For the replacement of missing teeth, dental bridges are a common option as a restorative technique along with dentures and implants.

Types of Dental bridges

Dental bridges are not removable and are of three types, namely:

• Conventional fixed bridge
• Cantilever bridge
• Resin- bonded bridge

Conventional and cantilever fixed bridges normally require cutting and shaping of the adjacent teeth to the missing tooth region, for support of the bridge by crowns. These supporting teeth are known as “abutment” teeth whereas the crown replacing the missing tooth itself is called a “pontic”.

Resin- bonded bridges require less tooth cutting of the adjacent teeth, protecting healthy and sound tooth substance. These are normally used for the replacement of anterior teeth as esthetics is a crucial factor in this region.

Procedure for a Dental bridge

It is essential to have healthy gums and sound abutment teeth structure before a dental bridge is indicated. If the adjacent abutment teeth are decayed, they may first need to be restored in order to be prepared for receiving a crown.

The dental bridge procedure may take up to 2- 3 appointments involving crown cutting, bridge fabrication and trial and placement of the bridge.

Once the oral health status has been assessed, a local anesthetic is administered to reduce pain and sensitivity during cutting and preparation of the abutment teeth. Once the crown preparation is complete, an impression using putty- like material is taken of the prepared teeth and missing tooth region to make a model, upon which fabrication of the dental bridge by a dental lab technician is done. While the model is at the dental lab for the bridge fabrication, a temporary bridge may be placed upon the prepared teeth to maintain tooth function, protect them from damage and to prevent an unsightly appearance while waiting for the bridge to be completed.

Fabrication of the dental bridge must be done extremely accurately to ensure success of the bridge in the oral cavity, without any later complications such as an ill- fitting bridge or a bulky bridge with undercuts which may lead to plaque accumulation and infection of the abutment teeth. If this occurs, the bridge will be a failure.

When the fabrication of the bridge is complete, it may be placed on a trial basis over the prepared teeth to ensure a precise fit. Once this is achieved, the bridge is then permanently cemented over the abutment teeth, replacing the missing tooth. The function and esthetics of the missing tooth as well as the prepared teeth is restored with the help of the bridge.

Dental bridges may also be additionally anchored by a dental implant, should the adjacent abutment teeth not be sufficient for its support and retention.

What is a dental filling?

To treat a decayed tooth with a cavity, a dentist uses biocompatible materials to fill in the cavity formed by the decay process. This is known as a dental filling, and is usually performed by a Restorative or Operative dentist, though a General dentist also performs fillings.

Dental fillings can be done to fill in cavities and can also be performed to repair cracked teeth or to build up lost tooth structure as well.

What is the dental filling procedure?

When preparing a tooth for a filling, it is crucial to always first remove the decayed areas of the tooth before placing the filling or the filling will fail its purpose of restoring the tooth’s natural structure and function. Removal of a decayed area of a tooth may be painful or make the tooth highly sensitive, so a local anesthesia is usually administered around the tooth bearing area prior to its removal.

After administering the local anesthetic, the dentist will then remove the decayed tooth substance with the help of a handpiece or “drill” as it is more commonly known. Modern technology allows for decayed tooth substance to be removed with the help of water and laser powered machines, eliminating the use of the drill altogether and making the experience more comfortable for the patient.

After removal of decay, the area is the checked for any remaining decay with a probe, then it is lined with a material to ensure prevention of sensitivity in the tooth pulp after the treatment. The material of choice is then filled within the cavity and is finished and polished to follow the natural anatomy of the tooth.

What filling materials are commonly used?

Although there are numerous materials used for fillings in teeth, the most commonly used are as follows:

• Silver fillings (Amalgam): The most widely used and conventional filling material available, made of silver and other metal alloys and is of superior strength and durability.
• Composite resin filling material: Tooth-colored durable filling material used to build up and restore teeth with a more esthetic result as compared to silver fillings.
• Glass Ionomer Cement (GIC) filling: Tooth-colored filling material which bonds naturally to tooth structure and has the ability to incorporate fluoride within its structure and release it into the tooth.

Porcelain/ ceramics:these are mostly used for inlays and onlays, and used to make dental crowns and veneers.