Updates in Dentistry

Missing teeth, referred to as edentulism, affects millions of people in America. According to the American College of Prosthodontists, there are 35 million Americans that do not have any teeth and 178 million people that are missing at least one tooth. Edentulism can cause poor nutrition, weight loss, and poor self-esteem, among other problems. As a dentist, I am frequently asked about what treatment options are available to replace missing teeth, and which option is best. The answer is not always easy, since each patient’s anatomy and goals differ, but the simple truth is that modern dentistry has numerous ways to restore missing teeth while restoring patient function and confidence. For the purpose of this article, we will review fixed bridges and discuss what advancements have been made with regard to materials and techniques.

What is a dental bridge? A dental bridge is a “fixed” appliance that is designed to replace one or more missing teeth. We refer to the prosthetic as “fixed” since the appliance is cemented in place and cannot be removed without professional help.

dental bridge prep

As the name denotes, the dental bridge uses teeth on each side of a missing space as “supports” or abutments, upon which a replacement tooth, or “pontic” is placed. By design, the two supporting teeth form a “bridge” of sorts upon which the replacement tooth is attached.

Dental bridges have been used with success for many decades and they are an effective way to replace missing teeth. Prior to the advent of implant technology, dental bridges and partial dentures were the primary means by which dentists replaced teeth in patients missing one or several teeth. As with any treatment, however, there are pros and cons and one of the downsides of a fixed bridge is that the adjacent teeth must be prepared for crowns for the bridge to be made. This is one aspect of the dental bridge that makes the dental implant very enticing, since the adjacent teeth need no treatment in order to replace the missing tooth with the implant.

Where has technology taken us with dental bridges? For many decades, the material of choice for dental bridges, due to strength, was porcelain fused to metal bridges. This means that the bridge has a metal core and is covered by porcelain. One of the disadvantages of PFM crowns and bridges is that there tends to be a metal collar or a slight rim of metal around the bottom of the crown and this can lead to “dark lines” appearing where the gum tissue meets the tooth. In esthetic cases, patients can find this appearance unsettling, if it occurs. Recent advancements in dental materials have increased our treatment options with materials, such as all-ceramic crowns and bridges. These new materials are as strong as or stronger than PFM, they are much more esthetic, and they are creating beautiful smiles!

all-ceramic bridge

(Picture from: glidewelldental.com)

Before After

(All-ceramic bridge; before and after)


(All-ceramic bridge; before and after)


(All-ceramic bridge; before and after)

Dr. Jeffrey Clark, D.M.D. is a dentist at Lakewood Dental Associates in Huntsville, Texas. He graduated Magna Cum Laude from Boston University Goldman School of Dental Medicine and completed a Masters in Medical Science from Boston University School of Medicine. He completed a General Practice Residency program at the University of Utah Hospital & Clinics and has advanced training in many aspects of general dentistry. He received the Predoctoral Research Award and was the recipient of the President’s Award for Excellence in Dental Research from the American Association for Dental Research National Student Research Group (AADR NSRG). His research has been shared at national and international symposiums and at numerous academic institutions including Harvard University.

To learn more about what modern dentistry can do for you visit: www.LakewoodDentalAssociates.com or call 936-291-0032.