Dental Bridge

As many of us know, when you have a missing tooth, it can be difficult to communicate, speak, bite or even eat effectively. When a tooth is missing, it is essential to visit your dentist to discuss the dental options for replacement.

Dental bridges are utilized in dentistry to replace missing teeth and provide a dental prosthesis that connects the adjoining teeth. The teeth on either side of the missing tooth are called abutment teeth and the replacement tooth is called the pontic (false tooth). The pontic teeth are usually made from gold, porcelain alloys, or a combination of materials. The anchor teeth (abutment teeth) can be your natural teeth or implants and they act as the main support for your bridge. Fixed bridges are strong and reliable and in most cases, they feel and look very much like natural teeth!

Dental Bridges have been an integral part of modern dentistry since the early part of the last century and prior to the use of dental implants was the preferred method for replacing missing teeth. Bridge technology is still viable and therefore we’ll be sharing some basic information and discussing the advantages (in certain cases), bridges can provide over dental implants. This is in lieu of the fact that dental implants are now the tooth restoration treatment method of choice for us and most dentists globally!

Some of the general advantages of dental bridges :

  • Dental bridges are usually small, lightweight, providing excellent chewing comfort
  • They correct and re-distribute the normal bite force, compromised by your missing teeth
  • Getting used to your new dental bridge is usually easy and comfortable
  • Controls shifting and moving of adjoining teeth
  • Only 2 – 3 appointments are needed to complete your bridge restoration
  • The longevity factor and general prognosis is good, if your hygiene and home care is maintained at a heightened level

Disadvantages of Dental Bridges :

  • Please remember that if something goes seriously awry with one of your abutment teeth, your entire dental bridge could be compromised. For example, if you develop a deep cavity, dental infection or periodontal (gum) disease with either supporting tooth, then you may lose the entire bridge. Therefore the space involved, design, fit and loading capacity, along with the diagnosis of whether to do a bridge or not is critical and should be done by a specialist in dental crowns and bridges.
  • A common error when making a dental bridge is their often too long! According to physical law (Ante's Law), the longer the span of the bridge, the more force is placed on the abutment teeth. This excessive force can cause intolerable stress on the adjoining abutment teeth. Therefore, careful consideration of the biting forces, relative to your dynamic occlusion and what you eat determines what should be done.
  • The biggest disadvantage with dental bridges is the adjacent tooth preparation, especially if it involves young teeth with little or no restorations. We at Therapeuo really don’t like preparing these virgin teeth to act as abutments, because studies indicate that these teeth will most likely need root canal therapy in the future. This condition occurs, because preparing a tooth or teeth for a dental bridge is still an injury to the tooth. Reducing much of the enamel from your tooth can lead to inflammation of the nerve which leads to tooth sensitivity or dental pain, a side effect occurring in 1-3% of cases. To reduce or prevent this unnecessary side effect from occurring, at TDMC we rely on a special minimally invasive lab process to prepare your tooth – teeth. This technique allows for the creation of strong crowns, requiring only 1mm of support tooth prep, and also limits the heat generated during the process. As a result, we can reduce the incidence of side effects to less than 1 in 500 cases.

Frequently Asked Questions

Our Restorative dentist and Crown and Bridge Specialist (prosthodontist) will provide you with the best choice for you to decide whether you're the right candidate for a bridge or not. In order to even consider the design and construction of a dental bridge, two stable, healthy, abutment teeth must be factored into the equation. X-rays and a thorough oral examination will be carried out to assess the adjacent teeth prior to providing you with a dental bridge option.

Before either a crown or a bridge can be made, the adjacent teeth (abutment teeth) must be reduced by contouring and reshaping them by removing enough tooth enamel to provide space for a dental bridge to be mounted on top of the remaining tooth stub. The removal of your anchor teeth's original shape and structure is the biggest disadvantage associated with traditional dental bridge designs. This causes the loss of significant amounts of healthy tooth tissue which can weaken the tooth, reducing its longevity potential.

In contrast, bridge restorations that are designed and supported exclusively by dental implants, offer a big plus to the adjacent natural teeth which will remain unscathed during the treatment process.

Before your dental bridge is made our prosthodontist will take an impression and perhaps, a digital scan of your mouth! The subsequent results will produce an exact model which will be used in the fabrication of your bridge. Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. If porcelain is to be used, our restorative dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.

The entire dental bridge making process is overseen by a master dental lab specialist. The crowns will fit like a glove onto your anchor teeth, because once your final bridge is cemented into place it'll be with you for a long time.

A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

Fixed bridges are strong and reliable and in most cases they feel and look very much like natural teeth. Dental bridges can last 5 – 15 years and even longer if they remain stable, and if your personal hygiene and home care is maintained at a high level.

While dental crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease (dental decay, cracked teeth, dental infection). Keep your gums and teeth healthy by brushing with fluoride toothpaste twice a day and flossing daily. Also visit us at TDMC regularly for checkups and professional cleanings.

This is an important question and it should be considered whenever you're thinking about using dental implants. Please note the examples shown below to illustrate this point!

  • Let's say you have two broken down teeth next to the missing space. This is a perfect example of why you should consider a dental bridge, as both of these teeth require crowns to protect them from future breakage disease or decay. It is mandatory for long term health and functionality of the teeth that they are examined thoroughly and carefully. We must make sure they're stable (no movement), the roots are long enough, and you have enough teeth remaining to support this bridge.
  • A focus on esthetics may also guide you to decide on a traditional bridge over an implant. Sometimes placing an implant can jeopardize the gum situation if the gum height is already low.
  • Patients with a very high and visible smile line need to carefully consider both possibilities! If you have a failed implant, sometimes changing plans and doing a bridge is better, because it's likely the implant site is compromised. There are many cases in which esthetics drive the decision for a dental bridge or implant, with a bridge you can instantly control the color and shape of three teeth.
  • Another strong advantage is that bridges can be done quickly, in fact, at TDMC a standard bridge can usually be completed in 4 days. Yes, a completed restoration with beautiful ceramics, whereas a dental implant takes a minimum of 4 to 6 months for the bone and implant to integrate fully. If you're told that you can have an implant and the final crown done in a week, please proceed with caution. Studies show that without adequate osseo-integration (bone cells adhering to the implant) you may be facing an unpleasant surprise, if your new implant has not integrated properly. At TDMC our oral surgeons perform hundreds of implant placement surgeries each and every year. We’re experienced, highly skilled and never take unnecessary risks with our patient’s oral care.
  • There is another reason why installing dental bridges makes sense, and it's directly related to your health condition and concerns. Some patients are not capable of undergoing implant or other larger surgical procedures due to cancer, diabetes, certain medications or auto-immune disease. Furthermore, because of your unique oral condition you may not want to engage in a complex bone reconstruction or implant surgery.
  • You may choose to go with a bridge if you have very little bone, which requires an additional bone grafting procedure in order to safely support an implant.

Using implants to support a bridge is an excellent way to save costs, by spacing your implants apart it will make them easier to clean and maintain. If you can't clean around your implants well, then you risk the development of premature bone loss. At TDMC, we routinely refrain from placing more implants than are structurally needed, as it is our intention that the implants we do place will be stable, functional and long lasting

  • It is mandatory for the long term stability of your dental bridge that you make sure your remaining-surrounding teeth stay strong and healthy.
  • Until you are used to your new bridge, you must consume soft foods or chew small morsels.
  • You must refrain from eating a lot of sugary or other unhealthy foods, as it will accelerate the accumulation of plaque and unwanted bacterial decay on your compromised anchor teeth.
  • After your bridge has been installed you may experience tooth sensitivity while eating hot or cold foods. This will subside over time.
  • You must maintain a high level of oral hygiene and home care in order to maintain the stability of your bridge.

You still need to clean your teeth (synthetic or not) twice a day and floss at least once every day. This video shows the basics of good oral hygiene. Check with your National Dental Care practitioner if you’re unsure of your technique.

Make sure you have a checkup every six months, or more regularly if you have a concern about any tooth. Your National Dental Care practitioner will examine your mouth and inspect the margins of the tooth carefully for any signs of decay. Your dentist may take x-rays as part of this process.

There are many variables that can affect the price including :

  • number of teeth needed to fill the gap
  • materials used, such as composite resin, zirconia, or metal alloy covered in resin
  • complexity/difficulty of the placement
  • additional treatments for other dental issues, such as gum disease, root canals or fillings

At Therapeuo the starting cost for a porcelain fused to metal bridge for three teeth starts at Rs 21,000 (three individual crowns costing Rs.7000 each).

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Cost of treatment:
Minimum billing for a Three-unit bridge : Rs.21,000

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Number of sittings required :
Minimum 2 sittings

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Duration per sitting :
around 60 to 90 minutes

Did You Know ?

The Etruscan civilisation were the first to use crowns as a means of restoring damaged teeth? In fact, the materials they used – ivory, gold and bones – were still the standard in dentistry as recently as the 20th century, when porcelain crowns were first invented. Today, crowns and bridges are customised specifically for the patient’s bite and can usually be placed in as little as two dental visits. With proper cleaning and regular dental check-ups, crowns and bridges can last many years, or even a lifetime.

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