Bridges and dentures are dental prosthetics used to replace missing or lost teeth. A dental bridge is what we call “fixed”, meaning the prosthetic is glued into your mouth and cannot come out unless removed by your dentist.
Dentures and partial dentures are also used to replace missing teeth, however these prosthetics are removable. They are designed to fit in your mouth resting on gum tissue or remaining healthy teeth and are removed and cleaned regularly at home. There are various pros and cons to each appliance. Ask your dentist which might be best for you.
A dental bridge works by preparing the healthy teeth on either side of a missing tooth area for crowns. Rather than the crowns being separate and distinct units, a dental bridge suspends a fake or “pontic” tooth in between these two new crowns to “span” the gap much like a roadway on 2 pylons over a gorge or river. The bridge is made by a technician in a dental laboratory as one solid piece of metal, ceramic or a combination of the two.
A “three unit bridge” uses two existing teeth to help carry the load and fill the space of a single missing tooth. Occasionally, additional teeth may be added into the bridge to add strength or improve aesthetics. Dental bridges can also be made using 2 or more implants to achieve a similar result.
Pros of Dental Bridges:
- The entire process, from start to finish, takes only a few weeks. Bridges are often the quickest way to replace a missing tooth.
- While bridges work by using the strength of existing teeth, they are not dependent on the density or shape of the bone at the site of the missing tooth.
- Dental bridges are a routine procedure for dentists and often do not require any additional treatments or surgeries to complete.
- If the neighboring teeth are already in need of large fillings or crowns, bridges are an ideal way to fix and strengthen those teeth while also filling in the gap of a missing tooth.
Cons of Dental Bridges:
- Bridges can be costly… Essentially, a bridge is three crowns and you can often estimate the cost of a bridge by multiplying the cost of a single crown by three. If two teeth need replaced, a bridge may involve four or five units to complete the prosthetic.
- Bridges require relatively healthy adjacent teeth both in front of and behind the area needing a new tooth. Since we are asking these existing teeth to carry the additional load of the new tooth, the gums and bone around in these areas must be in relative health.
- Because the three or four teeth in a new bridge are actually one single unit, you will be required to perform some extra tasks to keep these areas clean. You will not be able to floss in a conventional way around some parts of the bridge and keeping all the teeth of a bridge healthy is very important.
- Problems to one of the support teeth involved in the dental bridge can compromise the entire prosthetic. If one of these teeth breaks or fails the entire bridge may be lost.
“Dentures” is a shorthand term that patients often associate with a complete loss of all teeth. In reality, “dentures” can be an all encompassing term used describe removable prosthetic devices replacing any number of teeth. We often split dentures into two categories.
A removable partial denture, or “partial” is a dental prosthetic used to replace missing teeth in the upper or lower jaw. A partial uses remaining natural teeth as anchors, often latches on to these teeth with plastic or metal clasps to help stabilize the denture during chewing and talking.
Pros of removable partial dentures:
- Partials can be a very economical way to replace missing teeth. The number of teeth being replaced does not affect the cost of a partial denture.
- A single partial may be able to replace every missing tooth in the arch.
- Because a partial is removed, the prosthetic and remaining teeth are often easily cleaned.
- Partials can be very sturdy and if cared for, can last for many years.
Cons of removable partial dentures:
- Because of the lab time involved and the necessity of try-in and check up/adjustment appointments, the process of a partial may take several months and involve several appointments.
- Remaining teeth used to clasp or support the partial must be healthy and structural sound. These teeth may need to be shaped or fixed to allow room for the partial and occasionally, anchor teeth need to be crowned to ensure they are strong enough to hold the denture in place during chewing and talking.
- Partials may put stress on remaining teeth in the mouth and can weaken them over time.
- Patients may notice changes in speech or chewing ability because of the shape and bulk required to make a strong partial.
- Partials use metal or plastic clasps, plastic teeth and pink acrylic resin to hold the shape and replace teeth. These solutions and materials are less esthetically appealing than implants or bridges.
- Loss of, or damage to remaining teeth may jeopardize the partial. If teeth are lost a partial may need to be repaired, modified or replaced entirely.
- Small changes to the shape of the gums, the position of the teeth or even the patients weight may change the fit of the partial. Sore spots may develop and adjustments or repairs may need to be made from time to time.
A complete denture is a removable prosthetic used to replace all teeth in the upper or lower jaw. Dentures use plastic or porcelain teeth set in a pink acrylic base. Support for the denture comes from the gums, the remaining jaw bones and the muscles and tissues in the mouth. Complete dentures may be made to snap onto implants for added retention and support.
Pros of complete dentures:
- Complete dentures are the least expensive way to replace teeth if they have all been lost.
- Dentures can totally recreate a smile. The patient gets to select the size, shape, color and position of the teeth.
- Complete dentures are usually very durable and can last many years.
Cons of complete dentures:
- Because of the lab time involved and the necessity of try-in and check up/adjustment appointments, the process of a complete denture may take several months and involve several appointments.
- Remaining teeth need to be extracted prior to the fabrication of the long term complete denture. A waiting or healing period of several months is required to allow complete healing and to ensure a proper fit. A patient may choose to have a temporary or “healing” denture made to wear during this period or elect to live without teeth for several months.
- A certain bulk of acrylic material is required to give the denture adequate strength and allow it to stay in place. Some patients may not tolerate this material very well.
- Patients may experience changes in speech and changes or limitations in chewing ability.
- Dentures require a “learning” period where a patient must get used to taking and chewing with the prosthetic device. Over time, the muscles in the face will accommodate the denture and work to keep the denture in place but this process may take time. Some patients take several months to feel completely comfortable with their new dentures.
- Certain foods or eating patters may never as they were with natural teeth. Many denture patients will never bite into a sandwich or apple with their front teeth again, and while improvements come over time, there will be some foods that cannot be eaten in the same way as with natural teeth.
- Small changes to the shape of the gums and/or bones of the jaw, may change the fit of the denture over time. Sore spots may develop and adjustments or repairs may need to be made.