Dental Bridges

A dental bridge replaces one missing tooth by joining crowns on the two teeth beside the gap. At Pearl32 Dentistry and Wellness in Laguna Hills, we place bridges when the neighboring teeth already need crowns, when bone is thin, or when surgery is not advisable. A bridge is fixed in the mouth and does not come out at night. It costs enamel on two healthy neighbors, and it needs a different cleaning habit. We will walk you through both.

What is a three unit bridge?

A three unit bridge is one piece with three teeth in it. The two outer teeth are crowns that sit on your own teeth, called abutments. The middle tooth is solid and rests on the gum where the tooth is missing. It is cemented in place, so it does not come out for cleaning. We scan the prepared teeth with a digital scanner, and the bridge is made from zirconia or from metal covered in ceramic. Most people wear a temporary bridge for about two weeks.

When does a bridge make more sense than an implant?

A bridge fits three situations well. The teeth on both sides already need crowns, so no healthy enamel is lost. There is too little bone for an implant and you would rather not have a graft. Surgery is not advisable for medical reasons, or a medication makes healing slower. A bridge also finishes in about two weeks, where a single implant takes 16 to 28 weeks. Our page on implant versus bridge compares them in detail, and single implants explains the surgical route.

What does a bridge ask of the neighboring teeth?

Enamel. To hold the crowns, we reduce both neighbors by about one to two millimeters on every surface. That is permanent. If those teeth are untouched and healthy, that is a real trade off to weigh, and we say so plainly rather than talk you into it. Reducing a healthy tooth also raises the chance it needs a root canal later, in the range of one tooth in ten. We test both abutment teeth with cold and x-rays first, so you know what you are starting with.

How do you clean under a bridge?

You clean under the middle tooth once a day, every day. Floss will not pass between the units, because they are joined. Instead you thread floss under the bridge with a floss threader or a stiff tipped floss, or you use a water flosser aimed along the gum. A small interdental brush works for wider spaces. This habit decides how long the bridge lasts. We show you on your own bridge at the delivery visit, and we check it at every cleaning.

How long does a bridge last, and what will it not do?

Ten to fifteen years is the usual range, and many last longer. Bridges fail at the margins of the two crowns, where decay starts, or when an abutment tooth fractures.

A bridge will not stop the bone from shrinking under the gap, because nothing is loading that bone. Over years the gum under the middle tooth can hollow slightly. We add pink ceramic or reshape the tooth when that shows. A bridge will not save a hopeless abutment tooth either. If one of the neighbors is failing, we plan an implant instead, and we tell you before any enamel is touched.

What does a bridge cost in Laguna Hills?

We do not publish prices for bridges. The number depends on how many units are needed, the material, and whether an abutment tooth needs a buildup or a root canal first. Your cost is quoted in writing, itemized, after an examination.

Pearl32 is in network with most major PPO plans and Delta Dental HMO, and we file the estimate before you commit. Third party financing is available and the practice is not the creditor, through CareCredit, Cherry, Sunbit and Happen Bank (formerly LendingClub). See financing options or contact the office.

Questions people ask about dental Bridges

How long does getting a bridge take?

Two visits over about two weeks in most cases. At the first visit we numb the area, shape both neighboring teeth, scan them and fit a temporary bridge. The laboratory builds the final bridge. At the second visit we try it in, check the bite and the fit under the middle tooth, then cement it. If the bite needs adjusting, we see you again a week later.

Can a bridge replace two missing teeth?

Sometimes. A four unit bridge with two crowns and two middle teeth works when the abutment teeth are strong and the bite is even. Longer spans flex, and flexing breaks ceramic and loosens cement. For two or more missing teeth in a row, especially at the back, implants usually hold up longer. We take a cone beam scan and measure the bone before advising either way.

Will the bridge look like my own teeth?

That is the aim, and front bridges are the harder case. The middle tooth has to rise out of the gum as if it grew there, so we shape the gum with the temporary bridge first, often for two to three weeks. Color is matched against the teeth beside it before cementing. Zirconia handles the bite at the back, and layered ceramic reads better in the smile line.

What if my bridge comes loose?

Call (949) 830-0074 and come in during office hours, Monday to Friday, 8 AM to 5 PM. A loose bridge is often loose on one side only, which lets saliva and bacteria under a crown that still looks attached. That tooth can decay quickly. Do not press it back or glue it. We hold same day emergency slots for problems like this.

Do I still need to see the hygienist?

Yes, and the cleaning matters more now, not less. We check the margins of both crowns, the gum under the middle tooth and the bone level on x-rays. Most patients with a bridge come every six months, and some with gum disease come every three or four months. Bridges rarely fail without warning. They fail where plaque sits for months in one spot.

This page is general information, not a diagnosis. What is right for you can only be decided after an examination.