Like in the real World, a bridge is an architectural wonder which connects one side of a river bank to the other side by means of a horizontal arm in order to help us cross without effort. Not only engineers construct bridges, Dentist’s do too but at a much smaller scale. It also allows anything to pass through underneath without any hindrance. A dental bridge in essence has the same exact concept but the difference is in its application. When a tooth is missing and is bounded on both it’s adjacent sides by another natural tooth, in order to replace this missing tooth we custom fabricate a bridge. In case of a crown only one tooth that is requiring protection from occlusal forces is shaved down to accept that crown.
Whether it is a crown or a bridge for which treatment is planned, there are certain clinical requirements that need to be met in order to qualify for a bridge or a crown to be fabricated. What does a crown or bridge do for you? Basically it covers the compromised tooth and it serves to dissipate the occlusal forces that are coming its way.
- One or more missing teeth with adjacent healthy teeth
- Supporting teeth has good bone support and healthy gums
- Patient does not want dentures or implants
- Budget limitations
- Where there is a need to restore aesthetics and function
- Surgically Phobic patients
- Patient wants something permanent and does not want to take it in and out like dentures for example
- Extremely Poor oral hygiene
- Medically related hurdles
- Does not want to spend much and only wants dentures or implants
To fabricate this bridge, we need ample support that is strong enough to take the occlusal biting forces and the load that is directed upon it from each opposing teeth and transferring it along the axial plane of the supporting teeth. Then the Dentist shaves the two adjacent teeth that is present next to the missing tooth space. After which an impression is made with a jelly like substance which is placed on the tray and is inserted into your mouth. This is the procedure by which he or she measures your mouth. Once it sets, the tray is taken out and a model is poured. Today we have very accurate impression materials that hold their ground without any distortion with time and temperature. This also depends on the type of impression material that is used. This model and the respective mold are the exact replica of your mouth.
Once the dies are trimmed, the technician gets to start working on waxing the shape of your teeth. It involves casting metals similar to how a goldsmith would work on a chain or a pendant. it is indeed a lot of hard and precision work. After the base metal is casted, it is cooled down and porcelain is applied on it and re-fired to produce it’s final result. Once your Dentist evaluates the final work for its fit and contour, he or she proceeds to cement it in place after checking all parameters of aesthetics and function. Now you are ready to function.
Advantages of a Bridge or a crown:
- No surgical intervention such as with implants
- Work done above gum level
- Less conservative than with surgical approach to restoration
- Gets the job done of replacing missing tooth and restoring function
- Results may be more predictive than procedures associated with surgical intervention
Disadvantages of a Bridge or a crown:
- Perfectly healthy teeth may need to be shaved down in order to accept the crown or bridge
- May be more expensive when compared to a denture
- Bite, teeth and jaw complications
As with any other treatment, risk verses benefits must be analyzed, questions answered and a well informed decision made. This must be applied only after knowing all the relevant facts that will enhance the success of the case. Each and every case has its own set of challenges, and its possible drawbacks. Everything comes down to the case selection and its final outcome. Anything and everything in Dentistry is irreversible. Meaning, once a procedure has been started it must be finished and there is no turning back. So the efforts of an experienced Dentist and a well educated patient both play a major role here. They both are partners in this together. An experienced dentist has made his or her mistakes early on and leaned from them over the many years of applying it in different clinical situations. So experience is a fantastic teacher. It makes you fail first and then it teaches you. This takes many many years of onsite and hands on clinical experience. So before you get any major procedure such as Bridges or crowns done, have a chat with your Dentist, be well informed and get educated. So you can make educated decisions and not educated guesses.