Let’s Talk About Dental Bridges

What is a dental bridge?

A dental bridge is a fixed way of replacing a missing tooth or teeth.

There are few different varieties of bridge, but the most common type involves preparing the two teeth either side of the space in a parallel manner to enable the placement of your crowns and then creating a fake tooth between the crowns that will fill the space when the bridge is placed.

Since the bridge comprises two crowns (or retainers) and one fake tooth (a pontic) – check out our detailed information on crowns –it’s very relevant here.

Why choose Dr Workman to look after you?

Not only is Dr Workman a very good dentist, he has genuine caring nature and always makes sure you feel truly looked after. This is why he has such a loyal following of, families, young professionals right through to our older generation. With over 12 years experience, he is young, passionate, great at what he does and has an excellent aesthetic eye. If you would like a dental professional you can really trust,  who places your health, happiness and comfort as an absolute priority, then you would be hard pushed to look any further. If you have typed ‘dentist near me’ then our state of the art Maroubra dental practice won’t be far away.

Why would you need a dental bridge?

A bridge allows you to fill the space where one or more teeth have been removed.
It is a good idea where the teeth either side would benefit from a crown to protect them or if they already have crowns on them.
It’ also appropriate if you want something fixed in your mouth – not something that you take in and out.
If you don’t want an implant either for financial reasons, or you can’t have an implant e.g. because there is insufficient bone, a bridge is a good bet.

To properly answer the question of what problems a dental bridge can solve, we should firstly look at the consequences of missing teeth in order to justify why a bridge would be needed:

  1. Spaces don’t look good- especially at the front of the mouth.
  2. Missing teeth place extra force on your remaining teeth, meaning they are more likely to get problems such as wear, or fillings failing from additional pressure.
  3. The bite becomes unbalanced- this can cause problems with the way the teeth move across each other and potentially cause problems in your joints.
  4. The teeth opposite will over-erupt if they aren’t balanced, making them hard to clean, exposing the root and causing sensitivity.
  5. The teeth on either side may tilt causing further problems with the bite or the ability to clean the teeth properly, increasing your risk for gum disease.
  6. The jaws and teeth support the face and the teeth- losing one or more teeth causes significant and premature ageing.

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Signs and symptoms?

There aren’t really any signs and symptoms per se that you will experience, simply that you have a missing tooth or teeth.
Then it is about making a decision – is a bridge the best option for restoring the space in your mouth?

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Types/options?

Dental bridges are very predictable when there is some quality tooth structure remaining to fix on to.

A standard bridge is two crowns and a fake tooth, called a 3 unit fixed- fixed bridge.

It can also be fixed movable, meaning there is a joint in it that affords some movement or flexibility and this can be advantageous in certain situations.

You can also have a cantilever bridge that simply attaches a fake tooth to a crown on one side- this is very useful but reserved for more limited situations and requires, for the most part, a strong larger tooth to replace a smaller weaker tooth – as you don’t want a lot of force on the fake tooth. For example, replacing a lateral incisor off an eye- tooth (canine).

There are also bonded bridges or sticky bridges that don’t involve crowns but involve wings instead: these are bonded on and useful when crowns would be overly destructive and when the bite of the patient is favourable i.e. they will not exert too much pressure. This type of bridge is totally inappropriate if you grind your teeth heavily.

There are a few different material choices in the same way as for crowns: most fixed bridges are based on PFM (porcelain fused to metal crowns) for good strength and aesthetics.

All porcelain bridges of zirconia can be useful too and suited to the back teeth.

Emax are not as strong and so generally not used as a material for bridges.

What’s the procedure?

Like a crown, a bridge will generally take two appointments.

Assuming you have ‘treatment planned’ the bridge i.e. decided this is the best option and x-rays have been taken to confirm the teeth either side are good to support a fake tooth, Dr Jamie will prepare the teeth involved in the bridge, making sure they are parallel enabling the temporary; the final bridge can then be made and placed in accurately.

It may be necessary to replace old fillings with new cores in certain teeth, but they may of course be perfectly fine to use as they are.

The teeth are filed down minimally as required for the strength of the bridge, and an impression is taken to communicate to the lab what needs to be made.

Dr Jamie will choose the most appropriate material and then take a shade so that it matches your existing natural teeth, create a temporary and place this in position for the couple of weeks – until the final bridge is ready.

When you return to the surgery you will be given an anaesthetic again: the temporary bridge removed and the final bridge checked for aesthetics, bite and contacts before being cemented or bonded in.

All excess material will be removed and the cement will be allowed to set before a final polish.

Dr Jamie will also take you through some important points before you leave: how to look after your bridge and how to use superfloss.

Summary Box:

Treatment time 2 appointments – 1st 75 mins, 2nd

45 minutes (2 weeks later)

Cost $4000 (for a 3 unit fixed bridge)

Risks and problems?

The risks for dental bridges are the same as for crowns.

If they are of the fixed- fixed variety, that is they could come off due to the cement failing on both sides or worse they remain attached on one side and the decay gets underneath the other side eating away at the tooth underneath.

The bridge can fracture some of the porcelain: those who grind and clench their teeth are more at risk and should wear a protective night split.

Another issue could be that the nerve inside one of the retaining teeth has a problem and needs a root canal through the top to fix it.

Sometimes a root canal is needed before the bridge; sometimes it isn’t and then there are those unfortunate circumstances where problems arise after the bridge has been fitted.

The main issue with a failing bridge is that the bridge attaches the teeth together, and…if… there is an issue- the whole thing needs to be replaced. A very costly procedure!

That said when dental bridges are done correctly and in the hands of someone like Dr Jamie, they are a very aesthetic, comfortable and predictable way to replace a missing tooth long term.

Success rate/ how long do dental bridges last?

On average we would expect a dental bridge to last 10-20 years, but it could last longer. Exactly how long depends on many factors:

The retaining teeth – the quality of the core, and amount of tooth structure left.
The teeth involved – the level of bone support for them and the vitality of the nerve inside.
The dentist – their experience, preparation, the impression and cementation.
The technician – the quality and fit of the dental bridge provided.
The bridge – the design, the material and the number of teeth involved)
You – your bite, your other teeth and how well you look after your bridge and clean it underneath.

What are alternative treatments to a dental bridge?

Really what we are saying here is… what are the options for replacing missing teeth?
Aside from the bridge, there are always the same potential three options (not all of which may be available to you for different reasons):

  1. Do nothing
  2. An implant
  3. A denture or plate of some sort.

Each comes with their pros and cons and the choice will be affected by:

  1. Are the teeth available or not available to hold a bridge?
  2. What is the quality of these teeth? If the teeth were perfectly healthy, then for the most part an implant would be preferable, given the fact it keeps everything separate and avoids the need to file down healthy teeth.
  3. Is the amount of bone needed sufficient and/or available for an implant?
  4. How many teeth are missing? The costs for fixed restorations (implant/bridge) go up considerably the more teeth you add; this is not the case with the partial dentures.

Dr Jamie will give you his thoughts and help guide you through the different options and what would be best for you.

What are alternative treatments to a dental bridge?

Really what we are saying here is… what are the options for replacing missing teeth?
Aside from the bridge, there are always the same potential three options (not all of which may be available to you for different reasons):

Aftercare and recovery?

You will leave the first appointment with a temporary crown.
This isn’t as strong as natural teeth so go a little easy on it; it won’t look quite as good as the finished article either.
It can be a touch sensitive and using toothpaste for sensitive teeth will help.
Should you experience more severe pain, please contact us right away.

You need to keep the temporary clean and will only be able to floss the back and front of the bridge as the rest is connected together: pull the floss through in these cases, do not try to pull it back up…you may dislodge the temporary bridge.

You are also going to be numb, so always be careful until this feeling has worn off…taking care to avoid hot drinks and hot food. Be careful not to bite your lip.

The temporary can feel a little rough at first, but will smooth over in a few days.

Once the final bridge has been cemented you’ll need to look after it by brushing it well, flossing the back and front and using a special floss called Superfloss to floss underneath. This area must be kept clean keep the area clean.

Like more information?

Click the below to download our guides to:

Check out:

  1. Dr Jamie’s education site; Jamiethedentist.com where you can hear him speak and read about Bridges in a lot more detail.
  2. These other excellent resources:

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