Treatment
Dental Bridges in Mesa, AZ
There is a gap where a tooth used to be, and you would rather not have something that comes out at night.
A bridge fills that gap with a false tooth carried by the teeth on either side, cemented in place, with nothing to clip in and nothing to take out.
The treatment
What a dental bridge actually is
A bridge fills a gap with a false tooth that is carried by the teeth on either side of it. Those two teeth are prepared and crowned, the false tooth is joined to the crowns as a single piece, and the whole thing is cemented in. Nothing clips in, nothing comes out, and once it is fitted you should not have to think about it day to day.
That is what separates it from a denture. It is also what separates it from an implant: a bridge borrows its support from the teeth next to the gap, where an implant gets its support from the jawbone instead.
A bridge can also span a gap wider than one tooth, as long as the teeth at each end are strong enough for the extra load. And not every bridge is the same design. Some are bonded to the back of a neighbouring tooth and need far less preparation, though they suit a narrower set of situations, usually a front tooth under a light bite. Which design fits your gap is an examination question rather than a general one.
A bridge or an implant: the honest comparison
This is the decision most people are really making, and it turns on one thing: what happens to the teeth either side of the gap.
- If those teeth are sound and untouched, that is a genuine argument for an implant. Cutting down two healthy teeth to replace one missing one is a trade worth thinking hard about, and an implant does not ask you to make it.
- If they already need crowning (heavily filled, cracked, worn, or crowned once already), a bridge does two jobs at once and that objection falls away. This is the case where a bridge is straightforwardly the better answer.
- If waiting is the problem, a bridge is the quicker route. An implant has a healing stage while the bone fuses to the post, and it cannot be hurried. A bridge has no equivalent.
- If there is not much bone left at the gap, an implant may need grafting first. A bridge does not depend on the bone under the gap at all.
The other side of that is worth saying plainly: because nothing is anchored into the bone under the gap, that bone carries on receding the way it does under any missing tooth. An implant is the option that stops it.
There is more about the other route on our dental implants page. You do not need to have decided before you come in. Working out which one makes sense for your mouth is what the consultation is for, and if the answer is the cheaper or simpler one, that is what you will be told.
Cleaning under a bridge is the part people get wrong
Almost everyone with a new bridge is told to keep it clean. Far fewer are shown how, and the usual method does not work here.
Floss will not pass between the false tooth and the teeth carrying it, because all three are joined as one piece. So ordinary flossing cleans around the outside of a bridge and leaves the underside untouched: the strip of gum beneath the false tooth, and the margins where each crown meets the tooth it covers. Plaque sits there undisturbed.
Those margins are where a bridge tends to fail. The false tooth cannot decay. The teeth holding it up can, and they can do it underneath a crown, where you will not see it happening.
What actually reaches under there:
- a floss threader or superfloss, to pass floss beneath the false tooth and draw it along the gum
- an interdental brush sized to the space, where there is room for one
- a water flosser, which many people find easier to keep up with. It works best alongside threading rather than instead of it
- your usual hygiene appointments, so the margins are checked and cleaned by someone who can see them properly
If your hands are not steady, or the space is tight, say so at the fitting appointment rather than struggling with it at home. There is usually a tool that suits you better than the one you were handed first.
What shortens the life of a bridge
We will not put a number of years on your bridge, because the number would be about bridges in general and not about your mouth. What we can tell you is what tends to end them, and most of it is within your control:
- decay at the crown margins, from plaque left under the false tooth
- gum disease loosening the teeth that carry it
- heavy grinding or clenching, which loads the bridge harder than ordinary chewing does
- a supporting tooth that was already close to the end of what it could take before the bridge went on
Look after the two teeth doing the work and you are looking after the bridge. That is the honest summary, and it is why the cleaning section above is longer than the one about the procedure.
Good to know
A fixed replacement, with nothing to take out at night
Carried by the teeth either side of the gap
Those teeth are prepared and crowned
Fitted in stages, with a temporary in between
Cleaned underneath, not just around
What to expect
Four stages, spread over a few visits.
01
Assessment
An examination and X-rays, to check the teeth either side are strong enough to carry a bridge and that the gum and bone around them are healthy.
02
Preparation
Under local anaesthetic the supporting teeth are shaped so crowns will fit over them, and an impression or a scan goes to the laboratory.
03
A temporary
A temporary bridge protects the prepared teeth and fills the gap while the permanent one is being made.
04
Fitting
The finished bridge is tried in and checked for fit, bite and shade. Adjustments are far easier before it is cemented than after.
Candidacy
Is a bridge the right answer for you?
None of these settles it on its own. If the teeth beside the gap are sound and untouched, cutting them down to carry a bridge is a real trade, and an implant may be the better answer for you.
There is a gap of one or two teeth, with a tooth still standing at each end.
The teeth either side are already heavily filled, cracked, worn, or crowned.
You would rather have something fixed than something that comes out at night.
Waiting months for an implant to heal does not suit you.
There is little bone left under the gap, so an implant would need grafting first.
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Common questions
How is a bridge different from an implant?
A bridge is held up by the teeth either side of the gap. An implant is held up by the jawbone, where the root of the missing tooth used to be. That is the whole difference, and everything else follows from it: a bridge means preparing and crowning two neighbouring teeth, while an implant leaves them untouched but needs the bone to fuse to the post before the tooth goes on top. Which one suits you depends mostly on the condition of the teeth beside the gap.
Do the teeth either side really have to be drilled?
For a conventional bridge, yes. They are shaped so a crown can fit over them, and that change does not reverse. Once a tooth has been prepared this way it stays a crowned tooth. If those teeth are already heavily filled, cracked or worn, that matters far less, because they were heading for crowns anyway. If they are sound and untouched, it is worth asking whether an implant is the better fit for your mouth before you commit.
How do I clean underneath a bridge?
Not with ordinary floss. The false tooth is joined to its crowns, so floss cannot pass between them and only cleans around the outside. You need something that goes under the false tooth and along the gum: a floss threader or superfloss, an interdental brush where there is room for one, or a water flosser as an addition. Ask your hygienist to show you on your own bridge rather than in general, because the space under each one is a different size.
How long will a bridge last?
There is no honest single answer to that, and a number would be a guess about your mouth rather than a fact about bridges. What decides it is the health of the two teeth carrying it and how clean the space underneath is kept. Bridges usually come to an end not because the false tooth wears out but because decay or gum disease reaches a supporting tooth, often at the margin where the crown meets it.
Can I still have a bridge if the teeth next to the gap are not in great shape?
It depends on what is wrong with them. A heavily filled tooth can often still carry a bridge, and crowning it may be doing it a favour. A tooth that is loose, or that has lost a lot of bone support to gum disease, is a poor anchor, and adding the load of a false tooth to it can make things worse rather than better. This is why the assessment looks as closely at the neighbours as it does at the gap.
Will it look like a real tooth?
The false tooth is made to match the shape and shade of the teeth around it, and for most people it is not something anyone notices in conversation. The part worth asking about is the gum line: where a gap has been there a long time the gum and bone recede, so a false tooth can meet the gum a little differently from a natural one. Raise it at the planning stage, while the design can still take it into account.
No obligation
Ask about dental bridges
Tell us what is going on and we will call you back to arrange a time. If it turns out you need something other than dental bridges, we will tell you that too.
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Not sure what you need?
That's okay.
Many patients come in knowing something isn't right but aren't sure what treatment they need.
We'll start with a conversation and a thorough evaluation. Dr. Sandstrom will explain what he sees, discuss your options, answer your questions, and help you decide what makes sense for you.