What is a bridge?
A bridge is a dental restoration that replaces a missing tooth by anchoring an artificial one to the adjacent teeth. It can replace one or more teeth. A bridge can also be known as a fixed partial denture. A bridge can either be held in place by crowning the adjacent teeth or if a singular tooth is being placed it can have a wing which is cemented to the back of an adjacent tooth to hold it in place. Implants can also act as abutments to hold large bridges in place so that it is fixed if a patient doesn’t want a denture.
The false tooth on a bridge is known as the pontic, when a tooth is crowned and is anchored to the pontic this is known as the abutment tooth.
Why should I replace missing teeth?
Your appearance is one reason. Another is that the gap left by a missing tooth can mean greater strain is put on the teeth at either side. A gap can also mean your ‘bite' is affected, because the teeth next to the space can lean into the gap and alter the way the upper and lower teeth bite together. This can then lead to food getting packed into the gap, which causes both decay and gum disease.
Replacing a tooth also lowers the impact and strain of mastication on the other teeth as the biting pressure is spread more evenly which lowers the chance of teeth fracturing or breaking.
What is a bridge made of?
A bridge can be made of many different materials which depends on where it is in the mouth, aesthetic reasons and the cost of the bridge. The materials it is made of is entirely the patients choice but your dentist can advise you on what option is best .
The most common materials are;
What are the different types of bridges?
There are three different types of bridges that a patient can have;
- A Fixed bridge (traditional bridge) – this type of bridge is the more common bridge, it is comprised of a pontic between two abutments. A false tooth in the gap anchored between two crowns on teeth either side, the abutments can also be implants.
- A Maryland bridge (resin bonded bridge) –this type of bridge is different to the traditional bridge in the sense the pontics (f are attached via metal bands that are glued to adjacent teeth instead of anchored with crowns. It is more common in anterior (front) teeth.
- A Cantilever bridge –this type of bridge is similar to the fixed bridge but instead of the pontic being between two teeth it is only anchored to one as there may be only one tooth that can be used as an abutment. These types of bridges are more commonly used in areas of the mouth where it is not under a lot of stress from the forces exerted onto the teeth during mastication.
What happens in the appointment?
What happens in the bridge preparation appointment depends on the type of bridge the patient is having, the cantilever and the fixed bridge require some preparation on the abutment teeth so the dentist will use a local anaesthetic to numb the area and prepare the abutment teeth for crowns to be fitted. This means the dentist will file down the tooth/teeth to the shape of a fez hat ready to have a crown placed on top. Impressions of the mouth will be made using an alginate material and putty so cast models can then be made to fabricate the bridge on. These will be sent to a lab off site that usually takes 5-10 working days depending on what bridge and where the lab is. A temporary crown will be placed on the abutment teeth to protect the preparation of the tooth and restore it to full function.
The next appointment is when the bridge is fitted, the temporary is removed and the new bridge is put in place. The dentist will ensure you are happy with the appearance and feeling of the bridge and it will then be cemented into place using a dental cement. How do I look after my bridge? Looking after your bridge is essential in ensuring it lasts as long as it is expected to. The less it is looked after the more likely it is the bridge will fail and further restorations will be needed. As naturally there will be a gap between the false tooth and the gum this can act as a food trap and it is important to clean under the bridge where possible to avoid decay, gum disease and bad breath. The bridge itself cannot decay but decay can occur around the margins of the abutment teeth and underneath so treat it as you would a normal tooth. Using super floss threaded through the gaps is good at removing trapped food and avoiding the build-up of plaque. Interdental brushes can also be used. Be careful not to be too vigorous as this can damage or dislodge the bridge. Brush as normal around the bridge and the surrounding teeth.
How Do I Care for a Bridge?
It is important to keep remaining teeth healthy and strong as the success of the bridge (depending on the type selected) depends on the solid foundation offered by the surrounding teeth. Brushing twice a day and flossing daily helps prevent tooth decay and gum disease that can lead to tooth loss. Your dentist or dental hygienist can demonstrate how to properly brush and floss teeth.We recommend using a specific flossing system which is designed to access areas which are difficult to clean with traditional dental floss. The more effectively these areas are kept clean and free from plaque, the more likely it is that your bridgework and the adjoining teeth will continue to stay healthy for as long as ten years. It is highly recommend that individuals with bridgework should have dental hygiene sessions about every 6 months and avoid foods with a high sugar content, as this can result in decay which may spread to the healthy natural teeth.
The cost of a dental bridge
With several visits, expert manufacturing, expensive materials, and much skilled craftsmanship, it will come as no surprise that dental bridgework can be very costly.The cost of private dental bridges start from £900, depending on the number of visits and teeth involved and materials used. It’s possible to have dental bridgework done on NHS however the quality of materials may not be as high as you might get privately. For example, it is unlikely that you’d be able to get a porcelain pontic as an option with an NHS bridge.
The alternative to a dental bridge
The only alternatives to a dental bridge are dentures or implants. Single tooth dentures can be uncomfortable and awkward where only one or two teeth are involved, and are not generally recommended for this purpose. Dental implants involve having a false tooth fixed to a titanium post that has been screwed into the jawbone. This can be an expensive and surgical process and is only suitable to people who are medically fit, with healthy gums and thick jawbones.
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