A bridge is a device a dentist inserts to fill a gap where a tooth is missing. A "conventional" bridge consists of a false tooth (or teeth), known as a pontic, which is affixed to a crown on a tooth next to the gap. A "Maryland" bridge, on the other hand, is where the pontic is fixed to the teeth on either side using wings, meaning that it is not necessary to fit a crown to the other teeth.
Why do I need a Bridge?
Your dentist will recommend a bridge for cosmetic and clinical reasons. A missing tooth following an accident can obviously be unsightly and traumatic, and a bridge is an effective way to solve this problem. However, a dentist will also use a bridge in situations where it has been necessary to extract a tooth because of advanced decay. The clinical advantages of using a bridge are that it will reduce strain on the surrounding teeth, and prevent problems with the patient's bite developing- surrounding teeth will often start to move into a gap, and food can become trapped leading to increased decay and gum disease.
Alternatives to Bridges
There are two main alternatives to a dental bridge- dentures or dental implants. Dentures are not always the best solution if only one or two teeth need to be replaced, because they can cause difficulties with eating and even speaking, so be sure to seek your dentist's advice. Dental implants consist of a titanium "screw" which is inserted through the jaw, to which an artificial tooth is attached. Again, these are not always suitable- a patient must be medically fit, have healthy gums and a sufficiently thick jawbone to allow for this procedure. Implants are becoming more widely used, despite these reservations, and despite their high cost.
Consulting a dentist about a Bridge
Your dentist will usually recommend a bridge in situations where one or two teeth need to be replaced. Your teeth and gums must be healthy enough to support the bridge, so the dentist will evaluate this on the initial consultation. X-rays and other tests will be performed to ensure that the dentist can build a bridge that will be functional and cosmetically acceptable for a number of years.
What is involved in fitting a Bridge?
If using a standard bridge, the dentist will remove a small portion of the teeth around the gap, to accommodate the thickness of the new crown (or pontic, as above). An impression of the patient's bite will then be taken, and a device called a facebow may be used to ensure that the patient's jaw movement is accurately recorded. This information is then used to design the bridge, ensuring that it is the best possible fit.
The bridge itself is a semi-flexible structure, which is then bonded to the teeth, and the dentist will ensure that the replacement tooth is correctly aligned. This will occur at a second appointment, allowing time for the bridge to be built- the dentist may fit a temporary bridge during the period between appointments.
Bridges toward the rear of the mouth will usually be made of a precious metal substructure, with a porcelain tip that has been coloured to match the rest of the teeth. For gaps towards the front of the mouth, dentists will often use a bridge made entirely of porcelain. This is more visually attractive, but also more expensive.
After the Bridge is fitted
There should be no significant side effects after a bridge is fitted- they are easier to get used to than a denture, and with careful cleaning should last for many years.
Cost of Bridges
Bridgework is expensive, because of the time, materials and procedures involved. Even treatment that is funded by the NHS can be expensive- bridgework will cost at least £189 through the NHS, and this is unlikely to give you the same cosmetic options (such as the use of porcelain rather than metals) as would be available through private dentists. Our figures at Whatprice indicate that private charges are on average around £837 for bridgework.
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