What are Bridges?
A bridge is an artificial replacement of a missing tooth using the adjacent healthy teeth as support for the tooth replacement. The adjacent natural teeth supporting the bridge are called abutments, and the missing tooth is referred to as the pontic.
It is commonly fabricated using metal alloys and/or ceramics. The metal alloys are usually included for added strength and support for the overlying ceramics. Newer materials such as zirconia may also be used. The suitability of bridge treatment and choice of materials will be evaluated and determined by your dentist.
When Do I Need a Bridge?
- For replacement of a missing tooth to help restore your smile, speech and eating.
- To help prevent movement and drifting of teeth situated adjacent to the gap.
- If placement of an implant is not feasible due to medical conditions or a lack of space or bone.
- If a denture is not feasible due to functional, aesthetic and adaptability issues.
Are There Different Types?
A. Conventional Bridge
A conventional bridge comprises two crowns, each on either side of the missing tooth, joined together by an artificial tooth (pontic) replacing the gap in the middle.
Fabricating this bridge requires at least 2 to 3 visits.
- The first session involves the trimming and adjustment of the two adjacent natural teeth, after which a mould will be made and a temporary bridge placed.
- The next session involves fitting and cementation of the permanent bridge.
B. Acid Etched Bridge (Maryland Bridge)
An acid etched bridge comprises an artificial tooth (pontic) attached to metal wings that are bonded to adjacent healthy teeth. It requires minimal adjustment of the natural teeth and requires a minimum of 2 visits to complete.
However, as the bridge relies heavily on the adhesive bond to the adjacent teeth, it is commonly used only in situations where the pontic is not under high biting forces. As a result, even though this is a more conservative option, patients need to be carefully evaluated for their suitability.
A temporary bridge is usually not fabricated in between visits for an acid etched bridge due to the minimal preparation of the adjacent teeth.
What Are the Risks?
A. Conventional Bridge
The risks and complications include:
- Post-operative pain and/or sensitivity, especially if the adjacent teeth have not undergone root canal treatment.
- Devitalisation of the adjacent teeth, especially if they are excessively tilted and therefore require more trimming.
- Soreness of the gums surrounding the teeth involved.
- Dislodgement or fracture of the temporary bridge in between visits.
- Recurrent decay and gum disease after completion of the bridge.
- Fracture of the porcelain covering the bridge.
B. Acid Etched Bridge (Maryland Bridge)
The risks and complications include:
- Post-operative pain and/or sensitivity, especially if the adjacent teeth have not undergone root canal treatment.
- Soreness of the gums surrounding the teeth involved.
- Recurrent decay and gum disease after completion of the bridge.
- Fracture of the porcelain covering the bridge.
- Dislodgement or de-cementation of the bridge due to failure of the cement over time or if a large biting force is suddenly applied onto the tooth.
How Should I Care for My Bridge?
In addition to daily brushing and regular dental check-ups, the bridge needs to be cleaned daily with either a floss threader and floss or Superfloss to ensure that plaque is removed from the areas underneath and adjacent to the pontic. Your dentist will demonstrate this to you after the final bridge has been cemented.
