Understanding Fixed Bridges: Filling the Gap
Fixed bridges, quite simply, replace missing teeth to make chewing easier, improve appearance, and keep your teeth, gums and jaws healthy. Bridges consist of 1 or more replacement teeth attached to the natural teeth next to them. They are made of various metals, porcelain or a combination of both.
Often people underestimate the value of every tooth in terms of beauty, even those in the back of the mouth. Although the spaces created by these missing teeth may not be visible, they can cause a variety of problems and start a vicious cycle of destruction. In a normal, healthy mouth, your teeth have a natural balance. Each upper tooth contacts the corresponding lower tooth, allowing for a well-balanced chewing function. Losing a tooth quickly destroys this balance. Just 1 missing tooth can cause the position of other teeth to change – some teeth may tilt forward, or opposing teeth may move down. A missing tooth can also create spaces between your teeth, changing your bite and smile. These shifting, drifting and tilting teeth can cause a variety of problems – such as difficult or painful chewing (due to changes in your muscles, bones and joints), or abnormal decay areas (due to teeth that are hard to reach and keep clean) – which accelerate periodontal (gum) disease. Generally, if the missing tooth is not replaced, more teeth may eventually be lost due to the improper forces exerted during chewing.
In short, by replacing missing teeth you can:
Help restore and maintain a natural bite
Prevent unnatural stress on other teeth
Help keep opposing teeth in their proper place
Prevent shifting and tilting of adjacent teeth
Help prevent further dental decay and gum disease
Maximize your smile, speech and chewing function
If you lose a tooth, you can avoid unwanted problems and save remaining teeth by visiting your dentist immediately.
There are 2 main types of bridges: conventional and Maryland.
A Conventional Bridge has replacement teeth that are attached to crowns that fit over your natural teeth on either side of the space to be filled. The replacement teeth plus the crowns form a solid unit that is cemented into place to restore your natural bite. Conventional bridges:
Last 5-15 years (longer than a Maryland bridge)
Help to prevent movement of adjacent and opposing teeth
Are more expensive than the Maryland bridge
A Maryland Bridge has replacement teeth that are attached to the back of nearby natural teeth using a metal or porcelain strip. This type of bridge may be an option if the teeth next to the bridge are in good condition. A Maryland bridge:
Lasts 5-10 years
Requires less tooth reduction
Is less expensive than the conventional bridge
Metal backing may show through if the teeth are thin
It will take 2 or more dental visits to prepare and fit your bridge. First, your dentist reshapes the support teeth that will hold the crowns of your fixed bridge. Then an impression of the prepared tooth, and of the surrounding and opposing teeth, is taken. If appearance counts, your dentist selects a colour from a guide to make sure the replacement teeth match the colour of your natural teeth. To protect your prepared teeth while the fixed bridge is being made, your dentist may fit a temporary bridge that is held in place by temporary cement.
Between visits, expect to wait about 1 week while the lab work is being done. Be careful when cleaning your teeth or eating, because your temporary bridge can loosen. Let your dentist know immediately if the temporary bridge comes off or loosens.
At your second visit, your temporary bridge is removed and your dentist places the fixed bridge onto your prepared teeth, adjusting it in your mouth. Once the fit and bite are comfortable, the fixed bridge is cemented into place. If after trying the bridge for a few days you think it needs further adjusting, call your dentist.
In certain situations, and if your surrounding teeth are in good condition, your dentist may recommend the Maryland bridge. Talk to your dentist to determine if this is a good option for you.
Living with Your Fixed Bridge
Fixed bridges look and function similar to natural teeth. They remain in the mouth at all times and can only be removed by your dentist. Because trimmed down natural teeth (abutments) must carry the load of missing teeth, they can sometimes be overloaded. Patients need to “favour” the bridged areas slightly to avoid overloading and potentially loosening or damaging the prostheses.
Good oral hygiene can help your bridge last a long time. You can extend your treatment life expectancy by:
Brushing after each meal. Brush the surfaces and sides of your bridge like you do your natural teeth. Use an interdental brush to clean between large spaces.
Flossing at least once a day to clean food and bacteria from between teeth and at the gum line. Special thick floss can help keep your bridge clean and floss threaders help you to floss under a fixed bridge.
Seeing your dentist at least twice a year for a cleaning and checkup. Ask your dentist about special cleaning aids for your bridge.
Alternatives to fixed bridges include removable partial dentures, which are the most common alternative, or implants with crowns and/or fixed prostheses placed over them.