A bridge is a fixed denture enabling us to replace one or several missing teeth, held in place by the teeth on either side of the space.
Being a fixed denture, these bridges cannot and must not be removed, but become a part of you and should be brushed in the same way and at the same time as your own teeth. They therefore offer important advantages in comparison to removable dentures that need to be taken out of your mouth for cleaning and which may also move a little when eating, something that a fixed bridge doesn’t do.
Bridges on natural teeth
This kind of bridge is anchored to the teeth on either side, known as pillars, which are fitted with crowns. To proceed, we must first of all file down the outside walls of the pillars to take the crowns, which will subsequently completely cover them.
Bridges, due to being made up of crowns, as well as replacing one or several missing teeth, have the same functions and characteristics as the missing teeth. Whitening the other teeth in your mouth at the same time is common practice. Bridges therefore help to change and improve the colour of your teeth.
Bridges also change the shape and angle of your teeth, meaning that sometimes, in the case of extremely crowded or separated teeth, we make joined crowns or bridges instead of proceeding with orthodontics, therefore bringing your teeth into line and giving them a renewed aesthetic appearance.
Making a dental bridge
This involves the same steps as are required to make a crown.
At the first appointment:
- We sculpt the teeth to hold the bridge in place, until achieving the shape required to take the crowns, while giving them a particular shape and inclination.
- If the tooth to support the bridge has had a root canal and only has very little crown or a vary large filling, we insert a post into the root. This can be done in two ways:
- Directly: we extract part of the devitalisation material from the root and insert the post, cementing or fixing it in place with adhesive before using composite to reconstruct the stump to which the crown will be fitted.
- Indirectly:We also extract part of the devitalisation material and take a silicone impression or mould of the root cavity; this is then sent to the laboratory, where they will produce a customised post and stump, known as a false stump, which we will subsequently cement into the root cavity.
- Once the tooth stump is ready, we take a silicone impression and send it to the prosthetics laboratory. We also carefully note the colour and shade to ensure that the bridge will match the teeth next to it and not look false
- Finally, in the surgery, we will prepare a provisional resin bridge to protect the sculpted tooth, maintaining the appearance and function of your tooth while the permanent crown is being made at the laboratory.
At the second appointment:
We try the bridge to make sure that it fits properly, surrounding the teeth on either side, and that it correctly fills the space left by your missing tooth or teeth.
We check that the colour and shape match the neighbouring teeth. Its bite against the teeth opposite it must also be perfect, since knocking against one another could cause your bridge to become loose with time, even if made in porcelain. This could happen above all in people who grind and therefore wear down their teeth.
Lastly, we permanently cement the bridge in place, and you go home happy and satisfied.
Types of dental bridge
Resin or provisional bridge
Protects your tooth and keeps it looking good while making the final bridge, which takes from two to four weeks. Wearing this kind of bridge means that you can smile and talk naturally. You must be careful not to chew very hard foods, which could cause it to break.
This kind of bridge must be used for a maximum of two or three months, the amount of time your mouth takes to heal after extracting a tooth. With time, the provisional bridge will become porous, allowing germs to enter, while food pigments will cause it to darken, meaning that it will lose its initial colour. Also, with reabsorption of the temporary cement used to fix it in place, the bridge could experience decay in the areas where the cement has come loose.
This kind of bridge cannot be used as a permanent bridge.
This kind of bridge is made from a metal structure enveloped in porcelain of the same colour as the teeth next to it. It is the one we use most. The metal structure makes it very strong, which is why it is used for long bridges, particularly at the back of the mouth, in cases where you are missing two or more teeth.
The inner metal layer gives the result a degree of opacity to conceal a darkened underlying tooth or metal stump inserted to strengthen the tooth in question.
It is very important for the porcelain to be of high quality, to choose the exact colour required to give it for a natural appearance, and to have it made by a good laboratory.
100% Porcelain bridge
This kind of bridge is above all used on the front teeth. It is slightly translucent, meaning that it gives your tooth an attractive natural colour. The underlying tooth must be the same colour as those on either side. This is a rather fragile bridge, meaning that its use is not advisable for long bridges or for back molars unless the bite is highly favourable.
Zirconia is a white metal with a slight translucence or opacity, depending on the type and quality of the zirconia. It is used above all for front bridges, when the colour of the underlying tooth is quite pale.
It isn’t as strong as the porcelain-fused-to-metal bridge, and is not therefore advisable for us on long bridges or back molars.
If you’ve chosen the option of a fixed bridge, at our surgery we’ll advise you as to the kind best adapted to your aesthetic and functional needs.
Implants are substituting bridges
Generalised implant use means that increasingly fewer bridges are fitted. When making a bridge, we must lightly file your teeth to act as supports; these teeth will bear the weight transmitted by the teeth that fill the space and have no roots.
With implants, we do absolutely nothing to your adjacent teeth; here the force of chewing is transferred to the implants and from there to your jawbone in the same way as it is by your own teeth. This guarantees that your adjacent teeth will last over time and that the alveolar bone will remain in place, stimulated by the implants.
The advantage of bridges over implants is that, once the tooth to be replaced has been extracted, the bridge is made more quickly, combined with the fact that we don’t have to wait so long for the extraction wound to heal. In addition, placing a crown over the teeth to take the bridge, even if it wears down, means improved appearance if said teeth have darkened in colour.
It is important to remember that you must have a yearly check-up at our surgery in order to study your teeth and gums, as well as any bridges or implants you may have. If you have implants, we must check to ensure that there is no (highly unlikely but nonetheless possible) tooth decay at the base of the supporting teeth, to see if your bridge is moving in cases where the teeth supporting them don’t have enough strength, and to check whether they are suffering from any kind of strain.
For further information…
If you’d like to know more about the subject, you can read the following articles in our blog:
In the dentures category:
In the dental implants category:
At our dental clinic we will advise you on the denture best adapted to your aesthetic, functional and economic priorities.