What Is the Downside of Having a Dental Bridge in Aurora, CO?

Written by the Aspenwood Dental Team

Key Takeaways

• The biggest trade-off of a traditional bridge is that the healthy teeth on either side are reshaped to hold crowns, and that enamel does not grow back.
• The supporting teeth carry the whole bridge, so decay or gum problems around them put the entire restoration at risk.
• Cleaning under the false tooth takes extra tools and daily effort, and skipping it is how most bridge problems start.
• Each bridge type has its own weak point, and a bridge does not replace the tooth root, which is why an implant is sometimes the better long-term fit.

The main downside of a dental bridge is what it asks of the teeth next to the gap. A traditional bridge is held in place by crowns on the neighboring teeth, and to fit those crowns your dentist has to remove some of their enamel. Cleveland Clinic describes that step plainly as irreversible. From that point on, those teeth are carrying a bigger job than before, and the success of the bridge depends on keeping them healthy.

That does not make a bridge a poor choice. For many people it is a sound, fixed way to replace one or a few missing teeth, and it can be done without surgery. But it is worth knowing the trade-offs before you agree to one, because some of them cannot be undone. At Aspenwood Dental Associates and Colorado Dental Implant Center, an independent practice in Aurora since 1972, we would rather you choose a bridge knowing all of this than be surprised by it later.

What is a dental bridge, in plain terms?

A bridge replaces missing teeth by joining an artificial tooth to the teeth or implants on either side of the gap. The American Dental Association notes it is sometimes called a fixed partial denture and that a fixed bridge can only be removed by a dentist. The supporting teeth are called abutments. The false tooth that fills the space is called a pontic.

There are four main designs, and the downsides differ between them, which is why a single list of pros and cons online can be misleading:

• Traditional bridge: a crown on each side of the gap with the false tooth in between. The most common type.
• Cantilever bridge: supported by a crown on one side only.
• Maryland or resin-bonded bridge: held by thin metal or ceramic wings bonded to the back of the neighboring teeth instead of full crowns.
• Implant-supported bridge: rests on dental implants rather than on natural teeth.

The downsides that apply to most bridges

Healthy teeth are reshaped to hold it

For a traditional bridge, the teeth on both sides of the gap are filed down so crowns can fit over them. If those teeth were already heavily filled or damaged, crowning them may protect them. If they were healthy and untouched, you are giving up natural tooth structure to fill the space next to them. The ADA suggests that people who do not want good tooth structure removed for a bridge ask their dentist whether dental implants are an option.

The whole bridge depends on the supporting teeth

A bridge is only as strong as what holds it up. The ADA puts it simply: its success depends on the foundation. Cleveland Clinic lists the risks that follow from this. If decay or trauma damages a supporting tooth, the bridge is weakened. If a supporting tooth is not strong enough for the load, it can fracture. Because the teeth are joined, a problem on one of them often means the whole bridge has to come off to treat it, and Cleveland Clinic notes a bridge may break during that removal.

Cleaning under it takes real effort

Regular floss cannot pass between a bridge and the gum under the false tooth, because the teeth are joined. Plaque and food collect there, and if they are left, Cleveland Clinic notes they can lead to gum inflammation or cavities. Cleaning under the bridge every day with floss threaders or small interdental brushes is part of owning one. The ADA adds that people with bridges may find a water flosser helps them reach every nook and cranny. This is the downside people underestimate most, and it is the one most within your control.

The nerve in a supporting tooth can be affected

Preparing a tooth for a crown is a significant procedure for that tooth. In a 2004 systematic review of cantilever bridges, the most common biological complication reported was loss of vitality of the pulp, the living tissue inside the tooth, followed by decay of the supporting teeth. When the pulp of a supporting tooth is damaged, a root canal may be needed, sometimes through the bridge itself. Our post on the signs you may need a root canal explains what to watch for.

It does not replace the root

A bridge replaces the visible part of a missing tooth. It sits on the gum and does not go into the bone the way a tooth root does. After a tooth is lost, the bone that held it changes shape. A 2012 systematic review of human studies found measurable loss of both the width and the height of that bone within six months of an extraction. A tooth-supported bridge is not designed to change that. Cleveland Clinic notes that implants preserve existing bone and reduce the risk of future bone loss, which is one of the main reasons people compare the two.

It will need replacing at some point

Bridges are fixed, but fixed is not the same as indefinite. Cleveland Clinic makes the same point: only a dentist can remove a bridge, but that does not mean it lasts indefinitely. In a systematic review of conventional bridges followed for at least five years, the complications reported included the bridge coming loose, fracture of a supporting tooth, fracture of the bridge material, and loss of the bridge to decay or gum disease. How long any one bridge lasts depends on the design, the material, the health of the supporting teeth and how well it is cleaned, so we do not give a single number here.

The specific weak point of each type

Traditional bridges

The trade-off is the preparation of two supporting teeth rather than one. In exchange, this design spreads the load across both sides of the gap, which is why it remains the most common type.

Cantilever bridges

Only one tooth holds the bridge, so that tooth takes the leverage of the false tooth on its own. Cleveland Clinic notes that because of their design, cantilever bridges are not as strong as traditional ones. In the 2004 cantilever review mentioned above, the bridge coming loose was the most frequent technical complication.

Maryland or resin-bonded bridges

These remove far less tooth structure, which is their main advantage. The weak point is the bond. A 2017 systematic review of resin-bonded bridges found that the most frequent complication was debonding, meaning the bridge came loose from the teeth. Cleveland Clinic also notes these bridges are usually used for front teeth, because they are not strong enough for the chewing forces at the back of the mouth.

Implant-supported bridges

These avoid reshaping natural teeth, but they bring the requirements of implant treatment with them. According to Cleveland Clinic, implant placement may involve a few procedures and several months of healing, and there has to be enough jawbone to support the implants, sometimes with a bone graft first. They also need the same daily cleaning under the bridge as any other bridge.

When a bridge is still the right choice

None of this means an implant always wins. A bridge can be the more sensible option in several situations, and a fair comparison should say so.

• The teeth next to the gap already need crowns. If they are heavily filled or cracked, crowning them protects them and supports the bridge at the same time, so the main downside of a bridge largely disappears.
• Implants are not suitable right now. Cleveland Clinic lists active gum disease, severe bone loss in the jaw, unmanaged diabetes, some bone and autoimmune conditions, and smoking or vaping among the reasons an implant may not be the right option.
• You do not want surgery, or the timeline matters. A tooth-supported bridge avoids surgery and the months of healing that implants can involve.
• Your overall health makes healing harder. The ADA notes that chronic illnesses such as diabetes may interfere with healing after surgery, and that health is more of a factor than age.

If you are weighing the two, our pages on dental bridges and dental implants explain what each involves here. If the gap is still open and you are deciding whether to fill it at all, what happens if you don’t replace a missing tooth covers that question. Our posts on the true cost of dental implants in Aurora and what to know before switching to implant-supported solutions go further on the implant side.

How to lower the risks if you already have a bridge

• Clean under the false tooth every day with a floss threader, an interdental brush or a water flosser, not just the visible surfaces.
• Keep your recall appointments, so decay at the edge of a supporting crown or early gum problems are found while they are small.
• Tell your dentist about grinding or clenching. A guard may protect both the bridge and the supporting teeth.
• Do not ignore a change. Cleveland Clinic advises calling your dentist if the bridge feels loose, has visible cracks, causes pain when chewing, or if you notice tooth sensitivity or sore, bleeding gums.

How Aspenwood helps you decide on a bridge in Aurora

Your first visit with us is a complimentary consultation. You meet with a dentist first, for a real conversation rather than a rushed exam, and you leave with a clear diagnosis and a personalized treatment plan, with no obligation to go ahead. If a bridge is one of your options, we will show you which teeth would support it, whether those teeth would benefit from crowns anyway, and how it compares with an implant or a partial denture for your situation.

Bridges at Aspenwood are made in our in-house crown and bridge laboratory, where the lab technicians work alongside your dentist on the shade, shape and fit. You get the full price before treatment is scheduled, and our financial information and membership plan pages explain the payment routes we offer. Our aim is lasting oral health and a dental home for life, which means recommending the option that fits your mouth, not the one that is easiest to sell.

Frequently Asked Questions

Not sure whether a bridge is right for you?

Book a complimentary consultation and we will look at the teeth around the gap, explain what a bridge would ask of them, and compare it honestly with your other options before anything is scheduled. Reach us through the contact page or call (303) 529-2913.