A bridge is a fixed prosthesis that replaces missing teeth by crowning the adjacent teeth and spanning the missing space with an attached "false" tooth. Unlike a partial denture, a bridge is cemented in place and is not removed. A bridge can be used to replace one or two missing teeth, as long as there are teeth on either side of the missing tooth on which to anchor the bridge. The false tooth part of a bridge is called a pontic. The parts of the bridge that allow attachment to adjacent teeth are called abutments.
Missing teeth may also be replaced through use of a removable partial denture or implants. A removable partial is less expensive than a bridge but may offer less comfort. Removable prostheses are also not recommended for small areas because of the danger of swallowing or choking on the appliance. Implants involve surgically placing an artificial root on which to place a crown. Implants may not be indicated in all situations, and involve a waiting period for the implanted post to bio-attach to the jaw bone.
A bridge can last for fifteen -twenty years or longer if properly cared for. The important thing to remember is that decay can occur on abutment teeth even if the teeth are covered by crowns. The margin where the abutment meets the tooth and the space under the pontic are both areas that need careful attention. Proper oral hygiene, use of fluoride, and regular dental checkups will minimize the problem.
Care of Bridge
Since there is a space below the pontic (false tooth), bridge patients must use a special tool to clean the area of food particles. Use of a Proxi-brush or floss threader is necessary to prevent decay from taking hold in the adjacent teeth. We will show patients how to properly care for a bridge.
What a Bridge Looks Like
Bridges are generally made of a special high-strength porcelain or porcelain covering a precious metal base. In back teeth, we may leave a small metal margin near the gum line because it is softer against the gum, although we can use all porcelain margins if a patient has concerns about the bridge's cosmetic appearance. For front teeth, there are now all ceramic materials available for more natural looking bridge fabrications.
We lightly cement a temporary bridge in place for the two-week period while the porcelain bridge is being fabricated. The patient needs to take care to keep it in place. If it does come off, we can recement it at the office.
Before we cement a bridge, we ask for the patient's approval of the way it looks. For a front tooth bridge, a patient has the option of bringing a family member or friend to aid making aesthetic decisions. It is important for a patient to let us know if they have any concerns about cosmetics before the bridge is cemented; once it is in place, cosmetic changes would generally require replacement of the bridge.
Possible Complications to Bridges
Sensitivity or pain
Some sensitivity is normal for the first twenty-four hours. If it persists, or if pain experienced is severe, contact our office.
If the abutment teeth have suffered previous trauma through decay or fracture, there is a possibility that the tooth could abscess in the future; even there may be no indication of it at the time of bridge placement.
A bridge may need occlusal adjustment after placement. Because a patient is anesthetized in the office, he or she may not feel a discrepancy in the bite until later when the anesthetic wears off. If a bridge does not feel right when chewing, a patient should return to the office for an adjustment as soon as it is detected. Failure to correct this issue can result in unnecessary discomfort for the patient.