Dental Bridges – All Your Questions Answered

“What is a tooth bridge?”

Are you missing a tooth?  A tooth bridge, or dental bridge is one of the dental treatments used to replace missing teeth.  Bridges are fixed into the mouth by attaching them to neighboring teeth. Therefore unlike dentures (which are removable), tooth bridges stay in your mouth.

The most common bridge is a conventional bridge where the teeth on either-side of the gap are crowned, with a false tooth stuck to the crowns to fill the gap.

Dental bridges may be placed on your own natural teeth, on implants or on a combination of the two.

 

Why Might you Want to Replace Missing Teeth?

It is usually best to replace missing teeth for several reasons.  These include:

• For aesthetic reasons, including your smile and maintaining the shape of your face.
• To reduce the pressure on the other teeth (and any fillings, crowns etc. on them).
• Reduce the chances of getting jaw problems (TMJ).
• To prevent changes to the bite as teeth can move when there is a gap.
• To help keep the other teeth more cleansible and therefore reduce the potential for tooth decay and gum problems.
• For speech.
• To help with chewing.

 

When is a Tooth Bridge Suitable?

Tooth bridges are one of the options to replace lost teeth. They can be used in the following cases:

• A small number of teeth are missing, so the tooth bridge is a viable size.
• The teeth either side of the gap are strong enough to hold the bridge.
• These supporting teeth also need to have good gum health.
• Your oral hygiene is of an acceptable standard.

 

Types of Tooth Bridges

There are three main types:

1. Traditional fixed bridge
This is the most common type of bridge to be placed.  It is made up of one or more false teeth joined to two crowns that are placed on to the adjacent teeth and/or implants.

 

2. Resin-bonded (‘Maryland’) bridges 

Instead of crowns being used to hold the bridge in place, metal ‘wings’ are made onto the false tooth and are then bonded to the back of the anchoring teeth.  These have the advantage of being less destructive to the anchoring teeth than crowns.  Therefore they are often chosen when these teeth are sound.  They are also less expensive than fixed bridges.  This type of tooth bridge is not as stable however, and is usually only used on front teeth and when the patient’s bite is not excessive on the area.

 

3. Cantilever
Cantilever bridges simply means that the tooth bridge uses only one adjacent tooth to hold the bridge in place. These can be of a fixed design or use resin-bonded wings.

 

What are Dental Bridges Made of?

Like crowns, bridges may be made from:

• Porcelain fused-to-metal.
• Porcelain (or ceramic) only.
• Metal only (usually gold).

 

What Does the Procedure For Getting a Bridge Involve?

In order to decide if a bridge is appropriate and choose the design of the bridge, the dentist will examine the area, take X-rays and make up casts of the teeth.

Once it has been decided that a bridge is to be fitted and which type is to be constructed, an appointment is needed to prepare the teeth.

• Once the teeth are numb, they are filed down to the required size in order to make the space for the crowns/wings which will be attached to anchor the bridge in place.  This can take up to 45 minutes per tooth.
• A mold of the teeth is then taken, using a rubber putty material.  It is this mold which is sent to the dental laboratory where the bridge is made.
• Construction of the bridge can take around two weeks.  In the interim, your dentist will fit a temporary bridge which will protect the teeth and keep them in the correct position.
• This temporary bridge is removed at the next visit and the newly made bridge is cemented into place, once you are both happy with how it looks and fits.

Read more on the procedure in this article.

 

“How long does it last?”

Just as with natural teeth, the health of a bridge will depend on how well you care for it.

With a healthy diet, good oral hygiene, regular check-ups with the dentist and sensible use of bridges, one can expect a good bridge to last at least 5 years.  Many bridges will last well beyond this.  The life expectancy of a bridge will also depend on the condition and position of the tooth in the first place.

 

“How much does a bridge cost?”

The price of a bridge will vary greatly depending on:

• The skill and experience of the dentist.
• The skill and experience of the dental technician.
• The type of bridge and the cost of its materials.
• The price of any foundation work such as placing a post under the bridge.
• Whether the bridge is made by a machine in the dentist’s office or not.  Such modern machines are very expensive.
• The number of teeth being replaced, i.e. the size of the bridge.

 

Recovery and Care After Placement

Once the bridge has been fitted into place, your dentist will instruct you on how to care for it.  In general a bridge needs even more attention than natural tooth, as it is harder to clean properly.  This must include proper cleaning under the false tooth of the bridge and between it and the teeth beside ((‘interdental’ cleaning e.g. flossing).  Your dentist will instruct you on how to clean under the bridge properly.  This will involve the daily use of a floss ‘threader’ which is fed under the bridge to remove plaque build-up here.

Other points to note after a tooth bridge is fitted:

• No matter how strong a bridge is, it will not be as strong as healthy, sound teeth. Thus one will need to avoid particularly hard foods, and destructive habits such as biting ones fingernails or opening bottles with the teeth!
• A major risk factor to bridges is clenching or grinding teeth. If this is being done at night, the dentist may make a mouth guard to be worn at night-time.
• There may be some sensitivity on the tooth for a few days after a bridge is placed. If this is prolonged, or the bridge feels sore to bite on you should contact your dentist.
• Porcelain bridges may chip.  Is minor chipping occurs this can be left. Otherwise the chips can sometimes be repaired but if not the tooth bridge may need replaced.
• If gaps occur between the supporting teeth and the bridge, decay may set in and the bridge may loosen. This is more likely with ill-fitting bridges. The dentist will check the condition of the bridge at each check-up.
• Bridges may eventually fall out.  In such an event, bring the bridge to the dentist.  If everything appears healthy the dentist may be able to re-cement the bridge.  If there is an obvious reason for the bridge falling out, such decay or tooth fracture, a new bridge may need to be made.
• On average, bridges last five to seven years. A major reason bridges fail is that new cavities develop on the supporting teeth. These cavities occur because of poor oral hygiene. With proper hygiene, which includes flossing your teeth under the bridge, they will last longer.

 

Summary

Bridges are one of the possible methods to replace missing teeth. They are an excellent choice when used in the correct circumstances. Getting a tooth bridge can carry some risks to the tooth so they are only placed when necessary. Bridges need to be kept very clean and well looked-after as the teeth under them are not immune to decay and gum disease.

 

For a great comparison of dental implants and bridges see here.