Dental Bridge
What is a Bridge?
Step-by-Step (What to Expect During Your Bridge Appointment)
1. Preparation of Abutment Teeth: Much like getting a single crown, the teeth on either side of the gap will be prepared. We will numb the area, then reshape those adjacent teeth by removing a portion of enamel to make room for the crowns that will fit over them. If these teeth have decay or old fillings, we’ll remove the decay and possibly build up any missing structure with filling material (so they can support the bridge).
2. Impressions and Temporary Bridge: After the abutment teeth are shaped, we take impressions or digital scans of the area. These records are sent to a dental lab where the bridge (with its crowns and pontic teeth) will be crafted. This process takes 1–2 weeks typically. In the meantime, we will make you a temporary bridge or a set of temporary crowns with a fake tooth to fill the gap, so you’re not left with missing teeth. The temporary is usually acrylic and is cemented with temporary cement. It will not be as strong as the final bridge, but it will look presentable and allow you to function carefully.
3. Bridge Placement: Once the permanent bridge is ready, you’ll return for a second visit. We remove the temporary and clean the prepared teeth. We try in the new bridge, checking that it fits well, the bite is correct, and the appearance is right. You will be able to see how it looks as well. We can make small adjustments if needed. If everything is satisfactory, we cement the bridge in place with a strong permanent dental cement. We then clean off excess cement and verify that your bite is comfortable.
4. Follow-Up Adjustments: As you start using the bridge, we may schedule a quick follow-up after a week or two to check your gum health around the bridge and ensure you’re cleaning it properly. If your bite needs any minor tweaks or you have questions about flossing under the bridge, we will address them.
Key Benefits of Getting a Bridge
– Restores Chewing and Speaking: By filling the space of missing teeth, a bridge allows you to chew food more effectively and comfortably. It also helps with clear speech – missing teeth (especially front teeth) can cause lisping or difficulty pronouncing certain words. With a bridge, your tongue and lips can make normal contact with teeth for proper speech sounds.
– Prevents Tooth Shifting: One of the biggest benefits is that a bridge keeps your other teeth in place. When there’s a gap, adjacent teeth tend to drift or tilt into the empty space over time, and the teeth in the opposite jaw may over-erupt into the gap. This can throw off your bite and lead to gum problems or further tooth loss. A bridge acts as a placeholder, preventing the chain reaction of shifting teeth.
– Aesthetics – Brings Back Your Smile: A well-made bridge looks very natural. The artificial teeth (pontics) are shaped and colored to match your real teeth, so your smile will look complete and natural again. This can boost your confidence if you’ve felt self-conscious about gaps.
– Quick Result Compared to Implants: A bridge is usually completed in a few weeks (over 2 visits). This is faster than a dental implant which might require several months of healing. If you’re looking for a relatively quick, fixed solution to replace a tooth, a bridge provides that.
– Stable and Non-Removable: Unlike a partial denture, a bridge is cemented in and does not come out daily. Many patients prefer this because it feels more like your own teeth. You don’t have to remove it to clean (you do have to clean under it though), and it generally feels secure. This can be an advantage in terms of comfort and ease once you adjust to the cleaning technique.
Common Risks or Side Effects (why I should not get a bridge)
– Effect on Adjacent Teeth: To place a bridge, the abutment teeth must be shaved down to accommodate crowns. This is an invasive procedure on those teeth, and if they were previously healthy (or lightly filled), we are now covering them. Those teeth could potentially be sensitive after preparation, or in some cases, the stress of being crowned and supporting a bridge could irritate the tooth’s nerve. There is a small risk an abutment tooth might need a root canal in the future if it doesn’t recover well or if decay leaks under the crown. We mitigate risks by ensuring the abutments are strong and healthy enough beforehand.
– Bridge Failure (Decays or Fractures): A bridge’s weak point is often where the crowns meet the natural teeth at the gum line. If oral hygiene is not meticulous, plaque can accumulate around those margins and lead to decay of the abutment teeth under the crowns. Additionally, the entire bridge is connected, so if one part fails (like one abutment tooth gets severely decayed or the porcelain cracks), it can compromise the whole unit. Porcelain or ceramic on a bridge can chip or fracture if exposed to trauma, just like a crown. A well-made bridge on healthy teeth can last many years, but it’s not permanent – eventual replacement may be needed if any supporting tooth fails.
– Gum Irritation: Right after getting a bridge, your gums under the pontic may be a little tender or inflamed from the process or from the contours of the new bridge. This usually settles as you keep it clean. If a pontic is designed to touch the gum (“ridge-lap” style), food trapping is minimal but cleaning might require threading floss. If it’s a hygienic pontic (leaves a space), food might get under it more easily but it’s easier to clean. We aim for a design that balances esthetics and cleanability. Any initial gum soreness can be managed with warm saltwater rinses.
– Difficulty Cleaning: Cleaning under a bridge requires some new techniques. You cannot floss between the artificial tooth and the gum in the usual way because it’s connected. You’ll need to use floss threaders, interdental brushes, or water flossers to keep the area under the pontic and around the abutments clean. Some patients find this cumbersome at first. Not cleaning well can cause bad breath, gum disease, or decay on the supporting teeth. We will instruct you thoroughly on how to care for your bridge. It’s crucial to commit to this hygiene routine to avoid complications.
– Altered Sensation or Bite at First: A new bridge might feel slightly strange for the first few days – your tongue will notice the difference where the gap used to be, and the bite force distribution might feel new. You might have mild thermal sensitivity on the crowned teeth for a short time. Usually, you adapt quickly, and it begins to feel normal. If your bite feels off or you feel high pressure on one side, an adjustment might be needed. Let us know if something consistently feels uncomfortable after a couple of days.
Alternatives to a Dental Bridge
– Dental Implant: A single dental implant with a crown is a popular alternative to a bridge for a single missing tooth. The implant replaces the tooth root in the bone and avoids involving the neighboring teeth. Implants have a high success rate and are a permanent solution with a 95%+ success rate over 10 years. The downside is that it requires oral surgery and a healing period, and not everyone is a candidate (depending on bone levels or health conditions). Implants can also be more expensive initially, but they don’t risk the adjacent teeth and they help preserve bone. If you’re missing multiple teeth, multiple implants or an implant-supported bridge may be options. We can discuss if implants are suitable for you.
– Removable Partial Denture: A partial denture is a removable appliance with replacement teeth that clip onto your remaining teeth. This is usually the most affordable route to replace multiple missing teeth. However, it’s not fixed in your mouth – you have to remove it to clean, and it may not feel as natural or comfortable for chewing as a bridge or implants. Partials can also put some stress on the supporting teeth and clasps may be visible. That said, some patients prefer a partial if they cannot or do not want to have the teeth drilled for crowns or undergo implant surgery.
– No Replacement: You may choose not to replace the missing tooth/teeth. We advise against this in most cases because of the issues it can cause: neighboring teeth drifting, supraeruption of opposing teeth, difficulty chewing, and aesthetic concerns. However, it is an option to leave a gap, especially if it’s a back tooth and you’re willing to accept the risks. Your dentist will inform you of the potential long-term changes if a gap is left. Keep in mind, gaps can often lead to more complex dental issues later, which can be costly or troublesome.
Post-Procedure Bridge Care Instructions:
– After Bridge Cementation: Once the bridge is cemented, avoid eating for at least 30-60 minutes to let the cement fully set. Even after that, introduce foods gently – avoid very hard or sticky foods on the bridge for the first day. You may feel some tightness or pressure on the abutment teeth initially; that’s normal. If the bite feels uneven or one side hits first, call us for an adjustment. It’s better to tweak it than to risk soreness or fracture from an imbalanced bite.
– Oral Hygiene Routine: Cleaning your bridge is paramount. At least once a day, you need to clean under the fake tooth (pontic) and between the bridge and gum. Use a floss threader or special floss like Superfloss to get underneath the pontic and clean the underside and sides of the abutment teeth. Also brush normally, including the gumline around the bridge, to remove plaque. A water flosser can be very helpful to flush out debris under the bridge on a daily basis. We will demonstrate these techniques for you. It might take a little practice, but soon it will be as easy as your normal brushing routine.
– Diet Considerations: Just like with crowns, avoid using the bridge to bite extremely hard items (e.g., don’t crack nuts with it, avoid ice chewing). While bridges are strong, the leverage on abutment teeth can be significant. Also be cautious with very sticky candies – they could potentially loosen a crown over time. Maintain a balanced diet; there are no major restrictions, but exercising reasonable care will prolong the life of your bridge.
– Fluoride Use: Consider using a fluoride mouth rinse or prescription fluoride toothpaste if recommended, especially if your bridge covers areas prone to decay. The edges of the crowns (at the gum line on abutment teeth) are still susceptible to cavities. Extra fluoride can help harden those areas and prevent decay.
– Regular Dental Visits: It’s important to come for regular check-ups and cleanings. We will use special instruments to clean around your bridge and we’ll periodically take X-rays to ensure the abutment teeth remain healthy under the crowns. Early detection of any issue will save the bridge. If we ever detect a small cavity on an abutment tooth, sometimes it can be addressed without removing the whole bridge – but prevention is best.
– Watch for Changes: If you ever feel the bridge loosen or notice any odd odor or taste around it (which could indicate trapped food or leakage), please schedule an appointment. Bridges should feel solid. Movement could mean cement failure or an issue with a supporting tooth. Addressing it quickly can sometimes mean the difference between a simple recementation or needing a new bridge.