Adhesive (Maryland) Bridges

What Are Adhesive Bridges And Why Are They Used?

Adhesive Bridges are similar to regular bridges but generally can only replace a single tooth because they have limited strength.The replacement tooth is attached to a small metal frame that is adhesively attached onto the back side of the adjacent teeth. They are mostly used to replace a front tooth that does not have too much force on it and when there is not enough space for an implant crown. Although adhesive bridges are intended to be non-removable, they can nonetheless become loose and may need reattaching or replacement.

Adhesive Bridges
Missing Tooth | Adhesive Bridge

Did you know:

  • Unreplaced missing back teeth often result in many other teeth including the front teeth becoming crooked, worn and a problem overbite
  • Missing front teeth often result in speech impediments

Frequently Asked Questions

The first step is to design and plan the bridge, similar to a construction blueprint to optimize its size, shape and design. During the second step, primarily the back side of your adjacent teeth are carefully and conservatively shaped to facilitate the placement and adhesion of the finished bridge. Normally a temporary bridge is not needed or made. Also during this second step, measurements or molds are made from which a precisely fitted and natural appearing bridge can be custom made in the dental laboratory. The laboratory process of making your bridge occurs between appointments and is completed by specially trained laboratory technicians. An adhesive bridge is best made using a framework of metal (usually silver color) for strength that is adhesively attached to the back of the adjacent teeth and an outer layer of ceramic which is tooth colored in the area of the missing tooth. The final steps involve completion of any adjustments to your bridge and its attachment, after which your bridge is not removable.

High quality, natural looking bridges need to be more than just ‘white’, they must match the complex color scheme of your other teeth or they will stick out like a ‘sore thumb’. Color is approximately matched using standardized color tabs which are selected with your approval and is included in basic bridge fees. If your bridge is prominently visible, some degree of additional customization will usually be required to more closely match your other teeth. This customization process can proceed until the best possible match is obtained subject to the limitations of man-made materials and fees based on the length of time required for customization. When skillful clinical treatment is combined with artful laboratory technical work it is often difficult to detect the difference between a well made bridge and your natural teeth. Natural teeth will tend to slowly darken with age. Teeth replaced with an adhesive bridge will remain the same original color.

Shape is extremely critical and is one of the most frequently overlooked aspects of many bridges. This has resulted in an otherwise attractive smile being ruined by bridges not matching the remaining teeth and appearing as if they stick out.
A well made bridge should have a perfect bite and feel completely even with the other teeth on the very first day and does not require time to settle in. An uneven bite will either be uncomfortable or allow your other teeth to shift and become crooked.

An adhesive bridge should feel comfortable, look natural, maintain your ability to speak and allow careful chewing in the area of the bridge. Our patients tend to forget about the adhesive bridge except to be careful not to bite hard on it.
Do not expect your general dentist to obtain the results routinely obtainable in our prosthodontic specialty office. General dentists try to stay on top of all the general routine treatments patients need but can’t be expected to be capable of providing specialized treatment. There are some capable dental specialists in Mexico and elsewhere but always beware of ‘discount dentistry’. An attempt to obtain specialty treatment from those without the appropriate training and experience is likely to create problems and regret.

Cleaning bridges is not too different from cleaning natural teeth. You must thoroughly brush your teeth and clean between the teeth and under the replacement tooth using any of the various cleaning aids. You will be shown and coached on the techniques necessary to care for your bridge and supporting teeth. Bridges and their supporting teeth must be regularly cleaned and checked to ensure the gum and bone does not break down or the supporting teeth do not get cavities or decay.

Excellent fit is critical because cleaning and health are otherwise impossible resulting in decay, gum disease or other complications.

An adhesive bridge is often considered to be a temporary replacement as they can become detached from the teeth that they were attached to. This will usually result if excessive forces are placed on the replacement tooth but can also occur if the teeth are a little loose or if a sudden jolt occurs such as biting something hard. Sometimes these bridges can come loose for no apparent reason. Adhesive bridges often give fairly reasonable service for periods of up to about five years although each patient must be prepared for potential loosening which would require an attempt to re-attach the bridge by completely removing the bridge, cleaning it and then new adhesive attachment.

All Tooth Replacements

All tooth replacement treatments, in our office, should achieve the following:

  • Restore a smile and chewing ability by eliminating gaps caused by missing teeth
  • Prevent teeth in the area of a missing tooth from tipping over or becoming crooked
  • Help maintain the natural shape of your face by providing support for your lips and cheeks

Case Studies

Adhesive Bridges

Case Study Title

Miss Q.T. at age 20 had some missing teeth but the spaces were too small to allow the placement of a dental implants and orthodontic braces were declined by Ms. Q.T. which might have created the proper space for tooth replacement with implant supported crowns. In addition, the gum and bone had shrunken causing dark shadows where the teeth were missing which can be corrected, but requires additional treatment that was also declined. Miss. Q.T. decided that she wanted to have just two adhesive bridges. The adhesive bridges were completed with the look and functionality that Miss Q.T. desired with minimal amount of treatment.

Case Study Title

Mr. D.M. was referred to us by his periodontist because his periodontal disease had resulted in the loss of some of his teeth and others tipping and moving out of alignment. We stabilized the position of the remaining teeth by connecting the back teeth together using crowns and bridges. Mr. D.M. lost a lower front tooth due to gum disease and because of the extent of bone loss, an implant supported crown may not have been the best option. A bridge was avoided because the adjacent teeth were small and poor supports. An adhesive bridge was attempted knowing that this type of restoration can come loose but knowing that no option was ideal. The adhesive bridge was completed, as well as the crowns and bridges on the back teeth, and the patient’s bite has remained stable ever since.