types of fixed bridges, used for different situations depending on the condition of the abutment teeth. The most common is the traditional bridge, which requires an abutment tooth on both sides of the gap to support the pontic. This design is used when a space is bounded by healthy teeth.
A cantilever bridge is utilized when a missing tooth has healthy abutment teeth only on one side. This design places more stress on the single supporting tooth and is typically reserved for areas of the mouth that experience less intense biting forces. The third type is the Maryland bridge, or resin-bonded bridge, which avoids the need for full crowns on the abutment teeth. Instead, the pontic is attached by a framework bonded to the back surface of the adjacent teeth, requiring less reduction of the natural tooth structure.
The Installation Process
The process of receiving a fixed dental bridge usually requires two to three visits to the dental office. The first appointment is dedicated to preparing the abutment teeth and taking impressions. The dentist must reshape the natural abutment teeth by reducing a portion of their outer enamel layer.
This reduction is necessary to create adequate space for the dental crowns that will fit over them without making the final bridge appear bulky. After the teeth are prepared, the dentist takes an accurate impression of the area. This impression is then sent to a dental laboratory, where technicians custom-fabricate the permanent bridge to ensure a precise fit and natural appearance.
Before leaving the first appointment, the patient receives a temporary bridge placed over the prepared abutment teeth. This temporary restoration protects the exposed tooth structure and maintains the aesthetic of the smile while the permanent bridge is being made. Fabrication typically takes a few weeks to complete.
During the final appointment, the temporary bridge is removed, and the permanent bridge is checked for fit, color, and comfort. The dentist ensures the bite alignment is correct, making any necessary adjustments for optimal function. Once the fit is confirmed, the bridge is permanently cemented onto the abutment teeth using a strong dental adhesive.
Materials and Lifespan Expectancy
Fixed dental bridges are constructed from materials chosen to balance strength, durability, and aesthetic appearance. One common option is porcelain-fused-to-metal (PFM), which uses a metal alloy base for structural support covered by a layer of tooth-colored porcelain. PFM bridges offer resilience for chewing and a natural look, though the underlying metal can sometimes become visible at the gum line.
For maximum aesthetic appeal, full porcelain or ceramic materials are often selected. These materials mimic the light-reflecting properties of natural enamel, but they may not offer the same fracture resistance as metal-containing options. Zirconia, a highly durable ceramic material, has become a popular modern choice as it provides both exceptional strength and a natural, tooth-like appearance.
The expected lifespan of a fixed dental bridge ranges from five to 15 years, but this duration is variable. The material choice influences longevity, with strong materials like gold alloys and zirconia often lasting longer than pure porcelain. However, the health of the supporting abutment teeth and the patient’s daily oral hygiene habits are the most significant factors determining how long a bridge remains functional.
Daily Care and Cleaning Techniques
Maintaining a fixed dental bridge requires specific cleaning techniques to preserve the health of the supporting abutment teeth and the surrounding gum tissue. Plaque and food debris can easily accumulate beneath the pontic, leading to decay in the abutment teeth or gum inflammation. Regular twice-daily brushing with a soft-bristled toothbrush and fluoride toothpaste is necessary to clean the surfaces of the crowns and the pontic.
Specialized tools are needed to clean the area underneath the pontic where standard floss cannot reach. Floss threaders, which have a stiff end to guide the floss under the bridge, or products like Superfloss are designed for this purpose. The floss must be gently threaded through the space and moved back and forth to remove trapped particles and plaque from the underside of the artificial tooth.
Interdental brushes are another effective tool for cleaning the spaces between the pontic and the abutment teeth. Many patients also find that a water flosser, which uses a pressurized stream of water, is effective for flushing out debris from the hard-to-reach areas around and under the bridge. Consistent daily cleaning of this sub-pontic area is necessary to prevent problems that could compromise the restoration.