Detailed Procedure Guide: Dental Bridges
What are dental bridges?
A dental bridge, aka implant bridge, is a permanent appliance that is cemented onto dental implants.
As the name implies, bridges span areas that are missing a tooth or multiple teeth and fill in larger spaces.
Fixed implant-supported bridges are a long-term solution and do not come out, unlike removable partials, which move when chewing and have to be removed every day for cleaning.
Fixed dental bridges are typically recommended when you are missing multiple teeth in a specific area of the mouth. A fixed bridge can also be used to replace a completely edentulous (toothless) arch.
Fixed (or cemented) bridges are an attractive option because they look like real teeth, feel like real teeth, and function like real teeth, which is why most people choose fixed bridges over removable partial dentures.
What is the treatment process for a dental bridge?
If you are missing more than a few teeth, longer span fixed bridges are considered the treatment of choice to restore natural function and aesthetics.
The process begins with a dental exam and assessment, including X-rays.
Then dental implants are placed in the jawbone, creating a foundation for the fixed bridge.
Finally, the bridge is attached onto the implants.
How is a bridge different from a removable partial denture?
Some people are under the impression that bridges and partials are the same; in fact, they are dramatically different.
Removable partial dentures (“partials”) are made from acrylic, plastics or metal. In other words, partials are not “teeth” but replicas that fill in spaces where teeth have been extracted.
Partials are also much larger than bridges and must snap onto adjacent teeth for retention.
It’s important to understand the difference between bridges and partials; otherwise you may be disappointed with the feel and function of removable partials.
How do you determine if you’re a good candidate for a dental bridge?
If you’re missing several teeth in a row and have adequate bone, an implant-supported fixed dental bridge is almost always the best way to restore natural function.
Without a fixed dental bridge:
- Teeth may shift into the empty space
- Teeth that have drifted may become more difficult to clean, making you more vulnerable to tooth decay and gum disease
- Bone may shrink and your mouth may lose some of its shape
A fixed dental bridge can:
- Restore a natural look to your mouth and smile
- Restore the ability to speak normally
- Restore the ability to chew normally
- Help prevent future dental complications
If you’re missing all of your teeth and you have adequate bone, longer multi-unit implant bridges can provide you with new teeth that are very similar in appearance and function to natural teeth.
Average cost of a dental bridge
There are many variables that affect the cost of dental bridges, including:
- The number of missing teeth
- Materials used to create the bridge
- The difficulty of the placement
- Your implant dentist’s geographic location
According to Implant Evolution’s research, the cost of a three-unit fixed bridge ranges from $3,700 to $6,900 with an average cost of $5,300. This price range assumes two implants, two abutments, and a three-tooth cemented porcelain bridge.
A full arch implant-supported bridge (replacing 12-14 teeth) can range from $16,000 to $26,000. The total cost depends on:
- The number of missing teeth,
- and The number of implants required
This cost range includes all of the implants, abutments and bridges needed to completely restore an entire arch. As such, a fixed bridge is often less expensive than replacing every missing tooth with an implant.
Bone density requirements and required scans
As with any implant surgical procedure, preoperative planning is essential to success. State-of-the-art diagnostic imaging equipment allows your implant surgeon to use detailed 3-D images to determine both bone density and total hard bone volume.
It is imperative that there is adequate bone volume available to support an implant-supported bridge. Without this bone, an implant-supported fixed bridge can fail.
In some cases implants may need to be spread out to work around areas with inadequate bone.
Anesthesia: Can you be put under sedation for this procedure?
Like other implant procedures, local anesthetic is used to numb the surgical area.
For shorter dental bridges, local anesthetic may be adequate for the surgical appointment. But you may choose to be sedated and larger or more complex bridge procedures may call for general anesthesia.
You should discuss sedation options with your implant dentist early in the treatment planning process.
Are implant-supported dental bridges a same-day procedure?
Yes and no. Some implant-supported bridges can be a same-day procedure while others require extended healing periods.
In cases where there is adequate bone volume, implants can be placed and a temporary bridge may be fabricated immediately. This is sometimes referred to as “Teeth in a Day.”
On the other hand, it is common to have a healing period of ten to twelve weeks before the permanent bridge is fabricated. Some of the determining factors are bone quality, the number of implants required, and cosmetic demands.
You should discuss the options with your implant dentist and carefully consider the risks and rewards for each option. If you’re considering “teeth in a day,” keep in mind that it requires extensive planning, and may call for a lot of flexibility and patience on your part.
Preoperative instructions and tips
If you’re getting a fixed bridge, your implant dentist will provide you with specific instructions in advance of your procedure, which will likely be similar to the following:
- Brush your teeth prior to your appointment
- Wear loose-fitting and comfortable clothing
- Do not smoke or drink alcohol for at least 24 hours before your appointment
- If you are having general anesthesia, do not eat or drink anything for at least eight hours prior to surgery
- Arrange for a responsible adult to accompany you to your dentist’s office, one who can drive you to and from your appointment and wait in the waiting room during your procedure Use the restroom before your surgery, if necessary
- Take care of all financial arrangements before your surgery
Recovery from this procedure is generally well-tolerated and post-operative pain can be controlled with medication.
Post-surgical instructions and advice for proper healing
Your implant dentist will provide you with specific instructions to follow in the wake of your procedure, which will likely be similar to the instructions that follow:
- Avoid disturbing the wound for several days after surgery
- Some redness or bleeding is normal during the first 24 hours, which can typically be controlled by a gauze pad
- Soft foods and liquids can be ingested on the same day as surgery; typically you can return to a normal diet within several days after your procedure
- Rinse with warm saltwater four to five times a day, including after meals
Just like other implant procedures, most dental implants require several weeks to integrate before the bridge can be placed.
Immediate dental bridges that are done the same day cannot be used for normal chewing for several weeks or the implants may not integrate properly. A soft diet is required until the implants have osseointegrated adequately. As you may know, osseointegration is the process by which bone grows around the implant threads and “locks” the implant into the bone.
Proper upkeep and issues with recovery & rejection (Peri-implantitis)
Most implants have success rates greater than ninety-five percent but proper post-operative care is needed for proper healing.
Without proper home care—including brushing and flossing your implant-supported bridge—implants can develop bone loss just like natural teeth.
Another risk is that peri-implantitis—a condition characterized by inflammation and progressive loss of supporting bone—can occur over time in the absence of regular checkups and ongoing home care.
Implants can also be damaged by smoking, which can lead to implant failure.
The recovery time for a fixed bridge is very similar to other dental implant procedures. But because multiple implants are required to support fixed bridges, the recovery time may be slightly longer than single implant surgery.
Also, fabrication of the dental bridge may require additional appointments. Larger or longer bridges require more implants and more complex surgeries.
Spaces that require implant-supported bridges tend to be longer spans. This engineering issue limits other treatment options, such as tooth-borne bridges or partials.
Unfortunately, there are few other options that provide the same results as implant-supported bridges. Fixed bridges have exceptionally high patient satisfaction rates as compared to other options.