All bridgework – as with most restorative dental work – will eventually need repair, revision or replacement, but good quality bridgework that is well maintained should provide excellent long-term service.
Why bridgework fails?
Bridgework usually fails due to decay or leakage under the crowns on the supporting or ‘abutment’ teeth, or sometimes due to fracture of one or more of the ‘abutment’ teeth. If this can be successfully treated and the teeth are still maintainable, new bridgework can be made. Otherwise, it is usually necessary to consider dental implant-supported crowns and/or bridges as an alternative, particularly if the abutment teeth are very compromised or unrestorable. The case shown on the right is an example of failing bridgework replaced with individual single crowns with dental implants for the missing teeth.
Types of bridges
There are several different types of fixed bridgework or bridges:
- Conventional bridge – usually cemented to a tooth at either side of a gap where teeth are missing
- Cantilever bridge – cemented to one tooth next to a gap and replacing a single tooth
- Resin-bonded bridges – can either fixed at both ends or cantilevered and is really only suitable for single missing teeth.
- Removable bridges (can be taken out for cleaning) and are really a type of denture and can be used with precision attachments on the teeth or existing crowns.
- Dental implant supported fixed bridges – bridgework can also be made on dental implants and be fixed by being screwed to the implant or cemented to an abutment (or post) on the implant.
A common challenge of any type of bridgework is the difficulty involved in trying to make the artificial teeth look individual and natural – as if they are actually emerging from your gums like the rest of your teeth. This often requires some soft tissue augmentation or gum grafting.
Other dental problems with a fixed bridge include the fact that if one of the supporting teeth fails, the entire bridge is vulnerable, plus it is difficult to repair any chips or fractures in the porcelain. Removable bridges on the other hand can cause significant wear and stress on attached teeth and trap food and plaque more easily.
It is important that the oral hygiene is maintained to a high level as bridgework makes cleaning the teeth are little more difficult as you can no longer floss between the bridged teeth; instead you will need to use a special floss threader or ‘super floss’ to reach under the bridge.
Preventing dental bridge problems
Numerous studies have shown that the single most important factor in the success and longevity of any dentistry is the skill, precision and attention to detail of the person who performs the work. That’s where our expertise in all aspects of restorative dentistry, coupled with other disciplines, helps us to achieve the best possible results for our patients. Tidu Mankoo has nearly 30 years’ experience treating complex dental bridge problems and other failing dentitions – enabling hundreds of people to enjoy a renewed quality of life, year after year. We are not interested in short-term, quick-fix dentistry; our philosophy is to provide the best long-term life-changing dentistry for our patients.