The dental bridge is an appliance used to replace missing teeth or teeth that will be taken out. A bridge typically consists of two crowns covering the teeth on either side of a toothless space. The crowns connect to a false tooth used to replace the missing tooth/teeth. The false tooth is known as a pontic, and the crowns are known as retainers. A bridge exists as a fixed prosthesis, meaning that it is meant to remain in the mouth permanently. Many prefer this method to that of the removable prosthesis, which must be removed for hygiene and maintenance. Although the dental bridge has proven to be an effective way to restore missing teeth, there are some risks involved that should not be ignored.
Recurrent Decay
Preparation for a dental bridge requires shaving down teeth on either side of the empty space. This is so that the crowns can fit down over the teeth in order to retain the false tooth. If the margin of the crown does not fit exactly onto the prepared tooth, there is a chance for bacteria to contact the tooth surface beneath the crown. Without correction, the teeth can become decayed to the point of being lost, and the bridge must be removed. Before the bridge is cemented into place, the dentist should check thoroughly to be sure that all margins are closed.
Pain
The dentist must take the existing bite into consideration when fabricating a dental bridge. Teeth produce strong biting forces, and the synthetic material used to fabricate the bridge does not absorb these forces as well as the natural teeth. If the new bridge does not properly reproduce the bite of the patient, moderate to severe pain can result. This can often be corrected with minor adjustments to the bite, performed by the dentist.
Periodontal Disease
If a patient is at risk for periodontal disease, placement of a dental bridge can make the condition worse. Biting forces on a bridge can cause strain on the ligament surrounding the tooth, leading to bone loss over time, according to H.T. Shillingburg in "Fundamentals of Fixed Prosthodontics." Also, if the bridge ends beneath the gum line, irritation can occur, leading to gingival recession. Proper oral hygiene is essential to prevent periodontal disease from starting or progressing.
Limited Options
Once the teeth on either side of the bridge have been shaved down to fabricate the bridge, there is no way to get the tooth structure back. If there is a reason to remove the bridge once it is cemented, there will be limited options for restoring the space other than fabricating a new bridge.
References
- Cosmetic Dentistry Guide: Dental Bridges for Replacing Missing Teeth
- Colgate World of Care: What are Dental Crowns and Tooth Bridges?
- "Fundamentals of Fixed Prosthodontics," 3rd Edition; H.T. Shillingburg; 1997
