Missing a Tooth? “Bridge” the Gap

What is a Fixed Partial Denture (Dental “Bridge”)?

A fixed partial denture (FPD) is a prosthetic device that replaces one or more missing teeth by “bridging” the space between two teeth.
A dental “bridge” is a lay term for a fixed partial denture.
Fixed dental bridges (FPD’s) are cemented onto “abutment” teeth – the teeth that support the bridge on either side of the space or “span”. The part of the “bridge” replacing the missing tooth is a pontic.
Unlike removable partial dentures, fixed partial dentures (“bridges”) cannot be removed by the patient.

Who should get a Fixed Partial Denture (“Bridge”)?

If you are missing any teeth and are committed to maintaining good oral hygiene practices, you may be a candidate for a bridge.
A bridge is the most natural choice to fill the space in your mouth left by missing teeth.
Fixed bridges may correct an altered bite, and improve your chewing ability, and speech. They also safeguard your appearance by preventing the collapse of your facial features that can cause premature wrinkles and age lines.

What types of bridges are there?

Besides traditional bridges, another popular design is the resin bonded or “Maryland” bridge, primarily used for the front teeth when the bite does not interfere.
A “Maryland” bridge is usually the most economical choice when the abutment teeth are healthy and don’t contain fillings.
A cantilever fixed partial denture (“bridge”) is supported by a tooth or teeth on only one end. Its use is limited because of the mechanical forces that may be placed on the unsupported “cantilever” end.
If there are no adjacent teeth to act as anchors, our dentist may recommend an implant – a metal post that is surgically imbedded into the bone and “capped” with a crown.
In some cases where the span is large, your dentist may recommend a removable partial denture or even an implant-supported replacement.

How do I care for a bridge?

With a bridge, it is more important than ever to brush, floss and see your dentist regularly.
If you do not control the buildup of food debris and plaque, your teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge.
Your dentist may also recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums.
If you maintain optimal oral hygiene care, you can expect your fixed “bridge” to last as many as 8 to 10 years, or even longer.

When a filling won’t do – try a Crown

What are crowns?

Artificial replacement that restores missing tooth structure by covering part or all of the remaining tooth structure with a material such as cast metal, porcelain, or a combination of such materials. In lay terms a crown is often referred to as a “cap”.
A crown is necessary when a tooth is generally broken down and fillings won’t solve the problem.
A crown may strengthen and improve the appearance of a tooth.
If a tooth is cracked a crown may hold the tooth together so the damage doesn’t get worse.

Crowns are also used:
- To support a large filling when there isn’t enough of the tooth remaining—Protect weak teeth from fracturing
- Restore fractured teeth
- Cover badly shaped or discolored teeth
- To attach a fixed partial denture (“bridge”) to the supporting teeth. As part of the fixed partial denture (“bridge”) the crowns are called retainers and the supporting teeth are called abutment teeth.

How is a crown placed?

To prepare the tooth for a crown, it is reduced so the crown can fit over it.
An impression of teeth and gums is made and sent to the laboratory for the crown fabrication.
A temporary crown is fitted over the tooth until the permanent crown is made.
On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.

Why crowns and not veneers?

Crowns require removal of more tooth structure; hence, they cover more of the tooth than veneers.
Crowns are for teeth with significant loss of tooth structure. Veneers are used for esthetic reasons on stained teeth with little or no lost tooth structure.
Crowns may be placed on natural teeth or dental implants.

How should I take care of my crowns?

Avoid chewing hard foods, ice or other hard objects.
Avoid clinching and/or grinding your teeth.
Visit your dentist twice yearly and brush twice a day.
Cleaning between your teeth is vital with crowns.
Floss or interdental cleaners remove plaque from the crown area where the gum meets the tooth.

Reprinted with permission from the Academy of General Dentistry

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Health Tip:

Tetanus booster for adults

Tetanus does not result from the rusty nail or whatever created the wound. The danger lies in the bacteria Clostridium tetani that lives in the soil or manure on that nail or gardening tool. When these spores get into a wound—deep or shallow—they can produce a potent toxin. Also called lockjaw, tetanus seriously affects the central nervous system and can be fatal.

Onset of symptoms can occur anytime from three days to three weeks. Call your health care provider if you have an open wound, particularly if:

You are injured outdoors
Have been bitten by an animal
The wound has been in contact with soil or manure
You have not received a tetanus booster (vaccine) within five years or you are not sure of your vaccination status

Adults should have a tetanus booster shot every 10 years, known as the Td vaccine. It is a "2-in-1" vaccine that protects against tetanus and diphtheria. It contains a slightly different dose of diphtheria vaccine than what you received as a child. It can be given to anyone older than 7 years and is injected, usually into the arm.

Instead of the standard Td booster every 10 years, adults between the ages of 19 and 65 should receive Tdap one time in their adulthood to boost the immune system for pertussis, as well as tetanus and diphtheria.

Diphtheria, a contagious bacterial infection created that causes severe inflammation of the throat and larynx and can also affect the whole body. Pertussis or “whooping cough” is a serious bacterial infection that afflicted children and infants before vaccines were available. Adults may be infected later in life as their immunities wane. Neither of these infections are related to tetanus, but both vaccines are compatible and convenient to use with the tetanus booster.