Replacing Teeth with Dental Bridges
Dental Bridges, what are they?
A fixed partial denture (FPD), sometimes called a “fixed bridge” or simply a “dental bridge” is the use of multiple dental crowns splinted together to replace a missing tooth or teeth. In a situation where you have a missing tooth and there are appropriately healthy teeth on either side of the space, a fixed dental bridge can provide a good solution to replace the missing tooth.
|An FPD or dental bridge is made by preparing the adjacent teeth for crowns. The process occurs in the same way and the steps are quite similar. There are usually several trial steps in between to verify the fit which are not needed for most single crowns. The supporting teeth are called the ‘abutments’. The dummy teeth in between are called ‘pontics’. The design and preparation are exacting and it is important to try and determine the strength and health of the teeth on either side of the space. This is because we are asking those teeth to now carry the wieght of the missing teeth as well as their own.|
|The FPD or “dental bridge” usually has a cast metal substructure for strength though there are now some ceramic substructures that can carry a substantial biting load. The design of the underside of the pontic tooth can vary. Sometimes it is bullet shaped to make it seem as if the fake tooth is emerging from the gums. Other times it may have a small gap or overlap for clearance and to enable cleaning underneath.|
|Once cemented in place, the dental bridge looks and feels much like your own teeth. One exception is that you will not be able to floss between the bridged teeth normally. Instead, you will need to use floss threaders or an interdental brush to clean under the pontic.|
Limitations of a Fixed Dental Bridge
These are just a few situations where a fixed dental bridge would not be an acceptable treatment choice. In the first picture on the left, the patient has a long span of 3 missing teeth which need to be replaced. This is too long of a gap to try to span. In the middle case, there is only “land” on one side and nothing to support the dental bridge from the back side. On the right side, again, there is simply too long of a gap to try and fill. The adjacent teeth on either side will not support so high a load without fracturing. For these cases, we usually begin to look at alternatives like dental implants or removable partial dentures.
|This is the end result of too much stress on an abutment tooth. Unfortunately, when this happens, the whole bridge need to be removed, the fractured root extracted and an alternative needs to be treatment planned and fabricated.|
|This is what usually happens when you don’t replace a missing tooth. It is not possible for us to predict, once you have lost a tooth, exactly to what extent this will occur. What results, however, is a situation in which the misaligned teeth must first be corrected before a bridge can be fabricated. Note how the bite is no longer level and the abutment teeth are no longer straight up and down.|
Dental bridges can be as simple as three teeth or as complicated as a whole arch of teeth. We can use segmented portions keyed together or one long span. Many times, if teeth have compromised bone support, we can use a dental bridge to link them together and help support one another. The design, however, must be carefully planned to avoid over-stressing the abutments. Another consideration to joining the teeth is that if any one tooth in a key spot breaks or fails to carry the load, the whole segment that rests on it may need to be replaced. We are always happy to discuss your options and encourage you to think carefully about the treatment choices we may recommend.