Bridges
A bridge replaces no more than a few teeth by attaching to remaining teeth on either side of the gap.
Bridges can be of differing strengths for a variety of purposes. If the wrong design is used for the wrong purpose the chances of failure are high, on the other hand a long term bridge used for a short term purpose is excellent, but costly. The latter may be the most suitable for those in the public eye or the embarrassment of breakage would be acute.
Temporary bridges
These are used for short periods of two weeks to six months, while a long term bridge is made or healing is taking place. By their nature they are not strong and may break needing repair or replacement. Also a temporary cement is used, so are more likely to dislodge. Unfortunately these risks have to be accepted and not be upset by having to return for repairs. Where you are travelling or otherwise return for repair is difficult it may be better to have a temporary denture. We know that some have psychological problems with accepting the thought of dentures, but there are times to be practical for the short-term.
Medium term bridges
These are generally small bridges replacing one tooth, and may consist of a false tooth held by a metal wing cemented to the next tooth, or a reinforced plastic variation of this. These we expect to last for 3 to 5 years, but they can survive for many more. We have seen some last for at least 20 years, but this is rare. When plastics are used the initial appearance can be excellent, but plastic wears quickly, takes in stains more easily and so ages more than other materials. Where a front tooth has to be extracted we often use plastics to produce an immediate bridge so that the person arrives and leaves with a tooth and others are unaware they have had a tooth out.
Long term bridges
With a long term bridge we are looking for something that we can be confident will last for 15 years and more. These usually consist of a metal substructure with porcelain over the top to look like natural teeth, The teeth at either end of the gap are shaped to accept the bridge, and it is cemented with a long term cement. Whenever a substantial piece of tooth is removed to accept a bridge (or crown for that matter) there is a risk that the tooth will fail to heal properly and the tooth dies at some stage, perhaps within months or years. It has been estimated 10-20% of teeth are affected, requiring root-filling to avoid losing them.
The Pros and Cons of bridges
The pros
- A number of choices at differing costs
- Cheaper tham implants
- Fixed into position, avoiding the use of dentures
- Can be used as immediate replacement of an extracted tooth so long as there are teeth on either side
- Appearance is good
- function like normal teeth so you quickly become unaware of their presence
The cons
- More expensive than dentures
- Further work may be required to root fill supporting teeth
- the temporary forms may dislodge more frequently than we would like