Bridges

What is a bridge?

A bridge is a false tooth that is attached to 2 crowns either side of the gap that is being filled. It takes its name from being a bridge like structure between 2 teeth. Like our crowns, it is usually made from ceramic. A bridge can help to restore chewing function and support your dental health if you have a few gaps caused by missing teeth. It can be a good alternative to partial dentures if you have enough strong teeth with good bone support to accommodate the bridge. Your dental team will help you to decide what is the best method of replacing any missing teeth you have.
A bridge is what is known as an indirect restoration. This is because the tooth is prepared at one visit and the restoration is fitted at a separate appointment. The restoration is constructed in a laboratory between the 2 visits, rather than directly in the mouth.


What is involved in the treatment?
Your bridge treatment will be divided over two appointments, with roughly 19 days in between the appointments to allow for the work to be prepared by the dental technician in their laboratory. During the first appointment, the dentist prepares the teeth and takes impressions, and during the second visit they will fit the bridge.


Appointment 1, Preparation:
Before the dentist starts working, anaesthetic will be used to numb the nerves around the tooth. The dentist will first use a numbing gel, so you don’t feel the injection.
The dentist will take your tooth shade for the restoration so it matches your natural tooth colour. This information will later be sent to the technician who is making your bridge.
Firstly, the teeth that will be supporting the bridge need to be prepared and made to the correct shape. These teeth are being prepared for the crowns that the bridge will be bonded to. This will involve removing a layer of the outer surface, leaving a strong inner core. The amount of the tooth removed will be 1.6mm. The dentist will usually use the high-speed handpiece to carry out this process, and the nurse will be on hand with the high power suction to remove any excess debris and water,
In a standard bridge treatment, it is important that the prepared teeth are parallel to each other so that a good impression can be taken for a good fitting bridge.
Once the tooth is shaped, the dental team will take some impressions (mould): one of the prepared teeth, one of the opposite jaw and possibly another to show the way you bite your teeth together. These impressions are prepared for the technician who is going to make the bridge in the dental laboratory. The impressions help the technician to build a restoration that fits the gap and prepared teeth perfectly, matches the surrounding teeth and fits in with your bite.
The dentist will then prepare what we call a temporary restoration. This is a temporary solution that is made in practice, and protects the prepared teeth and maintains the spatial relationship to opposing and neighbouring teeth whilst you wait for your final bridge to be placed at your next appointment. Sometimes temporary crowns are placed on the prepared teeth instead of a temporary bridge filling the gap too.

Appointment 2, Bridge Fit:
This is a shorter appointment than the first, as all of the preparation for fitting the bridge was carried out at the first appointment.
To begin your appointment, the temporary restoration is first removed by the dentist. If you have been experiencing sensitivity with the tooth that is being treated, then anaesthetic will be placed before it is removed, but in most cases this is not required.
To remove the temporary bridge work, the dentist will either use a metal hand tool to gently pop it off, or in cases where it is more securely attached, the high-speed handpiece may be used to help the process. Any remaining cement would be gently removed using a hand scaler.
Next, the prepared bridge is tried in to ensure it fits and matches well with your other teeth. Once the restoration has been tried and the dentist is happy with it, the bridge is permanently cemented in place.
Following your bridge fit, it may take some getting used to before the permanent crown feels normal in your mouth; however, after a little time has passed, the crown should look, function, and feel like a regular tooth.


Aftercare
To ensure the longevity of your bridge, it is important to follow the care instructions given to you by your dentist. This will include a recommended schedule for visiting the hygienist for a plaque prevention treatment, as well as special care instructions for flossing. Underneath the bridge will need to be cleaned with a special floss and technique to ensure good gum health and prevent decay

Dentures

There are a variety of denture options available to suit your needs and budget. Replacing missing teeth with a denture can help you to comfortably eat a healthy and varied diet, speak clearly, and allow you to smile with confidence.


What is a denture?
Dentures are removable false teeth that fit over the gums to replace any missing teeth, to restore function and minimise potential dental problems caused by gaps in teeth.
When there are gaps in the teeth, you may experience problems eating and speaking, and the surrounding teeth around the gap may move and grow into the space at an angle, which can hinder chewing function. Additionally, when the teeth have room to move, they can loosen which poses the risk of further teeth falling out.


What types of dentures are there?
At Oldmachar Dental care we will work with you to find a solution for your smile that will help to enhance your oral health, lifestyle and self-esteem. As a private and independent dental practice, we have the flexibility to work with the lab and materials that best suits your requirements, including your finances. Our dentists will talk you through all your options, and support you to have the best possible denture you can afford.


Full Dentures
A ‘complete’ or ‘full’ denture is one which replaces all the natural teeth in either the upper or lower jaw. It will fit closely over your gums, and contain a full set of false teeth attached to a gum coloured plate. A full denture will give back support to your cheeks and lips, enhancing your facial appearance.
If teeth are required to be extracted before the full denture is fitted, you may have an interim denture known as an ‘immediate’ denture opposed to a ‘conventional’ denture whilst your gums heal. Following extraction, the gums can shrink and change shape, altering the fit of a denture, so a short term solution might be advised before your explore your long term denture options to ensure an optimum fit and function.


Partial Dentures
A ‘partial’ denture fills in the spaces left by lost or missing teeth. Partial dentures are commonly made from plastic or metal, but there are a variety of solutions available.
A plastic denture can be very affordable. It may need to be fastened to your natural teeth using metal clasps for better fit. It can easily be unclipped and removed, but there are some drawbacks to the clips such as damage caused to the natural teeth it’s attached to. Dentures made from metal (Cobalt Chrome Dentures) can be more comfortable, with better grip and less movement, but the initial cost can be substantially more and they can be harder to adapt if there are changes required such as adding an additional false tooth. 
Our dentists will work with a dental technician to create your dentures. The dentist will take measurements and impressions (moulds) of your teeth/mouth, and then send these along with the details of your requirement to the dental technician. The dental technician will then create the denture to your specifications. Depending on the denture you go ahead with, will depend on the number of appointments and time scale required to create your denture.


Are there any alternatives to dentures?
There are a few alternatives to partial dentures if you have only a few missing teeth, including fixed bridges and implants.
 A fixed bridge is an alternative to a partial denture and may be suitable for some people. Crowns are put on the teeth either side of the gap and are joined together by a false tooth that’s put in the gap.
 An implant replaces individual teeth. It uses a screw, commonly made from titanium, to act like the root structure of a tooth, and is screwed into the jaw bone and has a false tooth attached to it. This can be an expensive procedure, and its surgical nature does entail some risks.
How long will my dentures last?
A well looked after denture can last many years. Due to normal wear, and changes in the shape of your mouth, your denture will probably need to be re-lined throughout its lifetime. Depending on the type of denture you have, will depend on how easily it can be repaired or adapted to any changes. These will all be considerations to think about when you are choosing your denture.


I have full dentures. Do I still need to visit the dentist?
Yes. It’s important to visit your dentist regularly as there can be changes to your gums and bones which can affect the fit of your denture. Poor fitting dentures can cause discomfort, and lead to problems including sores and infections, and/or make eating and talking more difficult. By visiting your dentist regularly you can maintain a good fitting and well-functioning denture.
Additionally, it’s important to monitor the soft tissue in your mouth (gums, tongue, cheeks, roof of your mouth), to ensure a healthy oral environment.
Alongside your examinations, you should also maintain a good oral health care regime, including brushing your gums, tongue and roof of your mouth with a soft brush. This removes plaque and helps the blood circulation in your mouth. If you wear partial dentures, it is even more important that you brush your teeth thoroughly every day, and you may be referred to the hygienist regularly to help maintain your remaining natural teeth.