A dental bridge is a way of replacing one or more missing teeth by permanently fixing the replacement tooth to one or more of your own standing teeth. As with most things, there’s more than one way of doing this and each comes with its own pros and cons.
Missing teeth can also be replaced by implants or dentures.
So is it always necessary to replace a missing tooth?
Not always. Gaps can cause problems, though – and not just with your appearance. For example, other teeth can tip into the space, altering the bite and causing stagnation of food, which can lead to gum disease and tooth decay.
There are essentially 2 types of dental bridge: those that require other teeth to be modified to support them and those that don’t – or which require only very minor adjustment. This second type are often referred to as adhesive or ‘Maryland’ bridges and are held in place by means of a ‘wing’ which is cemented to the back of one or more teeth beside the gap. The number of wings required to support the replacement tooth (called a ‘pontic’) depends on the bite.
Maryland bridges are used mainly at the front of the mouth if the teeth next to gap are sound and have no large fillings or crowns. The main advantage is that only minimal shaping of the supporting teeth is required – so you usually don’t need an injection. There are two potential disadvantages of the traditional Maryland bridge:
1. They are not as strong as conventional bridges and are more likely to come unglued.
2. The pontic of this sort of bridge cannot be translucent like natural teeth because the supporting metal framework would show through. Also, because teeth are translucent, the metal wings can give a grey cast to the supporting teeth. To get around this problem, adhesive bridges with fibre-reinforced natural coloured plastic wings are available, but they are more expensive than the metal type.
The other sort of bridge requires a tooth on one or both sides of the gap to be prepared for a crown. The laboratory will then make a crown with a pontic fixed to the side. In this case it will usually be necessary to numb the area before gently shaping the tooth or teeth that will support the bridge.
The Procedure.
Typically, it takes two appointments to supply a bridge. During the first visit, the supporting (abutment) teeth are prepared. The dentist then takes impressions (moulds) from which the technician will make the bridge in the required materials – usually porcelain or porcelain fused to a supporting metal framework. A temporary bridge is fitted to restore your appearance and protect the exposed teeth and gums while your bridge is being made.
During the second visit, your temporary bridge will be removed and the new permanent bridge will be checked and adjusted, as necessary, to achieve a proper fit. It will then be cemented into place. Depending on the type of temporary bridge used and on the amount of tooth preparation that was necessary, it may be necessary to numb the area for this.
For the next day or two, you may have some slight discomfort and sensitivity to hot and cold while the supporting teeth settle down. If you experience anything more severe or if the discomfort lasts beyond a few days, please contact us.
And remember: to keep your smile beautiful and healthy, you must maintain a high level of oral hygiene and visit your dentist and hygienist regularly. To clean properly around a bridge requires an alteration in technique, especially with regard to flossing. The dentist or hygienist will go through this with you. Please make sure you fully understand what you need to do before you leave the treatment room.
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