Dental Bridges

Dental bridges are designed to replace missing teeth. They not only restore chewing function, but also improve the appearance of your teeth and improve your oral health.

Dental bridges are designed to replace missing teeth. They not only restore chewing function, but also improve the appearance of your teeth and improve your oral health. This dental solution consists of crowns (which fit on either side of your natural teeth) and artificial teeth that fill the gap in your smile.

What is a Dental Bridge?

Dental bridges are used to replace missing teeth. As the name suggests, this procedure literally "bridges" the gap in your smile. Dentists can design custom bridges that match the color of your natural teeth.

A dental bridge consists of several components:

Abutments (Teeth Serving as Bridge Supports)

Abutments refer to the supporting pillars that hold the dental bridge. While this term typically refers to natural teeth, it can also include small connector posts used in bridges supported by dental implants.

Pontics

Pontics are artificial (false) teeth that fill the gaps left by missing teeth. Depending on your condition and the type of bridge you receive, your bridge may include one or more abutments and one or more pontics.

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Types of Dental Bridges

Dentists can choose from various types of dental bridges depending on your oral health goals. Dental bridges are generally categorized into four main types:

1-Traditional Dental Bridge

These bridges are the most common type of dental bridge. They have dental crowns (caps) on both ends with artificial teeth (pontics) in between. The dentist attaches the bridge to healthy natural teeth (abutments) on both sides of the gap, while the artificial teeth fill the space (pontics). Traditional dental bridges are preferred when you have healthy natural teeth on both sides of the gap.

2-Cantilever Dental Bridge

Similar to a traditional bridge but with a crown on only one end, not both. Therefore, when the dentist bonds the bridge onto the abutment tooth, the artificial tooth (pontic) "hangs" or extends over the gap. Cantilever bridges are used when you have a natural tooth on only one side of the gap. Due to their design, cantilever bridges are not as strong as traditional bridges.

3-Maryland Dental Bridge

A Maryland bridge (or resin-bonded bridge) uses metal wings instead of crowns to support the bridge. A dentist bonds the wings to the backs of your adjacent teeth to hold the bridge in place. Maryland bridges are commonly used to replace front teeth. However, these devices are not sufficiently durable to withstand the chewing forces on back teeth.

4-Implant-Supported Bridge

Similar in structure to a traditional bridge but sits on dental implants instead of natural teeth. Dental implants are small, screw-like posts that replace missing tooth roots. Before attaching a bridge to dental implants, the implants must fully integrate (fuse) with the jawbone. This process typically takes three to six months, but it can be longer depending on your situation. Dentists may recommend implant-supported bridges when you are missing three or more teeth.

Your dentist will consider several factors, including but not limited to the following, to determine the type of bridge you need:

• Your age (dentists generally do not place bridges in children).
• Number of missing teeth.
• Size of the gap.
• Condition of adjacent teeth.
• Presence of natural teeth on both sides of the gap.
• Overall health of your teeth and gums.
• Your personal preferences.

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How Dental Bridges Are Applied

What happens during a dental bridge procedure?

The procedures vary depending on the type of dental bridge you choose.

Applying a Traditional or Cantilever Bridge

If you opt for a traditional or cantilever bridge, your dentist will follow these steps:

1. Apply local anesthesia to ensure your comfort during the dental bridge procedure.
2. Shape your natural teeth that will support the new bridge, known as abutment teeth. This step involves removing a small amount of tooth enamel, which is irreversible.
3. Take dental impressions and send them to a dental laboratory where a technician will use them to create the final bridge.
4. Place a temporary bridge until the final bridge is made. This interim period typically lasts between two to four weeks.

Each step must be meticulously followed to ensure the successful completion of the bridge procedure.

During the second visit (when the final bridge is ready), your dentist will:

1. Remove the temporary dental bridge.
2. Try on and check the fit of your new final dental bridge.
3. Cement the new dental bridge in place.

Some dentists use CAD/CAM (computer-aided design and computer-aided manufacturing) technology to create custom bridges in the same appointment.

Applying a Maryland Bridge

To place a Maryland bridge (or resin-bonded bridge), your dentist will:

1. Prepare your teeth for the metal wings.
2. Take dental impressions and send them to a laboratory. (A lab technician will use them to create the final dental bridge.)

When your final bridge is ready, your dentist will schedule a second appointment. During this appointment:

1. Try on and check the fit of the new Maryland bridge.
2. Apply dental acid to the back surfaces of your abutment teeth. This helps bond the dental resin cement.
3. Bond the wings of the Maryland bridge to the back portions of your abutment teeth using dental resin cement.

Applying an Implant-Supported Bridge

An implant-supported bridge is applied over several sessions, one of which involves a surgical appointment.

During the first visit, a dentist, periodontist, or oral surgeon will:

1. Administer anesthesia to numb your mouth and keep you comfortable.
2. Place dental implants into your jawbone during the oral surgery procedure.

After surgery, your implants will need time to heal and integrate with the jawbone (a process known as osseointegration). This process typically takes three to six months but may take longer depending on your situation.

Once your dental implants have integrated, your dentist will:

1. Attach impression caps to the dental implants and take dental impressions. (Impression caps are small connector posts that extend slightly above your gum line.)
2. Take dental impressions while the impression caps are in place. These impressions will be sent to a dental laboratory.
3. Remove the impression caps and send the abutments to the laboratory to create your new implant-supported bridge.

When your final implant-supported bridge is ready, your dentist will:

1. Place the implant abutments and attach the bridge to the dental implants, verifying its fit.
2. Secure the bridge in place. Your dentist may use dental cement or tiny screws for this purpose. (However, this should not cause discomfort.)

Since dental implants can take several months to integrate with the jawbone, implant-supported bridges require a longer process compared to other bridge types.

Benefits and Risks of Dental Bridges

Advantages of dental bridges:

• Provide a natural aesthetic appearance, offering a natural solution to tooth loss.
• Restore chewing and speech functions (eating or speaking with missing teeth can be challenging).
• Prevent adjacent teeth from shifting into the space caused by missing teeth.

Disadvantages of dental bridges:

• Dental decay or trauma to abutment teeth can weaken the dental bridge.
• If your abutment teeth are not strong enough to support the bridge, they can fracture.
• Failure to regularly clean the bridge and the underlying gums can lead to gum inflammation or decay.

Post-Operative Recovery for Dental Bridges

Recovery time for your teeth and gums typically lasts one to two weeks, though it may take longer to fully adjust to your new dental bridge.

How Long Do Dental Bridges Last?

On average, a dental bridge can last between five to 15 years. Some may last longer with proper care and regular maintenance.

These are called "permanent bridges." Only a dentist can remove them, so they are termed "permanent." However, they do not last forever and may need to be replaced when showing signs of wear or damage.

How Do I Care for My Dental Bridge?

Dental bridge care is similar to caring for your natural teeth. To keep your bridge in good condition:

• Brush your teeth daily and use dental floss.
• Choose non-abrasive fluoride-containing toothpaste.
• Clean under your bridge daily; you can use dental floss threaders or interdental brushes (small brushes that can reach between your teeth).
• Avoid excessively hard or difficult-to-chew foods.
• Avoid chewing on ice, pens, toothpicks, or nails.
• Visit your dentist regularly for check-ups and cleanings.

When Should I Call the Doctor?

You should make an appointment if your dental bridge is loose or shows visible cracks.

• Your bridge is loose or has visible cracks.
• You have pain while chewing.
• You experience tooth sensitivity or painful, bleeding gums.

Dental Bridges vs. Implants: Which Is Better?

Generally, dental implants tend to be more durable than bridges. This method also preserves existing bone structure and may reduce the risk of future bone loss.

However, remember that everyone's oral health needs and preferences are different. It's important to have a detailed discussion with your dentist to determine the best treatment option for you.

What Is the Optimal Age for Dental Bridges?

Dentists typically do not recommend dental bridges for individuals under 17 or 18 years old, though exceptions may be made based on the situation. For instance, if a child loses a permanent tooth, the dentist may consider alternatives like a Maryland bridge. However, it should be noted that in such cases, other options such as temporary partial dentures or commonly known as "flippers" may be more effective.

How Many Teeth Can Be in a Bridge?

Generally, a dental bridge fills the gap between one to three teeth. In some cases, a bridge can replace up to four consecutive teeth. However, longer bridges typically require more support. Therefore, healthy natural teeth on both sides of the gap are needed to replace four missing teeth with a bridge.

How Long Should I Wait for a Dental Bridge?

It is generally recommended to replace missing teeth as soon as possible, as this prevents other teeth from shifting into the gap. However, if tooth extraction is necessary, it is important to allow several months for your gums and underlying bones to heal before fitting a dental bridge.

Is Getting a Dental Bridge Painful?

The process of fitting a dental bridge is typically painless. Your dentist will use local anesthesia to numb your gums before starting the procedure.

Do Bridges Feel Like Real Teeth?

It may take some time to get used to a new dental bridge. However, once you become accustomed to it, it will feel similar to your natural teeth.

Can a Dental Bridge Be Removed and Replaced?

If your bridge is loose, it is usually quite easy to remove. Your dentist can often recement it. However, if your bridge needs to be removed for another reason—such as to treat gum disease or decay in the underlying teeth—it may break during the removal process. In such cases, you will need a new dental bridge.

Final Note on Dental Bridges

Missing teeth can leave a gap in your smile and affect your ability to chew and speak properly. If you have between one to four missing teeth, a dental bridge can be a solution for you. Bridges are generally more comfortable and more economical than partial dentures. If you have a tooth deficiency, talk to your dentist about replacement options. They can help you find a solution that fits your needs, budget, and preferences.