A Bridge Too Far?
Posted 15th August 2015
Do you have a missing tooth or teeth and you really dislike the space?
Have you considered having the space filled but you’re not really sure of the options?
Many people have this issue, and they may actually have attempted to resolve it with a denture (false teeth) but it’s not quite how they expected it to turn out.
Let us take a look at some of the solutions and see if we can help you come to a decision?
For many, this is the most straightforward way to replace missing teeth, especially if there are many missing. With the support of an excellent dental technician we can now make these aesthetically pleasing with an excellent fit. Unfortunately not everyone can tolerate a denture well and there can be downsides such as reduced tasting of food due to coverage of the roof of the mouth and the denture can move during eating.
Dentures can be made more retentive by adding clips around the teeth but they are not without their problems.
Dentures will still attract plaque and actually more plaque will accumulate on your teeth when a denture is in place so we know that patients with dentures need to clean their teeth and dentures more frequently and thoroughly.
As patients get older they will find that the denture supporting tissues will reduce or recede – especially if they are full denture wearers. This can mean very poor retention of dentures and frustration when eating. This can be dramatically improved by the addition of dental implant based retention, whereby a couple of dental implants are placed in the bone and some attachments are placed in the denture. The denture is then clipped into the implants for firm location and retention.
If you are missing just one or a couple of teeth then a dental bridge may be suitable. There are several styles but generally they come down to two types, those with minimal preparation of teeth and sometimes no preparation and those with more preparation.
- Minimal Preparation Bridges or Maryland Bridges – these have gained a new popularity with the improvement in dental adhesives. Usually a single tooth is missing and the tooth is replaced by a false tooth with a wing that sticks to the back of the adjacent tooth. This reduces the need for any tooth tissue to be removed and we know the less we do to a tooth the longer it’s life will be. Whilst a great solution they are not suitable for everyone, particularly if you may be a tooth grinder or have a very heavy bite. Your dentist will assess all these elements at your appointment and can let you know if this is for you.
- Bridges involving preparation of teeth – these type of bridges have been used for years now but are generally falling out of favour due to the destructive nature of the preparation of the teeth involved. A bridge would involve preparing the teeth either side of the gap for a crown or a cap and then the dental technician constructs a bridge that looks like three crowns but they are all attached together and then cemented into place. This can give a super aesthetic result but generally considered to be quite destructive. If the teeth either side of the gap are already heavily filled or have been crowned then this type of bridge can more than be justified. However, if the teeth either side of the gap have not had any dental work then it is very difficult to justify this kind of bridge and we would be looking for alternatives such as a Maryland, a denture or a dental implant retained crown.
Again, your dentist will assess all the teeth and will take x-rays of the teeth to assess the root structure and support too.
This is now considered by many the gold standard of replacing missing teeth. A dental implant made of titanium in placed into the bone where the tooth is missing. It is then covered over and generally left for a period of a few months. This allows the bone to grow into the implant or osseo-integrate. After a few months the implant is then uncovered and a crown is constructed to screw into the implant and fill the gap.
Dental Implants can be used to replace several missing teeth in a bridge like structure and as mentioned previously can be used to help stabilise a denture.
We will go into more detail about Dental Implants in our next blog, in the meantime click here for more information.