Which Is Better Denture Or Bridge?
There are a few treatment options available when one or more teeth are missing and the choice depends upon various factors such as the number and position of the missing teeth, the status of the remaining teeth, the status of the bite, the amount of available jawbone, age, and expectations of the patient. Both dentures and bridges offer good solutions, however what’s right for one person may not be right for someone else. We discuss both options and scenarios in which we might offer them.
Fixed dental bridges
Fixed dental bridges can have various different designs and are mainly used when only one, or a limited number of the teeth are missing. In general, there are two types of bridges – an adhesive bridge or a conventional traditional bridge.
An adhesive bridge is when the false tooth is bonded to the adjacent tooth with a special type of glue. It is a cheap and easy way of replacing the missing tooth but has a higher risk of debond compared to conventional type bridges because you are relying 100% on the adhesive to hold the bridge in. Most of the time this type is considered as a semi-permanent type of bridge.
A conventional traditional bridge is more long lasting but, will require some grinding away of the adjacent teeth. The teeth are prepared for full crowns, so the bridge is held in by adhesive and the mechanical shape of the teeth. They are more complex to be constructed and more expensive.
Dentures are removable prostheses which can replace anything from one missing tooth or even all of the teeth. Dentures are a cheaper option compared to bridges but might not be as easy to tolerate as they are not permanently fixed in place. This means they can move around; food can sometimes get stuck underneath and are often a lot bulkier than a bridge. Dentures can cause sore spots inside the mouth and can put pressure on the remaining teeth.
There is of course the option to replace missing teeth by the use of dental implants (the most reliable option to replace missing teeth) or of course, leave the missing gap and not replace the missing tooth at all. However, not replacing teeth can cause issues such as the ability to chew your food effectively. Plus, sometimes the adjacent teeth drift into space left by the missing tooth causing tilting or over eruption of the adjacent teeth.
Which treatment is best for a single missing tooth?
As a general rule, people with a single missing tooth will benefit from the implant or bridge option. If the adjacent teeth are strong and already have crowns on them, then the crowns can be bridged together to fill the missing gap without damaging much of the neighbouring teeth. If the two neighbouring teeth are sound teeth, then a patient must weigh up the advantage of having them ground down to accommodate a conventional traditional type of bridge. Nowadays, we generally avoid this option and go for the implant instead.
Adhesive bridges, sometimes called Maryland Bridges, work well is specific situations. If the tooth being replace is a small tooth (i.e., lateral incisor) and its being stuck onto a big tooth (i.e., canine, or central incisor) then it works well. The bigger surface area you have available to bond to the stronger the bond will be. Also, the bite is very important too – if you have a favourable bite, the bridge is likely to last a very long time.
For a single missing tooth, a denture is never the ideal situation. This is because a denture is not stuck in and therefore needs to generate some retention and support. We achieve this by covering more of the teeth and gums to get it to stay in and be stable. This often means the denture is bulky and the amount of plastic/metal covering the mouth just for one tooth is undesirable.
Which treatment is best for multiple missing teeth?
A patient with multiple missing teeth will benefit from an implant and denture solution. Patients with poor oral hygiene or gum disease are better with the denture option because this option has the advantage of adding teeth if need arises in future. So, if there is a risk of teeth failing in the future, a denture might be worth considering.
If you have multiple missing teeth, particularly large spans of missing teeth then a denture is more suitable. Larger span bridges (i.e., more than 4-5 teeth) are more complex and tend to fail catastrophically. This leaves you more susceptible to bigger issues in the future. Having the correct bite can make a huge difference to these complex bridges too.
So, as you can see there is a lot to consider and there is no clear-cut general rule of thumb. If you are interested in finding out which solution may be best for you it’s best to discuss this with your dentist to find out the pro and cons.