A dental bridge replaces one or more missing teeth by anchoring a replacement tooth, called a pontic, to the natural teeth or implants on either side of the gap. It is one of the oldest and most reliable ways to restore a smile, and it remains a good option for the right patient, though which type makes sense, and whether a bridge is the right choice at all, depends on your situation.
This page walks through the four types of dental bridge, which one fits how many missing teeth, what the procedure involves, and how a bridge compares to a dental implant.
What Is a Dental Bridge?
A dental bridge is a fixed restoration, meaning it does not come out the way a partial denture does. It consists of one or more artificial teeth held in place by the natural teeth or implants on either side of a gap, called abutment teeth. The pontic sits between them, restoring your bite, your speech, and your smile.
This is the first distinction worth getting straight, because the terms get used loosely. If it stays in your mouth, it is a bridge. If it comes out at night, it is a denture or a partial denture. One is a fixed prosthesis and the other is a removable prosthesis, and they solve the same problem in fundamentally different ways.
Bridges have been used in dentistry for well over a century. Modern materials, mostly porcelain fused to a strong underlying structure or increasingly zirconia, make them durable and difficult to distinguish from natural teeth.
The Two Questions That Decide Which Bridge You Need
Patients often arrive having read a list of four bridge types with no explanation of how they relate to each other. They are easier to understand once you know that the list is really answering two separate questions.
What holds the bridge up? Either your own natural teeth, or implants placed in the jawbone. That is the primary division, and it matters more than anything else, because a tooth-supported bridge relies on the health of the teeth beside the gap while an implant-supported bridge does not touch them at all.
How is it attached to those anchors? Among tooth-supported bridges, there are three designs, which differ only in how much of the neighbouring teeth get altered: full crowns on both sides, a full crown on one side, or thin wings bonded to the backs.
Everything below is one of those combinations.
Types of Dental Bridges
Traditional Bridge
The most common type. The abutment teeth on either side of the gap are shaped and covered with dental crowns, which anchor the pontic between them. It is strong and well established, and it makes the most sense when the neighbouring teeth already need crowns or are structurally sound enough to support one.
The tradeoff is that healthy enamel has to be removed from two teeth that may have had nothing wrong with them. That is the main reason patients ask about the alternatives below.
Cantilever Bridge
A cantilever bridge is supported on one side of the gap only, rather than both. In general dentistry this usually means a crown on a single natural abutment tooth, with the pontic extending off it unsupported.
That tooth-supported version is not what we do. Because the bite force lands on one anchor instead of being shared across two, we do not cantilever on molars, where chewing forces are heaviest. Where we do use the technique is in the front of the mouth, and on implants rather than natural teeth.
Two situations come up regularly. In the lower front teeth, there is frequently not enough width to place two implants side by side, and forcing both in produces a result that does not look right. A single implant supporting a cantilevered pontic replaces both teeth, looks considerably better, and costs less than two implants would. In the upper aesthetic zone, where a lateral or central incisor is missing, two adjacent implants may physically fit but the gum tissue between them often fails to develop properly, leaving a visible gap at the gumline. One implant with a cantilever avoids that entirely and gives a result that flows naturally across the smile.
Worth knowing: All-on-4 is itself a cantilever bridge. The rearmost teeth extend behind the last implant, which is what allows a full arch to be supported on four implants rather than eight.
Maryland Bridge, Also Called a Bonded or Resin-Bonded Bridge
Instead of full crowns, a Maryland bridge uses a thin framework with wings bonded directly to the backs of the neighbouring teeth, with little or no reduction of the abutment teeth. It is the most conservative of the tooth-supported designs and is most often used for a single missing front tooth, where bite forces are lighter.
The name causes confusion, so it is worth clearing up: bonded bridge, resin-bonded bridge, and Maryland bridge all describe the same restoration. The Maryland name simply stuck because the technique was developed at the University of Maryland.
The original version used a cast metal framework, and that is where the design’s reputation for a grey shadow showing through the front teeth comes from. Materials have moved on. Today the framework is more commonly zirconia, ceramic, or in some cases a plastic composite, which solves the aesthetic problem that limited the original.
Implant-Supported Bridge
Rather than relying on natural teeth, the bridge is anchored to implants placed in the jawbone. The implant acts as an artificial root, so the anchor is a screw in bone rather than a tooth.
A common example is four missing lower front teeth, restored with two implants at either end of the span and two pontics between them. Four teeth replaced, two implants, and no healthy tooth structure touched anywhere. For patients missing several adjacent teeth, this is usually what we recommend.
Which Bridge Fits Your Situation
The most useful way to narrow this down is by how many teeth are missing and whether the teeth beside the gap are healthy.
| Missing | Neighbouring teeth healthy? | Usual options |
|---|---|---|
| One tooth | Yes, and you want to preserve them | Maryland bridge |
| One tooth | They already need crowns | Traditional bridge |
| One or two front teeth | No usable teeth either side | Implant with cantilever |
| Several in a row | Healthy teeth at both ends | Traditional bridge |
| Several in a row | Compromised or absent | Implant-supported bridge |
| A whole arch | Not applicable | Full-arch implant bridge |
A tooth-supported bridge is not possible when all the teeth in an arch are gone, since there is nothing left to anchor to. That is where full-arch implant options take over.
Who Is a Candidate for a Dental Bridge?
A bridge may suit you if you have one or more missing teeth and:
- The teeth on either side of the gap are healthy enough, or already need crowns, to serve as abutments, or you are a candidate for implant support instead
- You want a fixed restoration rather than a removable one
- You are looking for treatment that can typically be completed in fewer visits than implant-based options, in the case of a tooth-supported bridge
A missing tooth does not get replaced with a bridge automatically. It depends on your bone, your bite, and your long-term goals. Left unaddressed, missing teeth lead to drifting, bite problems, and bone loss over time, which is worth discussing regardless of which replacement option you eventually choose.
The Dental Bridge Procedure
For a traditional or cantilever bridge, the process typically involves:
- Preparing the abutment teeth, reshaping them to accommodate the crowns that will anchor the bridge
- Taking an impression or digital scan, which goes to the dental laboratory to fabricate your custom bridge
- Placing a temporary bridge to protect the prepared teeth and maintain function while the final restoration is made
- Fitting and cementing the final bridge once it returns from the lab, checking your bite and adjusting as needed
A Maryland bridge skips most of step one, since the wings bond to the backs of the adjacent teeth with minimal preparation.
An implant-supported bridge follows a different timeline, starting with implant placement and a healing period before the bridge is attached.
Dental Bridge vs. Dental Implant
Patients often ask which is better, and there is no single answer. A traditional bridge requires no surgery and can be finished faster, but it means reshaping healthy neighbouring teeth, and those teeth carry additional bite load from then on. An implant leaves the adjacent teeth untouched and helps maintain the jawbone underneath, but involves surgical placement and a longer overall timeline.
There is also a bone consideration that is easy to miss. A tooth-supported bridge replaces what you see above the gum but nothing below it. Without a root in the bone, the ridge under the pontic continues to resorb. An implant replaces the root itself and keeps that bone stimulated.
What Affects the Cost of a Dental Bridge
Cost varies more than most patients expect, because no two cases need the same work. The factors that drive it:
- Number of units. A single-tooth bridge is a three-unit restoration, two crowns plus a pontic. Longer spans cost more.
- Material. Porcelain fused to metal, all-ceramic, and zirconia each carry different lab costs and different aesthetic and durability profiles.
- Condition of the abutment teeth. If a supporting tooth needs a root canal or a buildup before the bridge goes on, that adds to the total.
- Tooth-supported versus implant-supported. An implant-supported bridge involves surgery and healing time, and prices accordingly.
- Insurance. Many plans cover part of a bridge, particularly when it replaces a tooth lost to decay or injury rather than for cosmetic reasons.
We will give you an exact cost as part of your treatment plan at your consultation, along with a breakdown of your insurance coverage and financing options.
Caring for a Dental Bridge
A bridge does not need special products, but it does need consistent care:
- Brush and floss daily, using a floss threader or water flosser to clean underneath the pontic where it meets the gum
- Keep up with regular checkups so the fit and the health of the abutment teeth can be monitored
- Avoid biting down on very hard foods, which can stress the crowns or a bonded framework
The abutment teeth remain susceptible to decay and gum disease, which is why the health of the supporting teeth matters as much as the bridge itself.
Frequently Asked Questions
How long does a dental bridge last? The variables that matter most are how much force the bridge carries, how well the abutment teeth are maintained underneath it, and which design was used. A bonded bridge relies on an adhesive connection rather than full crowns, so it generally needs attention sooner than a traditional bridge does.
Is getting a dental bridge painful? The preparation is done under local anaesthetic, so the appointment itself is comfortable. Afterwards, most patients notice some sensitivity in the prepared teeth for a few days, which settles on its own.
How many teeth can one bridge replace? A tooth-supported bridge is generally limited to a short span, because the two abutment teeth carry the load of everything between them. Longer spans are better handled with implant support, where the anchors are placed where they are needed rather than wherever a natural tooth happens to be.
Can you eat normally with a bridge? Yes, for most foods. A traditional or implant-supported bridge restores close to normal chewing. A bonded bridge is more limited under heavy force, which is why it is used at the front of the mouth rather than on molars.
Does a bridge stop bone loss? A tooth-supported bridge does not. It sits above the gum and does nothing to stimulate the bone underneath, so the ridge continues to resorb. An implant-supported bridge does, because the implant replaces the root.
Is a bridge cheaper than an implant? A tooth-supported bridge usually costs less upfront. Over a longer horizon the comparison narrows, since a bridge involves work on two additional teeth that may eventually need treatment of their own.
Talk Through Your Options
The best way to know which type of bridge, or whether an implant-supported option, makes sense for your situation is a consultation where we can evaluate your bone, your bite, and your goals directly. As board-certified periodontists, we treat the full range of tooth replacement options and can tell you what we would genuinely recommend for your case.
Call (347) 493-2439 or book a consultation to talk it through with one of our specialists.
