A fixed bridge is a dental restoration that permanently replaces one or more missing teeth by anchoring artificial teeth to your existing natural teeth or implants. Unlike removable dentures, a fixed bridge is cemented in place and stays in your mouth at all times, functioning and feeling much like your original teeth. It’s one of the most common solutions for filling gaps in your smile, and the entire process typically takes just two visits over a couple of weeks.
How a Fixed Bridge Works
A fixed bridge has two main components. The replacement teeth, called pontics, fill the gap where your teeth are missing. These pontics are held in position by crowns that sit on top of the healthy teeth on either side of the gap, known as abutment teeth. The crowns and pontics are fused together as a single piece, and the whole unit is permanently bonded to your abutment teeth with dental cement.
Think of it like a literal bridge: the abutment teeth are the support columns on each bank, and the pontic spans the open space between them. Because it’s cemented in place, you don’t take it out to clean it or sleep. You chew, talk, and smile with it just as you would with natural teeth.
Types of Fixed Bridges
Traditional Bridge
This is the most common type. It uses crowns on the healthy teeth on both sides of the gap to anchor the replacement tooth (or teeth) in between. It works best when you have strong, healthy teeth flanking the empty space. A traditional bridge can replace one tooth or several consecutive missing teeth.
Cantilever Bridge
A cantilever bridge anchors to a healthy tooth on only one side of the gap instead of both. This is useful when there’s no viable tooth on the opposite side, whether because of a previous extraction or a tooth that never developed. Because it has support on just one end, it’s best suited for areas of the mouth that don’t bear heavy chewing forces.
Maryland Bridge
Instead of using full crowns over the neighboring teeth, a Maryland bridge uses a metal or porcelain framework that bonds to the back surfaces of the adjacent teeth. This means your dentist doesn’t need to remove much enamel from the supporting teeth, making it the most conservative option. It’s a good choice when preserving natural tooth structure is a priority, though it’s generally limited to front teeth where bite forces are lighter.
Implant-Supported Bridge
Rather than relying on natural teeth for support, this type anchors to dental implants that are surgically placed into the jawbone. It’s the most durable option, often lasting 15 to 25 years, and it doesn’t require altering any of your remaining healthy teeth. The tradeoff is a longer treatment timeline, since the implants need time to fuse with the bone before the bridge can be placed.
What the Procedure Looks Like
Getting a traditional fixed bridge typically involves two appointments. At the first visit, your dentist examines your teeth and gums, reviews your dental history, and confirms that a bridge is the right fit. If you have any existing issues like gum disease, those need to be addressed first.
Once you’re cleared, the dentist reshapes the abutment teeth by removing a layer of enamel so the crowns can fit over them. Then they take detailed impressions of your teeth, which a dental lab uses to custom-fabricate the bridge. You’ll leave that first appointment with a temporary bridge that protects the prepared teeth and keeps your smile intact while the permanent one is being made.
At the second visit, your dentist removes the temporary bridge and fits the permanent one. They check the alignment, make any necessary adjustments so your bite feels natural, and then cement the bridge permanently in place. A final check confirms everything is comfortable and functioning properly. The whole process, from first appointment to final cementation, usually spans about two weeks.
Materials Used in Fixed Bridges
The material your bridge is made from affects how it looks, how long it lasts, and how much it costs. The three most common options each have distinct strengths.
Zirconia has become increasingly popular because it combines high strength with a natural, translucent appearance. It resists fractures better than most other ceramics and rarely chips. High-translucency grades are particularly good for front teeth, where aesthetics matter most. It’s also a strong choice for people who grind their teeth.
Porcelain-fused-to-metal (PFM) bridges use a metal core covered by a tooth-colored porcelain layer. They’re durable and handle heavy biting forces well, making them a solid option for back teeth. The downside is that the porcelain layer can chip over time, and as gums recede with age, a dark line from the metal underneath may become visible along the gum line.
All-ceramic bridges offer the best color match to natural teeth but tend to be less strong than zirconia or PFM. They work well for front teeth where appearance is the top priority and chewing forces are minimal.
Recovery and Adjustment Period
Most people need about two weeks to fully adjust to a new fixed bridge. During that time, you may notice some soreness in the gums, sensitivity to hot and cold foods, or a slightly unfamiliar feeling when you bite down. These are all normal. Using toothpaste designed for sensitive teeth for the first few days can help, and over-the-counter pain relievers like ibuprofen or acetaminophen are usually enough to manage any discomfort. Avoiding extremely hot or cold foods during those first couple of weeks also makes the transition smoother.
How Long a Fixed Bridge Lasts
A well-maintained traditional fixed bridge typically lasts 10 to 15 years, and many last 20 years or longer. Implant-supported bridges tend to be even more durable, often holding up for 15 to 25 years. The biggest factors in longevity are how well you care for the bridge and the health of the supporting teeth and gums underneath it.
Cleaning and Daily Care
A fixed bridge requires a bit more attention than natural teeth because food and plaque can accumulate in the space between the pontic and your gum line. Regular brushing covers the surfaces of the bridge itself, but cleaning underneath it takes a few extra tools.
- Floss threaders let you guide regular dental floss under the bridge so you can slide it back and forth along the gum line to clear out plaque and food debris.
- Interdental brushes are small, thin brushes that fit between the bridge and gums and around the sides of the abutment teeth.
- Water flossers use a pressurized stream of water to dislodge particles from hard-to-reach areas and are especially useful if you find threading floss difficult.
- Antibacterial mouthwash helps reduce bacteria around and under the bridge after you’ve finished brushing and flossing.
A good daily routine is to thread floss under the bridge and clean along the gum line, follow up with an interdental brush around the sides, rinse with mouthwash, and optionally finish with a water flosser for a thorough clean. Keeping up with regular dental checkups is equally important, since your dentist can spot early signs of decay or gum issues around the abutment teeth before they become serious problems.
Cost of a Fixed Bridge
The price depends on the type of bridge, the materials used, how many teeth are being replaced, and where you live. As a general range:
- Traditional and cantilever bridges: $2,000 to $5,000 for one replacement tooth and a crown on each supporting tooth.
- Maryland bridges: $1,500 to $2,500 for one replacement tooth with the bonded framework.
- Implant-supported bridges: $5,000 to $15,000 for a bridge with two implants spanning three or four teeth.
If you need any preliminary treatment, like gum disease care or a deep cleaning, that adds to the total. Dental insurance is more likely to cover at least part of the cost of a bridge than it is for implants, which makes bridges the more accessible option for many people.
Fixed Bridge vs. Dental Implant
Both are permanent solutions for missing teeth, but they suit different situations. A fixed bridge is generally faster (weeks instead of months), less invasive (no surgery required), and cheaper upfront. It’s a particularly practical choice when you’re missing more than one consecutive tooth, since each implant requires its own surgical placement in the jawbone, which quickly becomes expensive and complex.
Implants, on the other hand, don’t require altering healthy neighboring teeth and tend to last longer. They also stimulate the jawbone, which helps prevent the bone loss that naturally occurs when a tooth is missing. However, implants require good overall health and a jawbone strong enough to support them. People with conditions that slow healing, such as diabetes, may not be ideal candidates for implant surgery. Your dentist may also steer you toward a bridge if the teeth surrounding the gap aren’t strong enough to stand alone but can still serve as reliable anchors with crowns.