What are bridges?
Bridges are made to replace missing teeth by fixing a ‘false’ tooth in the gap. They are ‘made to measure’ in a laboratory and unlike dentures, which can be removed daily for cleaning, bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.
How do bridges work?
Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, changing the way your teeth bite together. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular (jaw) joint disorders.
Bridges span the space where the teeth are missing. They are cemented to the natural teeth or implants next to the space. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the colour of your natural teeth.
What types of bridges are there?
Bridges may be ‘glued’ in place (eg. adhesive bridges) or are supported by adjacent crowns that cover the whole of the adjacent teeth (conventional bridge). Advantages of bridges
Cosmetic – Able to fill an unsightly gap.
Natural looking – Resemble the look of natural teeth. Patients can restore their missing teeth and give the illusion of always having a healthy, bright smile.
Stain resistant – Dental bridges are made from stain resistant materials, making this a superior choice.
Durable – Should last between ten to twenty years (longer for a conventional bridge), based on excellent oral hygiene.
Are cemented in place – Unlike dentures, which can move, conventional bridges stay in place because they are cemented over your teeth.
Restorative – Due to their natural tooth-like features, full function of your missing tooth can be restored. Bridges can help restore your ability to speak and chew.
Comfort – Provides a better choice over full or partial dentures, as they are fixed in place and do not move.
Disadvantages of bridges
Loss of tooth structure – Conventional bridges can be quite damaging to a tooth as they involve drilling part of it away. However if the teeth adjacent to the gap have already been heavily damaged or have multiple fillings, a bridge could be protective to the tooth. Careful consideration of this is needed in treatment planning. Adhesive bridges are much more conservative and do not require extensive drilling. However they are not as strong or as predictable. Some designs of adhesive bridge may help to preserve the maximum amount of natural tooth.
Damaged nerves – When a tooth is prepared for a full crown as part of a bridge, 1% to 15% lose vitality (i.e. the nerve dies) and may require future root canal treatment.
Special cleaning – Some extra care is necessary to keep the underside of the bridge clean, as it is prone to collecting plaque. Since the fake tooth is rigidly joined to the teeth on either side it is not possible to floss in the normal way and ‘Superfloss’ is needed.
How is a bridge made?
You will normally require a local anaesthetic to numb the teeth and surrounding gum. Some shaping of the teeth with a drill is necessary. Some impressions will then be taken by placing some soft material into your mouth; it will then go hard, leaving an impression of the shape of the teeth. You may be fitted with a temporary crown or bridge, usually made out of a plastic-like material. The impressions are sent off to the laboratory where the bridge is made. Two weeks later, you will attend the practice again to have any temporary items removed and the new bridge cemented (or ‘glued’) in place. Local anaesthetic is sometimes required. We will check that the fit and the way your teeth bite together is comfortable and that you are happy with the appearance.