If you are missing one or more teeth, your dental surgeon may suggest fitting a prosthetic device to fill the gap. Several solutions are available nowadays including a dental bridge, denture, or tooth implant plus crown.
But how do you know which is the best replacement tooth option for you? In this guide we focus on bridges – a way of filling a gap of one or two teeth between two healthy teeth.
We'll answer your questions about tooth bridges including:
- What is a dental bridge?
- Can I get a dental bridge for front teeth, and does a front tooth bridge cost more?
- What's the difference between a bridge, implant, and denture?
- What are the advantages and disadvantages of these different options?
- How much does a tooth bridge cost in the US?
- What's the difference between a traditional fixed bridge and a bonded bridge?
We have made this guide to teeth bridges as comprehensive as possible so you can find all the information you need in one place. We hope this helps you decide whether a bridge is the best option for you.
Table of contents
- 1 What is a dental bridge?
- 2 Types of dental bridges
- 3 Dental bridge vs. implant vs. denture
- 4 How much does a dental bridge cost?
- 5 Do I need to replace a missing tooth?
What is a dental bridge?
A dental bridge is a type of dental prosthesis which literally bridges the gap between two teeth. If you have lost one or two teeth to decay or because of an accident, a bridge can make your smile complete again. Where more than two teeth in a row are missing, an implant-supported bridge may be an option – more on those later.
Tooth bridges come in a variety of materials and finishes. Metal alloys are usually the cheapest option, but they have the obvious disadvantage of looking nothing like natural teeth, although in the case of gold this is sometimes the goal.
Porcelain and ceramic bridges, when made well, look exactly like natural teeth. However, they come at a much higher cost because of the materials and lab work involved.
A solution that balances cost with appearance is a bridge made from ceramic or porcelain fused to a metal base (as pictured). This type of bridge can lose its aesthetic appearance over time, though, and may not be as strong as pure ceramic. The best material for your bridge will depend on your budget and the position of your teeth.
If you have lost one or more teeth, you have likely noticed a negative effect on the function, appearance, and health of your smile. It may be more difficult to speak, chew, and eat as normal, and you may feel embarrassed about your smile because of the gaps left by missing teeth. To replace your missing teeth, and restore your smile and self-confidence, your dentist may recommend a dental bridge. A bridge is used to replace one missing tooth or a couple of missing teeth in a row. When in place, a bridge can improve your smile by:
- Restoring the natural shape and volume of your face
- Improving your ability to properly chew, speak, and eat
- Enhancing the beauty of your smile
- Preventing the remaining teeth from moving into the space left by the missing teeth
- Relieving uneven stress on the bite
- Replacing an unwanted removable partial denture
Dr. Robert Berry, Mountain Aire Dentistry
Types of dental bridges
Traditional tooth bridges use the adjacent teeth as anchors for the prosthesis. There are two ways to fit a bridge to the existing teeth: fixed or bonded.
A fixed bridge is the most common type of dental bridge as it provides a strong, durable way to replace one or two adjacent teeth.
The prosthesis used for a fixed bridge consists of a crown on either side and one or two pontics (artificial teeth) in the middle. The crowns are hollow and fit over the neighboring teeth to secure the bridge in place.
In order for the crowns to fit properly, the anchor teeth must be filed down from their original size as part of the dental bridge procedure. These two teeth have to be strong enough to support the bridge and take the extra biting pressure. Dentists may perform root canal treatment on the anchor teeth before removing the necessary amount of enamel.
After preparing the anchor teeth, the next step in the dental bridge procedure is to take a dental impression. This is sent to a laboratory where your bridge is precisely made to measure. In the meantime, your dentist may provide a temporary bridge to protect the exposed teeth and gums.
Once your permanent bridge is ready, your dentist will position it in your mouth and ask you to test how it feels. Provided you're happy with the fit, your dentist will fix it in place using a strong dental cement. Further visits are sometimes required to improve the fit, but not always.
The main drawback to a fixed bridge is having to ‘sacrifice' two healthy teeth. If you later decide to replace your bridge with an implant, the adjacent teeth will require crowns since the removal of enamel is permanent.
You'll also need to take special care when cleaning and flossing around your bridge. Using a water flosser can make the process quicker, easier, and more effective.
Aside from that, a fixed bridge is a strong and durable solution. If you opt for a ceramic or porcelain bridge, nobody should be able to spot that the teeth aren't natural.
Front teeth bridge
A dental bridge for front teeth may require two crowns on either side since the biting pressure on the front incisors is so great.
If you are missing one or more front teeth, or have been told you need to have them extracted, your dentist will be able to advise you on the best type of front tooth bridge for you.
When there is only one tooth to replace, your dentist may fit a bonded bridge (also called a Maryland bridge).
Rather than being fitted over the adjacent teeth with crowns, this type of bridge has metal or porcelain ‘wings' on each side which are bonded to the inner edge of the adjacent teeth.
A bonded bridge, of course, has the advantage of preserving the healthy adjacent teeth. The main downside is that it won't be as strong as a fixed bridge. Over time the adhesive holding it in place can weaken, causing the bridge to break off or become loose.
With any type of bridge for teeth, it is only the crown of the tooth that is being replaced. The root remains absent, and this can cause the jawbone to recede over time.
Long-term, this may cause sagging around the face. If you choose to have implants at a later date, you may first need a bone graft. This is really the main problem with a dental bridge that patients need to be aware of.
Dental bridge vs. implant vs. denture
Bridges, implants, and dentures are all dental solutions for the replacement of missing teeth. Each offers advantages and disadvantages over the others, which we have summarized below. However, the best way to determine which is right for you is to have a consultation with your dentist.
Dental implants are placed directly into your jawbone, where your tooth root would have been. They are usually made from titanium, a very strong material which is biocompatible with our bodies (meaning there should be no allergic reaction or rejection of the implant).
An abutment is fitted to the implant, and this is what holds the crown (the replacement tooth) in place.
The main benefits of implants over bridges are:
- They don't affect the adjacent teeth
- They are a more durable solution and can last a lifetime
- It's easier to maintain good oral hygiene with an implant (less chance of decay and gum disease)
- They help maintain the structure of the jawbone and the shape of the face
On the downside, implants require some surgery and are much more expensive than a bridge fitted over teeth. If you take into account the lifetime cost and inconvenience of replacing your bridge, though, an implant may work out as a good investment in the long run.
Treatment time is another consideration for some patients. The process for placing a traditional implant takes several months, as the implant needs time to settle and fuse with the bone before the abutment and crown are attached. For some patients this is just too long to wait, so a bridge is the better solution.
If you are missing a tooth because of trauma, you may need additional time to heal before the implant process commences.
For patients who are missing several teeth in a row or whose remaining teeth aren't healthy enough to be used as anchors, bridged implants may be an option. Dentists can install implants in place of anchor teeth and then fit a bridge (made from two crowns and one or two pontics) over them.
This option is more cost-effective than replacing each tooth with an individual implant since it uses fewer implants.
Dentures are what most people think of as ‘false teeth‘. They consist of one or more prosthetic teeth fixed to a frame made from plastic and metal which clips around existing teeth. The versatility of dentures means they can be made to fit around any number of remaining healthy teeth. People who have lost all their teeth can get a full set of dentures.
Although dentures are the most affordable option when it comes to replacing a missing tooth, they are also the least convenient to live with. Wearers must be careful about what they eat as certain foods will dislodge or damage dentures.
Although you can clean your teeth as normal while wearing a partial denture, you'll still have to remove it sometimes for special cleaning. Full dentures, on the other hand, have to be removed often and left in a cleaning solution overnight.
Because of the way our mouths change over time (especially when teeth are missing), dentures may only last for a few years before coming loose. If they are not replaced, they can become uncomfortable and cause mouth sores. There is also a chance of them slipping out mid-conversation.
Comparing the options
Below is a comparison table for the tooth replacement options described above:
|Dental bridge||Dental implant + crown||Denture|
|Permanency||Fixed to adjacent teeth; non-removable||Implanted in the jaw bone, fixed in place||Removable|
|Longevity||5-15 years, possibly longer||20+ years||5-10 years, possibly longer|
|Comfort||Like natural teeth if fitted well||Like natural teeth||May become loose over time and cause discomfort|
|Appearance||Like natural teeth (unless metal)||Like natural teeth||May look artificial; metal clips may be visible|
|Function||Like natural teeth||Like natural teeth||Certain foods must be avoided; remove to clean|
|Other pros/cons||Requires removal of enamel on neighboring teeth||Involves surgery; small risk of infection||Can slip out of place; easy to lose or damage while removed|
How much does a dental bridge cost?
Dental bridge costs will, of course, depend on the material used and the type of bridge chosen, as well as your dentist's fees for consultations, fitting, etc. Your local clinic can probably give you an idea of prices prior to a consultation, either by phone or on their website. Keep in mind that the three-unit bridge cost will be more than a two-unit and a two-unit more than a bridge for just one tooth.
Your dentist will certainly want to check your mouth and the state of your remaining teeth before confirming your treatment plan and providing a final cost estimate.
Cost of bridges in the US
If you have a dental plan, it may well offer you a discount on restorative treatment with a bridge. Some plans even make a contribution towards the cost of implants.
You'll need to visit a dentist to get a quotation for your treatment, but this table shows approximate costs for different types of bridge:
|Type of bridge||Average cost|
|Traditional fixed crown and bridge||$500 - $1,500 per unit|
|Bonded bridge||$700 - $2,300|
|Implant-supported bridge (2 implants, 3-unit bridge)||From $5,000|
You could also consider traveling overseas to get cheaper dental bridges. Costa Rica and Mexico are two of the most popular destinations for Americans seeking more affordable treatment.
You can also read our finance article for more funding options.
Do I need to replace a missing tooth?
With all these options to choose from, it may seem easier to do nothing at all and just live with a gap in your mouth – especially if it's towards the back where nobody really sees it.
However, there are several reasons why it's not a good idea to ignore the problem:
- It's harder to eat with a tooth missing
- The surrounding teeth will be subject to extra pressure and wear
- There is a greater risk of gum disease
- It may affect your speech
- The supporting jawbone will deteriorate over time and facial muscles may sag (this can be avoided with an implant, but not a bridge)
So if you or a loved one are missing one or more teeth, the question is not “Should I replace it?” but “How should I replace it?”
Both dentures and bridges for teeth are relatively affordable and may be covered by insurance, so getting a prosthetic tooth doesn't need to break the bank. For those who want a natural-looking, permanent way to fill a gap between teeth, a bridge may be the best option. Once fitted, you can forget that it isn't one of your natural teeth.
Implants are an even longer-lasting solution and they help retain the patient's jaw bone and facial shape. However, they cost a lot more than bridges. Fortunately, there are ways you can save money on dental implants if this is the option you wish to choose.