Teeth adjacent to the missing tooth are carefully prepared by the dentist after getting the patient comfortable with local anesthetic. A rubber base impression is taken of the prepared teeth and the mouth and is sent to the laboratory for fabrication. A provisional bridge is made in the office to protect the prepared teeth and to hold the space intact while the permanent bridge is being fabricated by the dental lab. At a second appointment, the lab processed bridge is tried, fitted and cemented into the mouth to become a fixed part of the mouth.
Patients can expect many years of service from these permanent dental bridges.
Most desirable alternative for a replacement of tooth is the placement of a dental implant followed by the restoration of implant with a crown. The cost for this option is almost the same as the cost of a fixed 3 unit bridge. The advantage of an implant supported crown is that the adjacent teeth do not have to be trimmed down by the dentist to facilitate this replacement. However, surgery is required to place the implant and there is a waiting period of up to 6 months to allow the implant to anchor into the bone. There are risks associated with surgery and less than a 5% chance that the body may reject the implant. Overall, implant option of replacement is gaining significant momentum as cost and success rates are becoming more favorable.
Removable partial dentures or removable bridges are a less expensive alternative to fixed bridges. They can be removed from the mouth for easy cleaning and do not require any significant trimming of natural teeth. Patients are generally less than satisfied with this option of replacement.
When a missing tooth is left unrestored, significant bite changes occur as a result of teeth drifting towards the open space left by the missing tooth. This reduces chewing capability and even loss of teeth. Doing nothing is not a good choice.
Fixed bridges require a good level of expertise from both of the dentist and the dental technician. Although the cost of bridges can be significant, they serve for many years with both strength in function and stability and beauty for esthetic enhancement.
Choice of material used for fixed bridges is a relatively insignificant factor in overall cost of a bridge. Porcelain fused to metal (PFM)bridges are the most popular fixed bridges. Metal provides strength and the porcelain provides the appearance of natural tooth.
All ceramic bridges are gaining popularity. Some ceramic bridges are weaker than PFM bridges but Zirconia based all ceramic bridges are proving to be just as strong if not stronger than PFM bridges.
Conservative bridges occasionally a need or a desire to replace a tooth without altering the adjacent tooth may be called for. They are termed Maryland bridges of resin- bonded bridges. They can be fabricated out of resin, ceramic or PFM and have limited applications. Conservative bridges are not as retentive as conventional bridges and may require re-cementation periodically.