Dental Treatments - Bridges

What is a bridge?

A bridge is a dental appliance that replaces one or more natural missing teeth, thereby “bridging” the space between two teeth. Fixed bridges are cemented into place next to the “abutment” teeth- -the surrounding teeth on either side of the space, or “span.” Unlike removable partial dentures, fixed bridges cannot be taken out of the mouth by the patient. A fixed bridge is a device that typically consists of three units a pontic (a false tooth) fused between two crowns that are cemented onto the abutment teeth.

Who should get a bridge?

If you are missing any teeth and are committed to maintaining good oral hygiene practices, you may be a good candidate for a bridge. A bridge is the most natural choice to fill the space in your mouth left by missing teeth. If left unfilled, this space can cause the surrounding teeth to drift out of position and can cause teeth and gums to become more susceptible to tooth decay and gum disease that can cause further tooth loss. Fixed bridges not only correct an altered bite, improve your chewing ability and speech, but they also safeguard your appearance by preventing the collapse of your facial features that can cause premature wrinkles and age lines.

What types of bridges are there?

Besides traditional bridges, another popular design is the resin bonded or “Maryland” bridge, primarily used for the front teeth. This is usually the most economical choice when the abutment teeth are healthy and don’t contain large fillings. The pontic is fused to metal bands that can be bonded to the abutment teeth with a resin cement and hidden from view, reducing the amount of preparation on the adjacent teeth. A cantilever bridge may be used if there are teeth on only one side of the span. This involves anchoring the pontic to one side over one or more natural, adjacent teeth. If there are no adjacent teeth to act as anchors, your dentist may recommend an implant-a metal post that is surgically imbedded into the bone and capped with a crown as an abutment.
In some cases where the span is large, your dentist may recommend a removable partial denture or even an implant-supported prosthesis.

What procedures are involved?

For a traditional fixed bridge, the first appointment consists of the dentist reducing the adjacent abutment teeth that will act as anchors. Impressions are made, from which a metal framework, including the pontic, is created. By the second appointment, the final bridge is fitted over the teeth. The total treatment time is usually between two or four weeks, depending on the type of bridge. However, because it is often difficult to match the natural shade of your teeth, the treatment time may be longer.

How do I care for a bridge?

With a bridge, it is more important than ever to brush, floss and see your dentist regularly. If you do not control the build-up of food debris and plaque-the sticky film of bacteria formed from food acids-your teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge. Your dentist may also recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums. If you maintain optimal oral hygiene care, you can expect your fixed bridge to last as many as 8-10 years, or even longer

We would like you to understand that treatment of dental conditions requiring crowns and/or fixed bridgework includes certain risks and possible unsuccessful results, including the possibility of failure. Even when care and diligence is exercised in the treatment of conditions requiring crowns and bridgework and fabrication of same, there are no promises or guarantees of anticipated results or the length of time that the crown and/or fixed bridgework will last. There are some risks associated with crowns and/or fixed bridgework, which include but are not limited to the following:

1 Reduction of tooth structure: To replace decayed or otherwise traumatized teeth, it is necessary to modify the existing tooth or teeth so that crowns (caps) and/or bridges can be placed on them. Tooth preparation will be done as conservatively as practical.

2 Numbness following use of anesthesia: In preparation of teeth for crowns or bridges, anesthetics are usually needed. As a result of the injection or use of anesthesia, there may be swelling, jaw muscle tenderness or even a resultant numbness of the tongue, lips, teeth, jaws and/or facial tissues that is usually temporary; in rare instances, such numbness may be permanent.

3 Sensitivity of teeth: Often, after the preparation of teeth for the reception of either crowns or bridges, the teeth may exhibit sensitivity. It may be mild to severe. This sensitivity may last only for a short period of time or for much longer periods. If it is persistent, notify us so that we can determine the cause of the sensitivity and seek to treat the condition.

4 Crowned or bridge abutment teeth may require root canal treatment: After being crowned, teeth may develop a condition known as pulpitis or pulpal degeneration. The tooth or teeth may have been traumatized from an accident, deep decay, extensive preparation for the crown or bridge, or from other causes. It may be necessary to do root canal treatments on the affected teeth. If teeth remain sensitive for long periods of time following crowning, root canal treatment may be necessary. Infrequently, the tooth or teeth may abscess or otherwise not heal, which may require root canal treatment, root surgery or possibly extraction.

5 Breakage: Crowns and bridges may chip or break. Many factors could contribute to this situation such as chewing excessively hard materials, change in biting forces, traumatic blows to the mouth, etc. Undetectable cracks may develop in crowns from these causes, but the crowns and bridges themselves may not actually break until sometime later. Breakage or chipping because of defective materials or construction is somewhat uncommon, and if it occurs, it’s usually soon after placement.

6 Uncomfortable or strange feeling: Crowns and bridges are artificial and will therefore feel different from natural teeth. Most patients usually become accustomed to this feeling over time. In limited situations, muscle soreness or tenderness of the jaw joints — temporomandibular joint (TMJ) syndrome — may persist for indeterminable periods of time following placement of the prosthesis.

7 Aesthetics or appearance: Patients will be given the opportunity to observe the appearance of crowns or bridges in place prior to final cementation. When satisfactory, this fact is usually acknowledged by an entry into the patient’s chart initialed by patient.

8 Longevity of crowns and bridges: Many variables determine how long crowns and bridges can be expected to last. Among these are some of the factors mentioned in the preceding paragraphs, including the general health of the patient, oral hygiene, regular dental checkups and diet. As a result, no guarantees can be made or assumed to be made regarding the longevity of the crowns or bridges. It is a patient’s responsibility to seek attention from the dentist should any undue or unexpected problems occur. The patient must diligently follow any and all instructions, including the scheduling of and attendance at all appointments. Failure to keep the cementation appointment can result in ultimate failure of the crown/bridge to fit properly and an additional fee may be assessed.

Please feel free to take the opportunity to ask any questions regarding the nature and purpose of crowns and/or bridge treatment.