Real-Life Communication
The radio is playing softly. You're sitting comfortably at your
workstation creating a fixed bridge for a customer. With a tiny instrument,
you smooth any high spots so that the dentist can ensure a good fit.
"You're
wanted in the front office," your associate calls to you. You carefully put
down the fixed bridge piece and go to the front office. Your friend Sarah
is standing at the desk, agitated. She smiles meekly when she sees you approaching.
You are startled. She is missing her front two teeth!
"What happened?"
"I
hit the goal post playing field hockey a few days ago," she says. You sit
down with her.
Sarah has to get a bridge in her mouth, but she doesn't
know whether to get a fixed or removable bridge and has come looking for your
advice. You tell her fixed bridges are more popular, but it's up to her and
her dentist to find the best solution.
This is what you know about
bridges:
Fixed bridges are usually made with crowns, cemented on to
the natural teeth on either side of the missing teeth. The artificial teeth
are suspended between the crowns. Abutment teeth (the natural teeth) are reshaped
to remove bulges so that the artificial crowns can fit over them to hold the
bridge in place.
Fixed bridges usually replace one or two teeth. If
more teeth are going to be replaced, the abutments may become loosened by
the stress of holding up a large number of false teeth. These long-spanning
bridges usually require double abutments. Patients with short crowns or short
roots on their teeth, and who require a long-spanning bridge, should probably
consider a removable bridge.
Most fixed bridges are made by fusing
porcelain to semi-precious or a non-precious metal base. Semi-precious metals
are used because they avoid the risk of a hypersensitivity reaction to the
nickel that is found in non-precious metals. Because porcelain can chip or
fracture, the chewing surfaces of the bridge should be made of metal.
The
bite of the bridge must be correct. All the teeth should come together evenly
and without interference with the opposing teeth. There shouldn't be any high
spots on the teeth or a sense of imbalance. Patients should never tell a dentist
they can get used to the bridge if the bite feels off-center or high.
A
fixed bridge can come loose in a few years, but this is usually because of
bad design or poor abutment tooth preparation. Sometimes a bridge can be re-cemented.
If it comes loose again, it should be remade. A cavity that develops within
two to three years is usually caused by poor construction of the crown and
too small of a margin at the gum line.
Sarah has a few questions for
you about bridges
- Will the dentist have to do anything to my other teeth if I get a fixed
bridge? I hate the thought of ruining more of my teeth.
- So will I be able to get a fixed bridge, or will I have to get a removable
one?
- I've read about metal sensitivity. How can I avoid that?
- I want these teeth to look as natural as possible. Do they have to have
any metal in them?
- When I've had cavities filled or a crown put on a tooth, it's felt a bit
sensitive. Should I expect the bridge to be a bit uncomfortable at first?