Dental Bridge Work

3 Unit Fixed Bridge

Sometimes called a fixed partial denture, fixed dental bridge work is performed to replace one or more missing teeth. They are used to correct an altered bite, improve chewing ability by alleviating the stress in your bite, improve speech, and also maintain the shape of the face by preventing the collapse of facial features that can cause premature wrinkles and age lines. Unlike a removable bridge (partial denture), which you can take out and clean, dental bridge work can only be removed by a dentist.

Fixed Dental Bridges

A fixed dental bridge replaces missing teeth with artificial teeth, bridging the gap where one or more teeth may have been. At a minimum, it involves 3 tooth areas. A typical three unit bridge contains one pontic (false) tooth and two abutment or retainer teeth. A fixed bridge restoration can be made from gold, alloys, porcelain or a combination of these materials such as porcelain fused to metal.

Dental bridges are designed so that the pontic tooth fits the missing tooth area, while the teeth on either side of the pontic tooth, the abutments or retainers, hold the pontic in place. Abutment or retainer teeth are your own natural teeth which will have crowns made. These crowns are then fused to both sides of the pontic tooth, then the three fused units are cemented into the mouth.

Types of Dental Bridges

There are several different types of dental bridge work.

    Traditional Fixed Dental Bridge Work - a pontic tooth (or false tooth) is held together by two crowns (a "cap" that covers the tooth, approximating its normal size and shape). This trio is then attached (cemented) to the abutment teeth (the surrounding teeth of each side of the gap).

    Resin Bonded Dental Bridges aka "Maryland" Bridge. This type of procedure is common when there are teeth missing in the front of the mouth. The Maryland Bridge is a resin bonded appliance. It is usually the most economical choice when the abutment teeth are healthy, thus reducing the preparation time. This type of bridge involves the pontic (false) teeth being fused together to metal bands that can be bonded to the abutment teeth using resin cement.

    Cantilever Dental Bridge Work - this type of procedure is most appropriate when there is only one abutment tooth on either side of the span. The procedure would involve anchoring the pontic to one side over one or more natural, adjacent teeth.

If there are no adjacent teeth to act as the anchors for fixed dental bridge work, your other option may be either an implant -a metal post that is surgically imbedded into the bone and capped with a crown to act as the abutment unit for a fixed dental bridge, or a removable partial denture.

The Process of Traditional Dental Bridge Work

During the first visit, the dentist will prepare (some dentists use the word prep) the teeth on either side of the space for the pontic (false tooth). These teeth will act as the anchors or retainers. Preparation involves reshaping the teeth by removing a portion of enamel to allow room for a crown to be placed over them. You will be given a mild anesthetic to numb the area, while the dentist removes an area of each abutment. The amount and type of reduction done to the abutment or retainer teeth varies slightly, as it is dependent upon the type of material that is being used to construct the dental bridge.

Making a Dental Bridge

The dentist will then make an impression of your teeth. Impressions serve as a model from which the bridge, pontic (false tooth), and crowns will be made. In the interim, a provisional dental bridge is made to protect the exposed teeth and gums while the bridge is being processed by the dental lab.

When the dental bridge work is complete, the provisional bridge is removed and the new permanent one will be inserted. Multiple visits may be required until an optimum fit is achieved with the metal framework and bite. The dentist may also temporarily cement the permanent bridge in place for a couple of weeks to make sure the fit is proper. After a couple weeks, the bridge is permanently cemented into place.

Caring for Fixed Dental Bridge Work

Caring for Dental Bridges

Crowns on the bridge cover most of the exposed portion of your tooth and decay does not affect a bridge since it is made of metal and /or porcelain. However, where the natural tooth meets the crown of the bridge can become decayed.

Brush your teeth carefully after every meal with fluoride toothpaste and a soft-bristled toothbrush. If you do not control the buildup of food debris and plaque, you teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge.

Brush after eating and before bedtime around the bridge with a soft toothbrush, especially where the bridge meets the gum line (margin). Food may become lodged causing the gums and teeth to become infected. This may lead to further complications resulting in the loss of the bridge. An electric toothbrush is highly recommended over manual to help you keep this area clean.

Your dentist may also recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and its adjacent teeth and gums.

Floss at least once to twice a day using a proxy brush, floss threader or automatic flosser to remove plaque under and around the margin areas to maintain good oral hygiene. On a bridge you must clean "under" as well as around the bridge.

Water Pik™ is a good dental appliance. It can be used with an antibacterial, alcohol free mouthwash at the gum line and under the bridge to keep the area of the dental bridge healthy.

A fluoride rinse should be used before bedtime. Swish the fluoride rinse vigorously in your mouth for at least one minute. Do not swallow any of the rinse and do not eat or drink anything for 30 minutes.

Have your teeth cleaned every six months by an oral health professional.

Limit your sugar and starch intake. The debris left behind from these types of foods may turn into damaging acids which promote plaque and is harmful to teeth and gums.

Avoid hard and/or sticky snacks such as popcorn, hard candy, caramel, and nuts.

Followup Care and Dental Emergencies

It is important to return for follow up care. At a follow up examination, potential problems developing with dental bridge work can be detected. If detected at an early stage, problems can be corrected easily at a nominal fee. Call you dentist immediately if the following occurs:

  • the tooth is the first tooth to hit when you bite down after a couple of days. An occlusion adjustment should take care of the problem.
  • you experience movement or looseness in the restoration. The fixed dental bridge work will need to be recemented.
  • you experience sensitivity to sweet foods
  • you experience a peculiar taste from the restoration site
  • a piece of material has broken off of the fixed dental bridge
  • you are experiencing sensitivity to pressure on the area

Nearly everyone who has one or more missing teeth is a candidate for dental bridge work. Dental bridge work 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. However, the difference between proper and improper oral hygiene is, generally, what determines the success of dental bridge work.

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