The parts of a bridge, in plain terms
- Pontic
- The false tooth spanning the gap. It rests against the gum and is attached to nothing underneath, and that open space is the part people get wrong when cleaning.
- Abutment
- The natural tooth at each end that carries the bridge, prepared exactly as it would be for a crown, with the same amount of tooth removed.
- Retainer
- The crown sitting on each abutment, joined to the pontic. They are cemented as one piece, which is why you cannot floss between them normally.
- Span
- How many teeth the bridge covers. Two abutments carrying one pontic is routine, and longer spans flex more and load the supporting teeth harder.
- Maryland bridge
- A resin-bonded design with thin wings bonded behind the neighboring teeth, removing very little tooth. It suits a single missing front tooth with sound neighbors, and a wing can come loose unnoticed.
What a bridge costs you in tooth structure
The gap is not the expensive part. Preparing two healthy teeth is. Each abutment is cut down as it would be for a crown, which is a significant thing to do to untouched teeth purely to fill a space next door. A prepared tooth is also more likely to need root canal therapy later, and because the unit is joined, if one abutment fails the whole bridge comes off.
So the questions get asked in order. Can the neighboring teeth be left alone, which means an implant. If not, do they already need crowns anyway. If they are heavily filled, cracked or already crowned, preparing them costs almost nothing you were not going to spend.
Bridge or implant
Neither is automatically correct. More on the dental implants page.
| Consideration | Fixed bridge | Dental implant |
|---|---|---|
| Neighboring teeth | Both are cut down to carry the bridge | Left untouched |
| Surgery | None | A surgical placement, and a bone graft in some cases |
| Time to finish | A few weeks from preparation to cementing | Months, because bone has to heal around the implant first |
| Bone under the gap | Keeps shrinking, since nothing loads it | Loaded by the implant, which helps it hold shape |
| Cleaning | Floss threaded under the pontic every day | Much like a natural tooth |
When a bridge is the better choice
Implants get most of the attention, and they are not the answer in every mouth.
- Not enough bone, and no appetite for grafting. Building bone back adds surgery, months and cost.
- Medical factors. Some conditions, medications used for bone density, uncontrolled diabetes and heavy smoking make implant healing less predictable.
- The neighboring teeth already need crowns. If they are cracked or heavily filled, one course of treatment solves three problems.
- Time. A bridge is finished in weeks where an implant takes months.
- Cost. A bridge is generally less expensive up front than an implant and crown. Financing options and a written estimate come before you decide.
Cleaning under a bridge, which decides whether it lasts
Floss will not pass down between the pontic and the abutment, because they are joined as one piece. It has to go underneath.
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Use a floss threader or superfloss
A threader is a soft plastic loop that works like a needle for floss. Superfloss comes ready made with a stiff end and a spongy middle.
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Pass it under the pontic
Thread the stiff end into the space beneath the false tooth, above the gum, and pull through until you hold both ends.
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Work it against each abutment, then along the pontic
Draw the floss against the side of each supporting tooth and move it gently up and down, because that surface at the gum line is where decay starts. Then run it along the gum beneath the false tooth.
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Do it once a day
A water flosser or interdental brush is a useful addition and neither replaces wiping those surfaces. If it feels awkward, ask and we will show you.
Fixed bridge questions we get asked
How much does a bridge cost?
A three-unit bridge is three crowns worth of clinical and laboratory work, so cost tracks the number of units and the material. Replacing a missing tooth is generally treated as restorative rather than cosmetic by plans, though missing tooth clauses and waiting periods vary. See insurance.
Will I be able to eat normally?
Most people adapt within a few days. It is cemented in place and does not move, so it feels quite unlike a partial denture, though very hard and sticky foods deserve the caution you would give any crown.
Will it look like a real tooth?
The false tooth can be made very convincing. The harder part is where it meets the gum, because the ridge shrinks after a tooth is lost, so the pontic is sometimes longer than its neighbors or shaped to disguise it.
What happens if one of the supporting teeth fails?
The bridge has to come off, and what follows depends on why. Usually a longer bridge, an implant, or a partial denture. See restorative dentistry.