Patients may lose teeth for many reasons: genetics, disease, decay, or trauma. Gaps in the teeth can detract from aesthetics of the smile, and may cause embarrassment, as tooth loss carries negative connotations about a person’s oral hygiene and habits. Missing teeth can also create issues with a patient’s ability to chew and bite food. In more extensive cases, or when certain locations in the mouth are impacted, missing teeth can even affect speech. After a tooth is lost, the remaining teeth may shift in ways that create misalignment or make the teeth harder to care for. While there are some structural fixes available for missing teeth, there are also cosmetic options. Dr. Lazare offers different types of correction for tooth loss at his Upper East Side general and cosmetic dental practice, including dental bridges.
What is a Dental Bridge?
As the name implies, a bridge replaces one or more missing teeth through an artificial tooth that is fixed into place by the adjoining teeth. The dental prosthesis restores both the form and function of the lost tooth by bridging a gap in the mouth. While dental implants (another popular option for tooth replacement) are secured directly into the jawbone, the false tooth in a dental bridge relies on the horizontal placement of the natural teeth on either side of the gap.
Types of Dental Bridges
The two main types of dental fixtures used in bridge restoration are fixed bridges and removable bridges. Fixed dental bridges offer a permanent solution to tooth restoration and can be performed by altering the natural teeth or by adding the implantation of dental implants. A non-invasive fixed bridge is known in dental medicine as the “Maryland Bridge.” The fixed bridge does not modify adjacent teeth. Rather, a tooth is secured to the other teeth with pieces of metal or resin that attach to the teeth on either side. Removable dental bridges are wearable devices that can easily be removed when the patient needs to clean the piece after eating.
How is a Dental Bridge Performed?
The patient’s procedure to undergo a dental bridge will vary, depending on which technique is performed. During a standard fixed bridge procedure, the patient will see Dr. Lazare for at least two visits. During the first appointment, the doctor will administer some local anesthetic to numb the area of the mouth he is working on, and prepare the teeth on both sides of the missing tooth/teeth. These teeth are modified and shaped so the supporting dental crowns can fit over them and secure the dummy tooth, also called the pontic, in place. Dr. Lazare will take an impression of the teeth during this phase to submit to an affiliate dental lab. The lab will then manufacture the dental bridge structure. The first Manhattan office visit to the dental practice will end with Dr. Lazare placing a temporary bridge so the patient can regain normal tooth function between the two appointments. The next time the patient visits with the dentist, Dr. Lazare will cement or bond the bridge into place where it will remain as a fixed long term solution.
A fixed Maryland Bridge may also require two appointments. While the teeth on the sides of the gap will not require major modifications, they will be prepared to accommodate the new metal or resin wings. Typically, a handheld dental drill will create a slight groove in the recipient site of the fixture. Dr. Lazare will then take a dental impression or a digital scan to submit to the laboratory. A laser can also be used to create the ideal gum line-tooth combination. Next, cement or another bonding material will adhere the bridge wings to the teeth. The material is purposefully created to be somewhat porous for ultimate bonding power.
A removable bridge is sometimes crafted like devices for orthodontic treatments. The tooth or teeth may fit into an upper or lower retainer-like piece, or may be part of a localized treatment that impacts a small area of the mouth. In some cases, these options are referred to as partial dentures. Other removable bridges can snap over existing teeth or fixtures installed in the mouth, covering a gap. The term bridge tends to be a general reference to a procedure that replaces a lost tooth by relying on the support of others, and there are a number of ways to complete a realistic dental prosthesis procedure.
Dental Bridge Materials
The pontic, or fabricated tooth, is commonly composed of porcelain, metal, or a porcelain-covered metal. In many cases where metal-free restorations are requested or indicated, e-max bridges or Zirconia bridges may be fabricated. Zirconia tends to be stronger than e-max, while e-max may have some more natural esthetic properties since there is more translucency. Because teeth are used for different purposes, porcelain tends to work well on the front teeth, while metal or hybrid pontics are best for back teeth that can withstand more movement and pressure. The more precious metal (typically gold) that a false tooth contains, the better it can be sculpted to fit in with the surrounding teeth. Additionally, this type of tooth positively contributes to the health and hygiene of the mouth. In a Maryland Bridge, the pieces that extend from the pontic and hold the tooth may be composed of metal or resin.
Benefits of Dental Bridge Placement
While dental implants are a great solution for tooth loss, not everyone is a candidate for the procedure. The bone may not be healthy enough to receive the titanium screw that replaces the tooth’s root structure, or a patient may be too young for the surgery. Dental bridges cost less, provide faster results, and typically do not require a surgery for placement.
FAQs about Dental Bridges
What is a dental bridge?
A dental bridge is a permanent or removable fixture that is installed in the mouth to replace a missing tooth. Unlike implants that are surgically implanted in the jawbone, a bridge is supported by the teeth on either side of the gap. Dr. Lazare can perform a dental bridge with crowns, or conservative modifications, like the Maryland Bridge.
Do dental bridges always require the modification of nearby teeth?
In order to secure the prosthetic tooth in place, the teeth next to the gap must be altered for the placement of a bridge. In permanent bridges, the teeth must be abraded and capped to help the middle tooth or teeth remain in place. For the Maryland Bridge and some types of temporary bridges, minimal modifications, or sometimes no changes at all, are part of the process.
Why do patients undergo the dental bridge procedure?
Restoring a missing tooth that was either lost or never properly formed is essential for good oral health and the aesthetics of the smile. Missing teeth can alter a person’s speech, affect the alignment of the remaining teeth in the mouth, and can cause an uneven distribution of pressure and wear. Dental bridges are a fantastic option for those who are not candidates for implant placement or who want a more immediate solution.
How do patients maintain proper bridge hygiene?
With removable bridges, patients can take the fixtures out of the mouth to brush and floss the teeth and clean the appliance. Some dental tools are designed to care for permanent bridges. Since these teeth are connected, and all may be composed of a synthetic material, special care must be taken around the gums to avoid periodontal disease. Special dental floss that can work its way under a bridge, rubber tips, and water picks are all designed to care for advanced dental work.
Dr. Lazare, D.D.S., M.A.G.D. – New York’s Everything Dentist
Manhattan’s own Marc E. Lazare is an expert in dental medicine. His focus is on general care as well as the cosmetic aspects of oral health. He is entrusted as “Dentist to the Stars,” and has been a driving force behind technological advances in dental medicine. Download his Dental Expert app for apple devices to learn more about the care he can offer to patients. Aside from creating digital content, Dr. Lazare is an inventor of modern dental tools. His impressive resume reads consultant, educator, and an authority in the evolving field of dentistry.
Contact Dr. Lazare’s office about bridge work and other dental solutions at 212-861-2599 or [email protected].