Why does my dentist recommend against a Maryland bridge?
Why does my dentist recommend against a Maryland bridge?
If you have a missing tooth, you may have come across a replacement option known as a “Maryland” or “cantilever” bridge to replace the empty spot of the missing tooth. However, your Winter Park dentist might recommend against this option. In this case, whether you are missing the tooth because it is a congenitally missing tooth or the tooth had to be extracted, you may wonder why many dentists don’t recommend this option. While a traditional dental bridge replaces a missing tooth by essentially fusing three “dental crowns” together to span across a missing tooth space, a “Maryland style” dental bridge uses some form of metal or composite framework to hold onto the adjacent teeth. While this can work well for temporary cases, we often see that in real-world usage, it usually becomes loose, easily fails, and falls out.
The reasoning behind the choice of a Maryland bridge is sound: not to disturb healthy teeth next to the missing tooth, your dentist wants to find an option not to perform any significant drilling on those teeth. And again, in some cases, this can be a sound choice for temporary use. However, if there is any history of cavities or other dental work on the adjacent teeth, it often makes more sense to pursue a traditional dental bridge. Instead of using only the back surface of a tooth to “bond” the bridge, the dentist will shave the full “crown” of the adjacent tooth. This procedure also accommodates removing and filling any existing cavities on those teeth. Because a traditional dental bridge has so much more surface area to bond to, it is a more durable and natural feeling replacement for the missing tooth.
A Maryland bridge is often performed when a tooth is missing during adolescence or early adulthood. This is because the teeth are generally healthy – however, the better choice for this situation is typically a dental implant. Every case is unique, and while an implant might be the right choice for some patients – others may be too young for it as their teeth and jaw structure are still growing. In those cases, another option might be a temporary partial denture that can be removable. This can also lead to better outcomes for daily hygiene as it is easier to brush and floss between those teeth.
What about a cantilever bridge?
In some situations, a patient may have a tooth with a “neighboring” tooth on one side (aka only one side of a bridge). Or, perhaps only one tooth has some decay, and it is not desirable to drill on the other healthy neighboring tooth. In this situation, some may choose a “cantilever” bridge that is only anchored on one side. Due to only having a single side to “retain” the bridge, these often fail as they can not withstand the biting forces to which we subject our teeth. Again, there are appropriate times when this may be the best option – however, it is typically for temporary use as it is tough to maintain the strength of such a design. As mentioned for the Maryland bridge, many of the same considerations apply when considering a cantilever bridge.
If you have an existing Maryland or cantilever bridge that is loose and need some help discussing the best option for you going into the future – please book an appointment with us! Sometimes, these options may have been the best choice for a patient in their younger or prior situation, but it may not be the best long-term situation. We often help patients temporarily fix and then set a path toward a more permanent solution that can withstand daily use.
What is a Dental Bridge?
An adequately fabricated dental bridge is a permanent, strong dental prosthetic that can replace one or more missing teeth that are adjacent to each other. You can visualize a dental bridge like a road 'bridge' that spans two solid foundations. In this way, a dental bridge should have two teeth to build on.
A bridge can fill a single missing tooth, two adjacent missing teeth, or even three adjacent missing teeth. This determines how 'long' the dental Bridge is and is often referred to as the 'number of units’. For example, spanning one missing tooth is a '3 unit bridge', and spanning three missing teeth would be a '5 unit bridge'.
As a side note, like in architecture, there are other types of bridges – namely, a "cantilever" or a "Maryland" bridge. However, we typically do not recommend these; they are only used for exceptional cases. If you have a unique situation, please call our office or ask your local dentist for an opinion on what is best for you.
Benefits of Dental Bridge
The benefit of a dental bridge is that it is permanently bonded and will be strong, providing a primarily natural look and feel. However, oral hygiene is of utmost importance to maintaining a dental bridge. As the teeth are bonded, there is no way to floss with traditional "up and down" flossing between those teeth; patients have to floss underneath the Bridge using a "floss threader" or other devices like a water flosser. In addition, keeping the teeth and gums under/around a bridge can not be stressed enough; if tooth decay were to deteriorate the healthy teeth, it could cause the Bridge to become loose and need to be replaced.
When considering if a dental bridge is right for you, one thing to note is that a bridge requires the two 'anchor' teeth to have some enamel and tooth structure removed to cement the crowns. Therefore, if those teeth are otherwise healthy (with no existing crowns or fillings) – the dentist will have to remove a portion of healthy teeth to place the Bridge. This can be undesirable for some patients, and your local dentist can advise you of the considerations so you may make the best decision for your situation.
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