Dental Bridges for replacing missing teeth

Reviewed by: Dr Pav Khaira

What are dental bridges?
Dental bridges are false teeth anchored on neighbouring teeth in order to replace one or more missing teeth. The false tooth is known as a pontic and is fused in between two crowns that serve as anchors by attaching to the teeth on each side of the false tooth and thereby bridging them together.

What are the parts of a typical dental bridge (fixed) ?
A dental bridge essentially consists of

• A pontic or false tooth used to replace the missing tooth, and is made from gold, alloys, porcelain or a combination of these materials
• Two crowns – serving as anchor the false tooth in place

When are dental bridges needed?
Bridges are recommended when there are one or more teeth missing that affect your

• Smile and appearance
• Bite as a result of adjacent teeth leaning into the space and altering the way the upper and lower teeth bite together.
• Speech
• Shape of your face
• Gum disease and tooth decay as a result of food accumulated in the gap

Must missing teeth be replaced?
Yes, missing teeth must be replaced for many reasons -

• To improve your appearance
• To reduce the strain on the teeth at either side of the missing tooth
• To prevent the neighbouring teeth from leaning into the resulting gap and altering the bite
• To prevent gum disease and tooth decay due to accumulation of food in the gap

There are three main types of dental bridges?

1. Traditional Fixed Bridge
This is the most commonly used type of bridge and consists of a pontic fused between two porcelain crowns that are anchored on neighbouring teeth or implants. The pontic is usually made of either porcelain fused to metal or ceramics. These are fixed and cannot be removed.

2. Resin Bonded Bridges or Maryland bonded bridges
These are opted when the gap to be filled is in between the front teeth and when the adjacent teeth on either side of the missing tooth are strong and healthy without large fillings. The false tooth is made of plastic and is fused to metal bands that are bonded to the adjacent teeth using resin that is hidden from view.

3. Cantilever Bridges
These are opted for areas such as the front teeth that are susceptible to lower stress. Cantilever bridges are used when there are teeth present only one side of the space, where the false tooth is anchored to one or more adjacent teeth on one side.

What are bridges made of?
Bridges may be made of

• Porcelain
• Porcelain bonded to precious metal.
• All metal dental bridges (Gold)

What are the steps involved in the procedure for fitting in dental bridges?
Dental bridges need more than one appointment with the dentist to be fitted in.

At the first appointment

• The dentist will numb the area with a mild anaesthetic.
• The teeth on either side of the space are prepared by trimming away a small area in order to accommodate the new crown over them.
• In case of teeth with fillings, a part of the filling is retained to serve as foundation for the crown.
• The dentist then uses dental putty to make an impression of the teeth, which will be used to make the bridge and crown in the laboratory.
• A temporary bridge is fitted in to protect the exposed gums and teeth
• A Vita shade guide may be used to determine the right shade for the dental bridge, by selecting a shade that resembles natural colour variations in your teeth, as well as suits your complexion, hair colour, the colour of your natural teeth and even your eye colour.

At the second appointment

• The temporary bridge is removed and the custom made bridge is fitted in and checked for its fit and bite, and adjusted accordingly. It is then cemented in place
• Often multiple visits are required to check and adjust the fit.
• In case of permanent or fixed bridges, the bridge is temporarily cemented in for a couple of weeks and checked for its fit. It is permanently cemented in only after several weeks.

How long will dental bridges last?
Dental bridges can last 10-15 years provided that you maintain good dental hygiene and eating habits.

How to take care of your dental bridges?
Practice good dental hygiene

• Clean the dental bridge everyday and prevent tooth decay, bad breath and gum disease
• Clean under the false tooth every day
• Keep the remaining teeth healthy as these serve as the foundation for the dental bridge

Brushing and flossing

• Brush twice and floss daily
• To floss use a bridge floss threader which is a flexible piece of plastic with a loop at one end to thread the floss.
• Thread one end of a 14 to 18 inches piece of dental floss through the loop, making sure to leave one side about half as long as the other
• Insert the end of the flosser without the hole in between the bridge and the gumline.
• Hold onto the longer piece of floss, gently bring it up and pull the pointed end all the way through.
• Floss using both your hands, moving the floss back and forth under the bridge
• Floss the bridge completely from its one end to the other

Diet and eating habits

• Eat soft foods or food cut into small pieces until you get accustomed to the dental bridge
• Eat a balanced and nutritious diet for good general and dental health

What are the advantages of dental bridges?

• They are natural in their appearance
• They generally require only two appointments with the dentist
• They have a good life period, lasting for 10-15 years, provided that you maintain good dental hygiene,
• They improve your appearance, bite issues as well as speech problems occurring as a result of missing teeth

What are the disadvantages of dental bridges?

• Teeth become mildly sensitive to extreme temperatures for a few weeks following the treatment.
• Your teeth and gums are vulnerable to infection as a result of accumulation of bacteria due to the food acids if proper hygiene is not maintained.