A porcelain fixed bridge is a custom made dental prosthesis fabricated to replace missing teeth. It uses the teeth surrounding a space (abutments) to anchor and support a false tooth (pontic). A bridge is usually made in 2-3 visits by a dentist or prosthodontist.
The Dental Bridge Process
The first visit consists of preparing the teeth that will support the bridge. The dentist will select a shade with the patient that matches the surrounding teeth. A local anesthetic (Novocain) may be administered and the dentist will shape the teeth adjacent to the space as if they were to have crowns (caps). An impression or mold of the teeth as well as surrounding and opposing teeth will be taken. This will ensure that the new bridge will fit and function properly with the other teeth. At the end of the visit, a temporary bridge will be made out of acrylic or similar material and cemented using temporary cement. The temporary bridge will not only protect the prepared teeth but also provide better esthetics by having the space filled.
At the next visit, the dentist will remove the temporary bridge and clean any cement or debris from the teeth. The dentist may elect to do a coping try in at this time. Copings are the metal shells that will support the bridge. Porcelain is applied over the metal to allow the bridge to blend with the surrounding teeth. If the copings fit properly, they will be returned to the lab for the final porcelain application. The temporary bridge will be recemented until the next visit.
The final visit involves cementing the bridge into place. The temporary bridge is removed and any cement or debris is cleaned from the teeth. The finished bridge is placed over the teeth and the dentist will check the fit, position and appearance of the bridge. An x-ray may be taken to ensure the fit between the teeth and below the gum is accurate. Once it has been determined that the bridge is a good fit, it will be affixed to the teeth using strong cement.
How long do dental bridges last?
The new bridge may last 10 or more years depending on how it is cared for. One of the most common reasons for replacing a bridge is new decay forming around the abutment teeth. This most often occurs when food and plaque is not properly removed from under the false pontic tooth and is trapped against the gum and supporting teeth. Because the pontic tooth is affixed to the adjacent teeth, floss cannot be snapped between the teeth. The use of a floss threader is essential for cleaning the space between the pontic and the gum. The floss is passed through the plastic threader (similar to threading a needle) and the tip is passed between the pontic and the gum below. This allows the floss to clean any food or debris that may be trapped. Not only will this keep the bridge clean but it will also prevent a bad odor or taste from forming from any trapped food.
What are the advantages of a dental bridge?
There are several advantages that may make a bridge the right choice for a patient. Porcelain bridges may mimic natural tooth esthetics very nicely. Because the bridge is cemented, patients also do not have to worry about removing it as they would with a denture. Cost may also be a deciding factor. Most insurance plans will cover a portion of cost of the bridge, making it a less expensive alternative to an implant.
The main disadvantage to having a bridge is the grinding of the adjacent teeth. Teeth that are otherwise sound and healthy need to be cut and shaped, removing valuable tooth enamel. If overcut, these teeth may become sensitive or painful and require root canals. A commitment must also be made to properly care and clean the bridge to ensure that it lasts as long as possible before needing to be replaced.