Can a dentist create a dental bridge using the lateral incisors as the anchor teeth?

I have a 3-tooth bridge using one central incisor and one lateral incisor as anchors. I have one front upper tooth. I am having the other central incisor pulled, and have to have new bridge made. I was told no dentist will use both lateral incisors as anchor teeth, they will have to use the canines. Is this true? Why not use lateral incisors? My canines, are fangs, high up in my jaw bone. I cannot get implants, as I cannot afford them and insurance does not cover them, they are not an option.

Doctor Answers 3

Can two lateral incisors be used as the anchor teeth for a four unit bridge?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Simply put, the lateral incisors are the smallest, weakest and least desirable teeth to use as an abutment for bridges. They are often used for three unit bridges that replace one central incisor because there are two teeth (one lateral incisor and one central incisor) used to replace one missing tooth. The patient has two roots taking the load of three teeth. So each root and tooth are needing to support 150% or more of its natural ability. Think of it this way, can you carry half your weight on your back?

What you're suggesting is that two of the weakest of all the upper teeth support a bridge replacing two teeth than would otherwise have longer and bigger roots with better bone support. In this case, both smaller lateral incisors are needing to support more than double "their own weight" (so to speak). So, can you carry around something on your back that weights more than you do?

As Dr. Timmerman noted, they will most likely break and then you will really be up the creek.

On the other hand, your upper canine teeth are strong teeth with the longest of all the roots. That is why your dentist is recommending this....he is just looking out for your best long term interests. Sure, there are dentists who will do what you suggest. If you are willing to take the risk that one or both of your lateral incisors will break and you will have wasted your money and need a second bridge, which will cost more than the first, then you certainly have the right to have your dentist so that treatment. However, your dentist will more than likely ask you to sign an informed consent, explaining to you the risks and complications, other more desirable treatment options, so that you knowingly accept the consequences.

But, please understand, it is certainly not malpractice to do a four unit bridge using lateral incisors as abutments, it's just not the best way to go.

Laguna Niguel Dentist

Some dentists play with fire

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

laterals are very skinny, meaning easily broken. It is only a matter of time they will break if you have a 4 unit bridge replacing two centrals anchored by the laterals. It will be much more expensive to fix THEN.

No dentist will do it? I am sure you can find someone, but you get what you pay for. I wouldn't do it.

Incisors as Abutments?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Generally speaking, lateral incisors are not strong enough anchors for a bridge. They fail over time. There will be too much pressure on these teeth. We have seen this in our patients for the last 28 years who had lateral bridges done years ago.

Your options might include:

  • Extend a bridge to the cuspids (eye teeth)
  • Implants
  • Partial dentures (not desirable)

May I suggest you seek the opinion of a specialist in crowns (Prosthodontist) and get an expert to see what would work best for your situation? Maybe a Periodontist also should get involved.

Best of luck.

Eric Linden, DMD, MSD
New York Periodontist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.