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 on 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.
Are fixed bridges necessary?
Many people who lose a back tooth are often inclined to do nothing to
replace it. After all, the tooth never was visible. Unfortunately, losing a tooth can start a
vicious cycle of destruction. In a normal, healthy mouth, your teeth have a natural balance. Each
upper tooth contacts a corresponding lower tooth, allowing for a well-balanced chewing function.
Losing a tooth quickly destroys this balance. Nature abhors a vacuum; if the tooth is not replaced,
other teeth will shift into the space caused by the missing tooth.
Each tooth has three or four neighboring teeth and, in the opposite arch, one or two biting
partners. These companion teeth provide support and stability.
Drifting, shifting, periodontal disease, and abnormal decay areas are some of the problems that
can occur when your tooth loses the support of a neighboring tooth. Statistics suggest that this
neighboring tooth will be lost next. Then the next closest neighbor is subjected to the same
conditions. With each lost tooth, the problems are magnified. The cycle continues.
Additionally, fixed bridges not only correct an altered bite and 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.
Types of Bridges
The Fixed bridge is the most popular type of bridge and consists
of a prosthetic tooth that is attached to two crowns, which fit over the existing teeth and hold
the bridge in place.
The Cantilever bridge is often used when there are teeth on only
one side of the span. A typical three-unit cantilever bridge consists of two crowned teeth
positioned next to each other on the same side of the missing tooth space. The filler tooth is
then connected to the two crowned teeth, which extend into the missing tooth space or end. If
there are no adjacent teeth to act as anchors, one may be recommended for an implant (a metal
post that is surgically imbedded into the bone and capped with a crown as an abutment).
Bridge preparation Construction of a fixed bridge usually requires two to three visits. At
the first appointment, the adjacent abutment teeth (they will act as anchors) are reduced to give
enough space to fit the crowns. An impression is taken, and, to maintain appearance and function, a
temporary bridge is placed. At the last visit, the new bridge will be fitted and adjusted for any bite
discrepancies, ensuring a perfect fit and comfort. The new bridge will then be cemented to the
teeth (see pictures below).
Bridges
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 buildup 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 to remove particles of food from hard-to-reach spaces between the bridge and adjacent teeth
and gums. The place where the crown of the bridge meets the tooth is called the margin. Keeping the
margins clean is critical to the longevity of the bridge.
Before & After
Case 1
Composite bondings were placed to close unsightly spaces between teeth.
Case 2
Silver fillings replaced with bondings.
Case 3
Composite bondings were used to beautify stained
teeth (stains that could not be removed with teeth whitening).
Case 3
Composite bondings were used to beautify stained
teeth (stains that could not be removed with teeth whitening).
