Patient Guide for a Maryland Bridge (Resin-Bonded Bridge)

Q: Why was a Maryland bridge recommended for me?

This is an excellent question about our conservative philosophy. A Maryland bridge is the ideal solution for specific situations where we want to replace a missing tooth without aggressively drilling on healthy adjacent teeth. The most common and successful uses are: Congenitally Missing Lateral Incisors: For younger patients who are born without their adult lateral incisors and have just completed orthodontic treatment. Replacing a Lower Incisor: When a single lower front tooth is lost, a Maryland bridge is an excellent, minimally invasive way to fill the space. In some cases, we can even modify and use your own natural tooth as the replacement. When an Implant is Not Possible: Sometimes, the space between the roots of the adjacent teeth is too narrow to safely place a dental implant, or a patient’s age or health may make implant surgery inadvisable. In these cases, a Maryland bridge is the best fixed alternative.

Q: What is the biggest risk with a Maryland bridge?

The primary risk for a modern, single-wing Maryland bridge is a “debond,” where the entire bridge comes loose from the supporting tooth. You must avoid biting directly into hard or tough foods with the fake tooth, as this can put too much twisting force on the bond. It is critical to be aware of any signs that the bond may be failing. Your Role is Critical: The best way to monitor your bridge is to pay close attention to any new sensations. If you notice that your floss suddenly feels different, if you feel a slight “click” when you chew, or if you can feel a new space with your tongue between the wing and your tooth, you must call our office immediately. Do not try to wiggle or test the bridge with your fingers. Simply be aware of how it feels during normal function and cleaning.

Q: How long will it last?

The longevity of a Maryland bridge is highly dependent on two factors: the clinical technique and your specific bite. Our bonding protocol is meticulous and multi-step, involving perfect isolation and surface treatment to create the strongest possible bond. However, if your bite places heavy twisting forces on the bridge, the risk of debonding increases. With a favorable bite and excellent home care, a Maryland bridge can last for many years, but it is not uncommon for them to need re-bonding during their lifetime.

Q: What are the alternatives to a Maryland bridge?

The ideal treatment hierarchy for replacing a single missing tooth is always to be as conservative as possible. The options, in order of preference, are typically: Dental Implant: This is the gold standard because it is a standalone solution that does not involve the adjacent teeth. Maryland Bridge: This is the next best fixed option if an implant is not possible, as it preserves the health and structure of the adjacent tooth. Traditional Bridge: This is a more aggressive option that we reserve for situations where the adjacent teeth already need crowns anyway. A removable partial denture is also a possibility, but for a single missing tooth, most patients find it to be a much less comfortable or desirable solution

Care for Your New Restoration

The Adjustment Period

One of the primary advantages of a Maryland bridge is that it is an ultra-conservative procedure.

Minimal Sensation: In most cases, the supporting tooth requires little to no preparation, so you should experience minimal to no post-operative sensitivity.
Numbness: If local anesthetic was used, it will wear off after a few hours. Please be careful not to bite your cheek or tongue while you are numb.

Temporary Restoration Care

Depending on the situation, you may have a temporary solution in place while your final bridge is being fabricated. If so, please be very gentle with it and avoid chewing on it directly.

Bite Adjustment Information

We will ensure your bite feels perfectly comfortable when we bond your final bridge.

If, after the numbness wears off, you feel that your bite is “high” or that you are hitting the new bridge first when you chew, please contact our office. A simple, quick adjustment is all that is needed.

Permanent Prosthetic / Denture Care

A Maryland bridge is a fixed prosthesis that replaces a missing tooth by bonding to the back of a single adjacent tooth with a small ceramic or metal “wing.” It is an excellent, conservative option, but its success depends entirely on the strength of the adhesive bond and your daily care.

The Cantilever Design

Modern Maryland bridges are designed as a cantilever, meaning they are only attached to one supporting tooth. This is a superior design because it allows the bridge and the supporting tooth to move together naturally. Older, two-wing designs were prone to failure because the two supporting teeth would move independently, placing stress on the cement and causing one wing to come unglued.

CRITICAL Hygiene Instructions

You must clean underneath the fake tooth (pontic) and around the supporting tooth every single day.

You will need a special tool: a floss threader, a water flosser (like a Waterpik®), or “super floss” are essential.
The Technique: You will thread the floss under the pontic, wrap it in a “C” shape around the supporting tooth, cleaning it thoroughly, and then clean the side of the pontic itself. This must be done every single day to prevent decay and gum disease.