Dental Bridges

A bridge stabilizes the bite of a patient who is missing one or more teeth. Bridges prevent the surrounding teeth from moving or shifting in the mouth. A missing tooth that is not replaced may cause surrounding teeth to become unstable and require removal, compromising oral health or change the shape of the face and diminish the beauty of a smile.

Unlike partial dentures, bridges are permanent; patients need not remove them. The missing tooth is replaced with an artificial tooth connected between two crowns (caps), which are permanently cemented or bonded on the adjacent teeth.

Bridges can be used to replace a small number of missing teeth if the neighboring teeth are sufficiently strong. The number of missing teeth, condition of the neighboring teeth, condition of the supporting gums and bone are all important factors which need to be assessed prior to making a bridge.

A dental bridge is one method to fill a gap created by a missing tooth (or teeth). Dental bridge or pontic is a custom-made false tooth or teeth, that is permanently placed between two healthy teeth, filling in the area left by a missing tooth or teeth. The bridge is held in place by crowns placed on the healthy teeth on each side of space to be filled.

Benefits of Dental Bridges

• Restores your smile
• Restores your ability to properly chew and speak
• Maintains the shape of your face
• Distributes the forces in your bite properly by replacing missing teeth
• Prevents remaining teeth from drifting out of position
• Helps preserve the natural function and position of the teeth
• Restores and maintains natural bite

Types of Dental Bridges

Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge.

Cantilever bridges are usually used when there are adjacent teeth on only one side of the missing tooth or teeth.

Marlyland bridges also called a resin-bonded bridges or a Maryland bonded bridges. Maryland bridges supported by a metal framework. Metal wings on each side of the bridge are bonded to the back of existing teeth.

Types of Dental Bridge Materials

There are three basic types of materials for dental bridges:

• Porcelain fused to metal dental bridges
• All porcelain dental bridges
• All metal dental bridges (Gold)

The all porcelain dental bridges and porcelain fused to metal (PFM) dental bridges are tooth colored bridges. PFM dental bridges are usually used to restore back teeth where the forces of chewing and grinding are strongest. All porcelain dental bridges are the most aesthetic and are used almost exclusively for front teeth where the need for strength is not as critical. Gold dental bridges are the most durable and offer the most precise fit. Gold dental bridges does not chip.

The porcelain bridges used at Dental Tourism India International Dental Center include the IPS Empress Esthetics crowns from Ivoclar Vivadent and Procera NobelEsthetics from Nobel Biocare.

Procedure for Dental Bridges Treatment

The course of treatment described here is for traditional bridges, one of several options available at our dental clinic. Consult your dentist to find out what the best solution is for you, given your specific condition.

• First evaluation and bridge tooth preparation
  • Local anesthesia is first adminstered at the region of bridge tooth preparation
  • The natural teeth adjacent to the missing gap is reshaped to receive the dental bridge
  • Records are taken and approved with the patient to determine the color, bite, length and shape of the bridge
  • An impression is taken for a replica model of the teeth
  • This model is sent to a lab where the individualized bridge is fabricated
  • A temporary bridge is placed on whilst the permanent bridge is made

• Fitting of bridge on delivery
  • The temporary bridge is removed
  • The permanent bridge is fitted and cemented into place on the teeth
  • A quality assurance check is done for any re-adjustments or re-works of the dental bridge

• Care of bridge
  • Brush and floss the bridge as recommended by your dentist or dental hygienist

Recovery Expectations

Both the preparation and placement of the temporary bridge as well as the bonding of the permanent bridge may cause some minor tenderness in the area. Some individuals may experience sensitivity in teeth. This sensitivity will disappear gradually over a few days to weeks.

Replacing missing teeth should actually make eating easier but until you become accustomed to the bridge, eat soft foods that have been cut into small pieces.

Postcare Instructions for Dental Bridges

It is important to keep your remaining teeth healthy and strong as the success of the bridge. The bridge depends on the solid foundation offered by the surrounding teeth.

• Avoid chewing on or eating hard foods on the restorations for 24 hours from the time they were cemented
• To help with discomfort or swelling rinse your mouth 3xd with warm salt water. (1tsp. of salt in 8oz of water)
• Keep crown area clean to maintain tissue compatibility (the contour of the prosthesis must allow the surrounding tissue to conform to a natural, healthy position)
• Some sensitivity in teeth may be experienced by certain patients. This sensitivity will disappear gradually over a few days to weeks. If teeth are sensitive :
  • Avoid hot, cold or acidic food and beverages
  • Pain medication be taken as directed as long as there is no medical contradiction based upon your medical history
  • Use flouride rinse and toothpaste for sensivity teeth
  • Clean teeth properly

Care for Dental Bridges

Dental bridges require the same regular and consistent home and professional dental care, as your natural teeth to prevent decay at the tooth-dental crown junction. To provide optimum longevity for your restorations, please follow the home care tips below:

• Brush after eating and before bedtime around the bridge with a soft toothbrush, especially where the bridge meets the gum line. At the gum line harmful bacteria can be harbored to cause decay and gum disease.
• Floss at least once to twice a day. Use the proxy brush or floss threader to remove plaque under and around these areas to maintain good oral hygiene. Buildup of food debris and plaque on your teeth and gums can become infected.
• Rinse with fluoride rinse before bed. Swish the fluoride rinse vigorously in your mouth for at least one minute. Do not swallow any of the rinse and do not eat or drink anything for 30 minutes
• Be careful about chewing toffees, gum, grainy rolls and tough food in this area
• See your dentist for regular professional check-ups and cleanings

The "bridge" prior to placement	The "bridge" in the mouth
A typical bridge	A Ceramic bridge

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.Bridges are cemented into place on the "abutment" teeth--the surrounding teeth on either side of the space or span. Unlike removable partial dentures,bridges cannot be taken out of the mouth by the patient.

A 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?

A person with missing teeth and committed to maintaining good oral hygiene practices,is a good candidate for a bridge. A bridge is the most natural choice to fill the space in the 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. Bridges not only correct an altered bite, improve the chewing ability and speech, but they also safeguard the appearance by preventing the collapse of 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,an implant is recommended--a metal post that is surgically embedded into the bone and capped with a crown as an abutment. In some cases where the span is large, a removable partial denture is recommended or even an implant-supported prosthesis.

What is the procedure of its fabrication?

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 around one week, 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 the dentist regularly. If buildup of food debris and plaque -the sticky film of bacteria formed from food acids-is not controlled, the teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge.We recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums. Crowns on the bridge cover most of the exposed portion of your tooth and decay does not affect a bridge since it is made of metal and /or porcelain. However, where the natural tooth meets the crown of the bridge can become decayed. If optimal oral hygiene care is maintained,a bridge can last for many years.

Suggestions and precautions

Adjustment period : It is ok for the bridge to feel a little out of place for a few days after cementing. This is because the teeth around this area are adjusting to new forces both in between the teeth and upon biting.

Preventive Procedures : To provide optimum longevity for your restorations and to prevent future decay and supporting-tissue breakdown, please use the following home care tips:

Brush after eating and before bedtime around the bridge with a soft toothbrush, especially where the crown or bridge meets the gum line (margin). At this margin area harmful bacteria can be harbored to cause decay and gum disease. An electric toothbrush is highly recommended over manual to help you keep this area clean Floss at least once to twice a day. Use the proxy brush, floss threader or automatic flosser to remove plaque under and around these areas to maintain good oral hygiene. On a bridge you must clean “under” as well as around the bridge. If you do not control the buildup of food debris and plaque your teeth and gums can become infected.

Water Pik™ can be used with an antibacterial, alcohol free mouthwash at the gum line and under the bridge to keep this area healthy Fluoride rinse is to be used before bed. Swish the fluoride rinse vigorously in your mouth for at least one minute. Do not swallow any of the rinse and do not eat or drink anything for 30 minutes.

Use a proxybrush (interdental brush) to clean around the area after each meal

Chewing : Do not chew hard foods on the restorations for 24 hours from the time they were cemented — to attain optimum strength, the cement must mature for approximately 24 hours Also avoid eating or chewing on hard objects, food or ice Limit snacks, if high in sugar brush this area or swish with water.

Sensitivity : Do not worry about mild sensitivity to hot or cold foods. This sensitivity will disappear gradually over a few weeks. Infrequently, sensitivity last longer than six weeks.

Recare : Inadequate return for examination is the most significant reason for prostheses failure. Visit us at regular six-month examination periods. Often problems that are developing around the restorations can be found at an early stage where they can be corrected easily and will be more affordable. Waiting for a longer time may require re-doing the entire restoration.

Problems : Call us immediately if any one of these conditions occurs: If the tooth is the first tooth to hit when you bite down after a couple of days, contact us for an adjustment; a feeling of movement or looseness in the restoration; sensitivity to sweet foods; a peculiar taste from the restoration site; breakage of a piece of material from the restoration or sensitivity to pressure.