Bridges

A dental bridge is a dental restoration that is used to replace one or more missing teeth by bridging the gap between adjacent teeth or dental implants. It consists of one or more artificial teeth, known as pontics, that are held in place by dental crowns attached to the teeth on either side of the gap.

Dental bridges are a common solution for restoring both the function and aesthetics of a smile after tooth loss.

Types of dental bridges

There are several types of dental bridges, each designed to suit different needs and conditions. The main types of dental bridges include:

Traditional Dental Bridge:

This is the most common type of bridge, consisting of one or more pontics held in place by dental crowns (abutments) on the adjacent teeth. The crowns are cemented onto the natural teeth, and the pontics fill the gap left by missing teeth.

Cantilever Dental Bridge:

This type of bridge is similar to a traditional bridge, but it’s supported by only one abutment tooth instead of two. It’s typically used when there’s only one natural tooth adjacent to the gap.

Maryland Dental Bridge (Resin-Bonded Bridge):

This bridge involves using a metal or porcelain framework with wings that are bonded to the back of adjacent teeth. It’s a conservative option that doesn’t require extensive preparation of the adjacent teeth, making it suitable for specific cases.

Implant-Supported Dental Bridge:

In cases where there are multiple missing teeth or no adjacent natural teeth to support a bridge, dental implants can be used as abutments. The pontics are attached to dental implants that are surgically placed in the jawbone.

This option provides stability and can be a good solution for individuals with strong bone density.

Hybrid Dental Bridge (Implant-Supported Hybrid Denture):

This type of bridge is used when there are numerous missing teeth. It combines the benefits of dental implants and dentures. Dental implants are strategically placed to support a full arch of artificial teeth, providing improved stability and function compared to traditional dentures.

What happens during a dental bridge procedure?

The dental bridge procedure can vary depending on the type of bridge being used. We will outline the general steps involved in the procedures for traditional or cantilever bridges, Maryland bridges, and implant-supported bridges:

Traditional or Cantilever Bridge Procedure:

1. Initial Examination: The dentist examines the patient’s oral health, takes X-rays, and determines the suitability of a bridge. If the adjacent teeth are healthy and strong enough to support the bridge, the process can proceed.
2. Tooth Preparation: The abutment teeth (the teeth adjacent to the gap) are prepared by removing a portion of their enamel. This creates space for the crowns that will hold the bridge in place.
3. Impression: An impression of the prepared teeth and the gap is taken. This impression is sent to a dental lab to fabricate the bridge, including the pontic (replacement tooth) and crowns.
4. Temporary Bridge: While waiting for the permanent bridge to be made, a temporary bridge is placed to protect the prepared teeth and maintain the appearance and function.
5. Bridge Placement: Once the permanent bridge is ready, the temporary bridge is removed, and the permanent bridge is carefully fitted and checked for fit and appearance.
6. Cementing: The permanent bridge is cemented onto the prepared abutment teeth, securing the pontic in place.

Maryland Bridge Procedure:

1. Initial Examination: Similar to the traditional bridge procedure, the dentist assesses the patient’s oral health and determines if a Maryland bridge is suitable.
2. Minimal Tooth Preparation: Unlike traditional bridges, minimal enamel reduction is required on the back of the adjacent teeth. These teeth will receive a mild etching to provide a surface for bonding.
3. Impression: An impression is taken, similar to the traditional bridge procedure, and sent to a dental lab for bridge fabrication.
4. Temporary Bridge: A temporary bridge might be placed while waiting for the permanent Maryland bridge to be created.
5. Bridge Bonding: Once the permanent Maryland bridge is ready, the dentist bonds the bridge onto the prepared teeth using dental bonding materials.

Implant-Supported Bridge Procedure:

1. Initial Examination and Planning: The dentist or oral surgeon evaluates the patient’s oral health and bone density. Dental imaging, like X-rays and possibly CT scans, are used to plan the placement of dental implants.
2. Dental Implant Placement: Dental implants are surgically placed into the jawbone at positions where the missing teeth were. A healing period of several months may be needed to allow the implants to integrate with the bone (osseointegration).
3. Abutment Placement: Once osseointegration is complete, abutments (connector pieces) are attached to the implants. These abutments will serve as the support for the bridge.
4. Impression: An impression is taken to create a model of the abutments and the gap. The dental lab then fabricates the bridge with pontics that match the patient’s natural teeth.
5. Bridge Placement: The bridge is tested for fit and aesthetics. Once approved, the bridge is attached to the abutments, either with screws or dental cement.

What are the pros and cons of a dental bridge?

Dental bridges offer both benefits and potential risks. It’s important to consider these factors when deciding whether a dental bridge is the right option for you. Here’s an overview of the pros and cons:

Benefits of Dental Bridges:

1. Restored Functionality: Dental bridges help restore the ability to chew and speak properly, which can be compromised by missing teeth.
2. Improved Aesthetics: Bridges can fill in gaps left by missing teeth, enhancing your smile and overall facial appearance.
3. Stabilizes Adjacent Teeth: Bridges can prevent the adjacent teeth from shifting into the empty space, maintaining proper tooth alignment.
4. Quick Solution: The process of getting a dental bridge is relatively quicker compared to some other tooth replacement options, such as dental implants.
5. Conservative Option: In cases where the adjacent teeth need crowns due to damage or decay, those teeth can be used as abutments for the bridge, reducing the need for extensive individual restorations.

Risks and Drawbacks of Dental Bridges:

1. Adjacent Tooth Preparation: For traditional and cantilever bridges, the adjacent teeth need to be prepared by removing some enamel. This irreversible process can weaken those teeth and make them more susceptible to future issues.
2. Potential Decay: Difficulty in cleaning under and around the bridge can lead to plaque buildup, increasing the risk of tooth decay and gum disease.
3. Bone Loss: Traditional bridges do not address the issue of bone loss that occurs when teeth are missing. Dental implants, which integrate with the jawbone, can help prevent this.
4. Bridge Failure: While dental bridges can last a long time, they may need replacement over the years due to wear, decay, or other issues.
5. Aesthetic Limitations: While bridges can improve aesthetics, they might not look as natural as dental implants, which emerge from the gum like natural teeth.
6. Influence on Speech: In some cases, the presence of a bridge can slightly affect speech patterns, particularly during the initial adjustment period.
7. Potential for Allergic Reactions: Some materials used in bridges may cause allergic reactions in rare cases.
8. Cost: While less expensive than some alternatives, dental bridges still involve costs for preparation, fabrication, and maintenance.

Considerations for Choosing a Dental Bridge:

1. Oral Health: The condition of your remaining teeth, gums, and overall oral health can impact the success of a bridge.
2. Long-Term Goals: Consider your long-term dental health goals. For instance, if you’re concerned about bone preservation, dental implants might be a more suitable option.
3. Financial Considerations: Bridges can be more affordable than implants initially, but keep in mind potential costs for maintenance and replacement over time.
4. Dentist’s Recommendation: Your dentist’s assessment of your individual case and their recommendation based on your oral health and needs are crucial factors.

Recovery and Expectations:

The recovery period after a dental bridge procedure varies depending on the type of bridge, your individual healing process, and any specific complications that may arise. Generally, here’s what you can expect:

1. Immediate Recovery: After the bridge placement procedure, you might experience some discomfort, mild pain, or sensitivity in the treated area. This is typically manageable with over-the-counter pain relievers prescribed by your dentist.
2. Adjustment Period: It might take a few days for your mouth to adjust to the presence of the bridge. During this time, it’s advisable to stick to softer foods and avoid very hot or cold beverages.
3. Long-Term Healing: For procedures involving dental implants, there might be a healing period of several months as the implants integrate with the jawbone. During this time, you’ll be monitored by your dentist to ensure proper healing.

Dental Bridge Lifespan:

The lifespan of a dental bridge can vary based on factors like oral hygiene, material used, the quality of the dental work, and the location of the bridge. On average, dental bridges can last around 10 to 15 years or even longer with proper care. Implant-supported bridges tend to have a longer lifespan due to the stability provided by the implants.

Caring for Your Dental Bridge:

To maximize the longevity and effectiveness of your dental bridge:

1. Oral Hygiene: Brush your teeth and the bridge regularly with a soft-bristle toothbrush and non-abrasive toothpaste. Floss daily using special floss threaders or interdental brushes to clean underneath the bridge.
2. Regular Dental Checkups: Schedule regular dental checkups and professional cleanings to monitor the condition of your bridge and overall oral health.
3. Avoid Harmful Habits: Avoid biting on hard objects like ice or using your teeth as tools, as this can damage the bridge.
4. Healthy Diet: Consume a balanced diet that supports oral health, and avoid excessive sugary and acidic foods that can contribute to tooth decay.
5. Night Guards: If you have a habit of teeth grinding (bruxism), your dentist might recommend a night guard to protect your bridge and natural teeth.
6. Tobacco and Alcohol: Limit or avoid tobacco and excessive alcohol consumption, as they can contribute to oral health issues.

When to Call the Dentist:

It’s important to maintain regular communication with your dentist and seek their guidance if you experience any of the following:

1. Persistent Pain: If you experience severe or persistent pain, discomfort, or sensitivity that doesn’t improve with time.
2. Loose Bridge: If your bridge feels loose, shifts, or becomes detached.
3. Signs of Infection: If you notice redness, swelling, pus, or an unpleasant taste around the bridge area, it could indicate an infection.
4. Chipped or Cracked Bridge: If your bridge becomes damaged, cracked, or chipped, contact your dentist to assess whether repairs or replacement are necessary.
5. Changes in Bite or Speech: If you notice significant changes in your bite or speech that are causing discomfort or difficulty.
6. Gum Issues: If your gums around the bridge become inflamed, bleed excessively, or appear discolored.

FAQs

How long does a dental bridge last?

Dental bridges typically last around 10 to 15 years or longer with proper care. Implant-supported bridges tend to have a longer lifespan.

What is the best type of dental bridge to get?

The best type of dental bridge depends on individual factors such as oral health, location of missing teeth, and personal preferences. Consulting a dentist can help determine the most suitable option.

Does a dental bridge hurt?

There might be some discomfort or sensitivity after a dental bridge procedure, but this is usually manageable with over-the-counter pain relievers. Pain should subside as you heal.

Conclusion

In conclusion, dental bridges offer a valuable solution for restoring both the functionality and aesthetics of a smile after tooth loss. These restorations provide several benefits, including improved chewing function, enhanced speech clarity, and a boost in self-confidence through an enhanced appearance. By preventing adjacent teeth from shifting, dental bridges also help maintain proper dental alignment and facial structure.