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When a tooth is missing due to loss or extraction, the surrounding teeth can shift – sometimes within very short periods of time. This movement is not predictable and does not always happen. However, any change in tooth position can cause problems with the bite or gums that can be expensive and time-consuming to correct later. It is therefore wise to consider the replacement of a missing tooth as quickly as possible, unless your dentist advises that your bite will remain stable.

How are bridges used?

Single or multiple missing teeth can be replaced by a fixed bridge. Teeth on either side of the space can be used to anchor the bridge either with some preparation of these teeth (conventional bridges) or no preparation at all (Maryland Bridges).

The conventional fixed bridgework requires the teeth either side of the gap to be shaped and cut for crowns. The tooth replacement is adjoined to the two crowns and the crowns fit on the prepared teeth, like sleeves. This type of bridgework provides an excellent aesthetic result and can last for many years. The downside is that sometimes otherwise healthy teeth need to be crowned.

Types of bridge

Maryland Bridges are made by sticking the replacement tooth to the teeth either side of the gap. There is no drilling of the adjacent teeth, but the aesthetic result can sometimes be poor and the bridge can require re-bonding periodically.

Alternatives to bridgework include removable bridges or dentures, dental implants, or to leave the space as it is. Typically, an implant is the treatment of choice as it is very predictable, does not involve any damage to adjacent teeth, and will last many years if looked after. Removable bridges or dentures are less ideal as they can promote collection of plaque and food debris around the adjacent teeth, but all these solutions have their place in the appropriate situation. Your dentist will always advise and discuss all the alternatives available to you.

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