A dental bridge is used to replace one or more missing teeth. It consists of a false tooth or teeth being anchored to the teeth surrounding the gap. The false tooth is called the pontic and it is fused in between two dental crowns which are fitted to the teeth adjacent to the gap/missing tooth. This helps to keep the false tooth in place and give the restoration the strength that it needs. The false tooth can be made of porcelain, gold alloys or a mixture of different materials.
Your dentist may recommend a bridge when you have one or more missing teeth which are impinging on your appearance, smile, speech or shape of your face. Missing teeth can often increase the chances of you developing gum disease or tooth decay due to food debris collecting in the gap. It may also affect your bite as surrounding teeth move or lean into the gap which changes the way your upper and lower teeth connect.
Procedure for a dental bridge
A local anaesthetic will be given to make sure the procedure is comfortable. The surrounding teeth are then prepared by removing tooth substance to accommodate the crowns (AKA bridge abutments). An impression is then taken of your upper and lower teeth and this is sent to a specialist laboratory where the bridge will be constructed. A temporary bridge will be constructed so that your teeth and gums are protected whilst the bridge is being made.
At your second visit the temporary bridge will be removed and the abutment/supporting teeth cleaned. You will be shown the bridge and once you and your dentist are happy with the bridge it will be permanently cemented into place.
Taking care of your bridge
Bridges will last for many years provided you take care of them by maintaining a healthy diet and adhering to a good oral hygiene regime. You must clean your bridge every day, paying particular attention to the false tooth as this will help prevent gum disease, tooth decay and bad breath (halitosis). Similarly you will need to continue caring for your natural teeth as these provide the anchor for the bridge.
Types of bridges
Traditional (or fixed-fixed) bridges are typically made from porcelain which is then fused to ceramics or metal. This kind of bridge is fixed and cannot be removed.
These are made of a special resin and a metal frame that has wings that are cemented onto the enamel of the surrounding teeth to hold the bridge in place. With Maryland bridges the teeth surrounding the gap do not need to have full crown and the wings of the structure are attached using a strong adhesive.
This leaves healthy teeth undisturbed or with minimal tooth preparation (removal of tooth substance). It also allows the bridge to be fitted quickly with minimal damage to the surrounding teeth. The dentine of the surrounding teeth needs not to be exposed, allowing the teeth to continue as they are with no increase in tooth sensitivity.
Advantages of Maryland bridges
- Less impact on surrounding teeth, they are largely unaffected by a Maryland bridge as there is no need to crown the surrounding teeth.
- Quick and easy to fit and adjust.
- Sometimes there is no need for local anaesthetic.
Disadvantages of Maryland bridges
Limited suitability, these bridges are only suitable to restore small gaps.
Risk of debonding, depending on what you eat and how you chew there is a risk of these bridges coming loose or debonding. They can be sent back to the lab for retreatment of the metal wing and be recemented however if they debond frequently an alternative treatment plan will be needed.