All of your teeth work together to help you chew, speak, and smile. If you've recently lost one or more teeth, you're probably aware of their importance to your appearance and dental health. Fortunately, missing teeth can usually be replaced with a bridge.

Here is an inlay bridge placed at this office:

This patient also had veneers done on the teeth surrounding the bridge shown here. This particular bridge is made entirely of porcelain (no metal) and as you can see, it looks entirely natural.

This patient had two teeth extracted, minor orthodontics and two 3-unit bridges placed to correct the rotated and crowded teeth. The right photo was taken eight months after finishing the case.

 What exactly is a Bridge or fixed partial denture?
A bridge (also called a fixed partial denture) is a restoration that replaces one or more missing teeth, by spanning the space where the teeth have been lost. There are two types of bridges: fixed and removable. Fixed bridges are cemented into place and can only be removed by a dentist. Removable bridges (also called partial dentures) are held in with clasps to other existing teeth and can be taken out for cleaning. Removable bridges, while less expensive, have a lot of extra hardware to do the same function as a bridge, and are not as comfortable as a fixed bridge.

 Why should I replace a missing tooth?
When a tooth is not replaced, the remaining teeth can drift out of position. Because the teeth do not touch each other in a normal manner, food and bacteria can gather in places that they normally wouldn't, leading to increased cavities and gum disease.

 Why do I need a bridge?
Your appearance, dental health and the proper functioning of your mouth are all important reasons for placing a bridge. A bridge helps maintain the natural shape of your face and may help support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.

More importantly, though, your dental health may suffer when teeth are not replaced. Teeth were designed to complement each other. When a tooth is lost, the nearby teeth may tilt toward the empty space, or the teeth in the opposite jaw may move up or down toward the space. This places unusual stress on both the teeth and tissues in your mouth.

In addition, the gum tissues and the bone that holds teeth in place can break down, increasing the risk of gum disease. Teeth that have tipped are difficult to clean, making them more likely to decay. As a result, even more teeth may be lost.

Missing teeth can also affect the way you chew and speak. Chewing on only one side may cause stress to your mouth and TMJ (temporomandibular joint) You also need your teeth to speak properly, since they help you make the many sounds needed in speech.

 How is a bridge attached?
The teeth on both sides of the space are prepared for crowns. Crowns are then made for the prepared teeth, and a false crown (pontic) is connected to those crowns. Then the crowns and pontic(s) are cemented onto the teeth as one unit. Bridges are very comfortable, and it is common to forget that you are even wearing them. Bridges can also be supported by implants. Implants attach artificial teeth directly into the jaw or under the gum tissue. Because they require extensive surgery, candidates for implants should have good general health and have adequate bone with which to place an implant.

 What materials are used?
Appearance and function are considered when selecting materials for bridges. Bridges have traditionally been made from gold alloys, non­precious alloys, porcelain, or a combination of these materials. Porcelain is often bonded to either precious or non­precious metal, but there are a number of all-porcelain bridges that are available. Your dentist will discuss which materials are best suited for you.

 How do I take care of my bridge?
It is very important to keep your remaining teeth healthy. Brush twice a day, and clean between the teeth with floss or interdental cleaners (specially shaped brushes).

A bridge can lose its support if the teeth or the bone that holds it becomes damaged by dental disease. Be especially careful to clean the areas under, around and between the bridge and your natural teeth. Dental floss threaders and special brushes can help you reach these areas. It is also important to visit your dentist regularly.

Remember, the ultimate success or failure of a fixed bridge depends on its foundation. Help keep your gums and remaining teeth healthy. Your dental health and your appearance are worth the effort!