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A dental bridge is a fixed restoration that replaces one or more missing teeth by resting on the teeth beside the gap. Those teeth, called abutments, are prepared and covered with crowns joined to the replacement tooth that spans the space, and the bridge is then cemented as a single unit that only the dentist removes. Bridges take several forms. The conventional design uses an abutment on each side of the gap and is the most common. A cantilever bridge is supported on one side only and requires particular conditions. A resin-bonded bridge uses thin wings cemented to the back of the neighbouring teeth, preserving more tooth tissue and suiting a limited set of cases. An implant-supported bridge consumes no sound teeth at all. Two alternatives deserve a neutral discussion: an implant preserves the adjacent teeth and transmits load into the bone, but needs sufficient bone and a longer timeline; a removable partial denture takes less tooth structure but feels less stable and is taken out by the patient for cleaning. A bridge is the stage that follows treatment of the cause. The reasons the tooth was lost, gum disease, decay and grinding, are addressed first, and the abutment teeth must have sound roots and healthy supporting tissues, because the bridge transfers the load of the missing tooth onto them as well. A bridge is not built on a mobile abutment, on a tooth with untreated inflammation or decay, or over gums that bleed at the preparation margins. The limits must be clear. A bridge replaces the missing crown, not the root, so it does not stop bone resorption where the tooth was extracted, and the gum contour under the span keeps changing. It requires preparing teeth that may be sound. Cleaning beneath the span cannot be done with ordinary floss alone; it needs threader floss or an interdental brush, and neglecting this decays the abutments, which is the commonest reason bridges fail. The belief that a restoration frees you from cleaning ends a bridge early, and the belief that extraction is easier and cheaper than saving a tooth creates the very gap that later demands a costlier and longer bridge or implant. How long a bridge lasts depends on your hygiene and habits, such as grinding or biting ice, not on a promised number of years, and suitability is decided by clinical examination and imaging, not by reading.
The teeth beside the gap are examined, their mobility and pocket depths measured, and radiographs assess the roots and supporting bone. The bridge is then compared with its two alternatives, an implant and a partial denture, according to your case, with the advantages and limits of each explained before you decide.
The gums are cleaned and inflammation treated until bleeding stops, decay is restored and damaged roots in the abutment teeth are treated, sometimes with a supporting core placed inside them. Preparation does not begin before the tissues are stable, because a bridge cemented over inflammation fails and hides the problem.
The area is anaesthetised and the abutment teeth are prepared by a calculated amount along a single path that allows the bridge to seat, then a digital scan or impression is taken with bite and shade records. A temporary bridge is fitted to protect the teeth, preserve the gum contour and allow limited chewing.
The bridge is made in the laboratory and then tried in to assess its seating on both abutments, the marginal fit, and the shape of the span over the gum so that it is cleanable rather than pressing on tissue. Shade and bite are assessed and contact points adjusted before final cementation.
The bridge is cemented with a suitable material, residual cement is carefully removed from beneath the gum, and the bite is adjusted in closure and lateral movements. You are then trained in practice to pass threader floss or an interdental brush under the span every day, the single habit the bridge's survival depends on.
Tell your dentist all your medicines and chronic conditions, especially blood thinners, diabetes, heart disease and osteoporosis, and any allergy to anaesthetic or materials. Say why the tooth was lost if you know, whether gum disease, fracture or decay, because it shapes the plan and prevents the same cause damaging the abutments. Mention grinding or clenching, which changes the bridge design and may require a night guard. If you plan to whiten your teeth, do it before the bridge shade is chosen. Clean your teeth carefully in the week before the visit, since bleeding gums distort the impression. Come after a light meal and allow enough time for the first appointment, which is the longest.
While the temporary bridge is in place, avoid sticky and hard food on that side, and if it comes loose contact the clinic promptly, because prepared teeth become sensitive and can shift. After final cementation, wait for the anaesthetic to wear off before eating, start with soft food on the first day, and expect a feeling of fullness that settles within days. Clean twice daily with a soft brush and fluoride toothpaste and, most importantly, pass threader floss or an interdental brush every day under the span and at both abutment margins; a restoration does not exempt you from cleaning, it tightens the duty, and decay in the abutments is the commonest reason a bridge is lost. Avoid biting ice and pens, and wear a night guard if prescribed. **Seek care immediately for facial or under-jaw swelling, fever, difficulty swallowing or breathing, pus or a persistent foul odour from under the bridge, or throbbing pain unrelieved by painkillers.** Also return if the bridge feels mobile, the bite feels high, or the gum around an abutment bleeds repeatedly.
Usually two to three visits over two to four weeks: 75 to 120 minutes for the preparation visit and 30 to 60 minutes for the fitting.
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