Ask The Dentist is a series of columns written by Dr. Mady to answer your questions about dentistry and oral health!
Dear Dr. Mady: I am missing one back tooth and my dentist gave me three options for replacing it: a removable partial denture, a permanent bridge, or a dental implant. I am leaning towards the bridge because it is a compromise. He said there were different kinds and I wanted to know which one is best for me and a bit about bridges and the procedure.- Jane in St. Joachim
Dear Jane: A bridge is certainly a decent treatment option for replacing a missing tooth. If you are missing one or more teeth, a bridge will literally do exactly what it says.
You can compare it with a bridge across a river. Each side of land is the tooth on either side of the empty (edentulous) space and the river is the empty space.
A traditional bridge is usually made up of two crowns with an artificial tooth, known as a pontic, which is attached to the crowns in the middle. If one tooth is being replaced, then it is called a three unit bridge, as in your case. There are other types of bridges that I will discuss later. Whether the teeth on either side have never been restored before or if they are heavily restored will determine which type of abutments should be used.
A full crown-type abutment or retainer requires reduction of tooth structure around and on top of the entire tooth. When the tooth is covered later, it is brought back to its original size and shape. In a case like this, I would recommend going with a dental implant. This will aid in oral hygiene and the teeth around the missing tooth will be healthier and last longer.
A cantilever bridge is another type where only one abutment is used. These are especially helpful if the missing tooth has a tooth remaining on only one side of it. The pontic basically hangs off or cantilevers off of the abutment.
A Maryland bonded bridge is the most conservative when it comes to tooth reduction of abutment teeth and cost because it involves little prepping of retaining teeth and is basically cemented or glued on by these metal wings.
As far as longevity goes, it is not uncommon for fixed bridgework to last in excess of ten years, especially when good oral home care is practiced.
Speech may change temporarily after the bridge is placed (especially anterior or front bridges), but if this occurs, it will go back to normal quickly. Eating will feel normal very quickly also, but don’t go crazy immediately. Cut your food in small pieces for the first while until you get used to having a tooth there. Remember to ask your dentist for floss threaders to clean under your bridge and to demonstrate their use.
Overall, if you decide to keep with your treatment plan, a dental bridge has a lot of benefits, just as an implant would.
They help restore a smile if the missing tooth shows. You will restore your ability to properly chew and speak. Sometimes a missing tooth or teeth can change the shape of your teeth, and replacing them restores that fullness. Finally, you will prevent remaining surrounding teeth from moving and drifting where they were not meant to be and your biting forces will be more properly distributed.
Make sure you have discussed all options and the risks, benefits and alternatives of each with your dentist before proceeding with any major treatment of this kind.