Fixed Bridges
 What is a
bridge?
A bridge is a dental appliance that replaces one or more natural missing teeth,
thereby "bridging" the space between two teeth. Fixed bridges are
cemented into place next to the "abutment" teeth--the surrounding
teeth on either side of the space, or "span." Unlike removable
partial dentures, fixed bridges cannot be taken out of the mouth by the
patient. A fixed bridge is a device that typically consists of three
units--a pontic (a false tooth) fused between two crowns that are cemented onto
the abutment teeth.
Who should get a bridge?
If you are missing any teeth and are committed to maintaining good oral hygiene
practices, you may be a good candidate for a bridge. A bridge 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. Fixed bridges not only correct an
altered bite, improve your chewing ability and speech, but they also safeguard
your appearance by preventing the collapse of your facial features that can
cause premature wrinkles and age lines.
What type of bridges are there?
Besides traditional bridges, another popular design is the resin bonded or
"Maryland" bridge, primarily used for the front teeth. This is
usually the most economical choice when the abutment teeth are healthy and
don't contain large fillings. The pontic is fused to metal bands that can be
bonded to the abutment teeth with a resin cement and hidden from view, reducing
the amount of preparation on the adjacent teeth.
A cantilever bridge may be used if there are teeth on only one side of the
span. This involves anchoring the pontic to one side over one or more natural,
adjacent teeth. If there are no adjacent teeth to act as anchors, your dentist
may recommend an implant--a metal post that is surgically imbedded into the
bone and capped with a crown as an abutment. In some cases where the span is
large, your dentist may recommend a removable partial denture or even an
implant-supported prosthesis.
What procedures are involved?
For a traditional fixed bridge, the first appointment consists of the dentist
reducing the adjacent abutment teeth that will act as anchors. Impressions are
made, from which a metal framework, including the pontic, is created. By the
second appointment, the final bridge is fitted over the teeth.
The total treatment time is usually between two or four weeks, depending on
the type of bridge. However, because it is often difficult to match the natural
shade of your teeth, the treatment time may be longer.
How do I care for a bridge?
With a bridge, it is more important than ever to brush, floss and see your
dentist regularly. If you do not control the buildup of food debris and
plaque--the sticky film of bacteria formed from food acids--your teeth and gums
can become infected, requiring further treatment and resulting in possible loss
of the bridge. Your dentist may also recommend using floss threaders that help
remove bacteria from hard to reach spaces between the bridge and adjacent teeth
and gums.
If you maintain optimal oral hygiene care, you can expect your fixed bridge
to last as many as 8-10 years, or even longer.
Sources:
Robert Margolin, DDS, FAGD;
"An Update on Conventional Fixed Bridges Part 1: Patient Assessment and
Selection," by D.L. Gutteridge, et al., Dental Update, April 1994;
Inlays, Crowns and Bridges, by Leslie C. Howe, et. al.,
Butterworth-Heinemaann Ltd., 1993;
"Crown and Bridge Procedures: Success Begins with Home Care,"
GP, Dec. 1992;
Change Your Smile, by Ronald E. Goldstein, DDS, Quintessence Publishing
Co., Inc., 1988;
"Fixed Bridges and Crowns," American Dental Association, 1985.
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