What are the other Names for the Procedure?
- Dental Bridge Procedure
What is Dental Bridge Placement procedure?
- Dental Bridge Placement is a procedure to replace missing tooth using a prosthetic apparatus that typically consists of two crowns and one dummy or false tooth in between the crowns
- A dental bridge can be described as a set of 3 or more synthetic tooth that is used to fill the gap caused by a missing tooth. The two crowns act as anchors for the middle false/artificial tooth (called a pontic). In some cases, there may be more than one missing tooth
What part of the Body does the Procedure involve?
A Dental Bridge Placement procedure involves a row of teeth including missing tooth/teeth.
Why is the Dental Bridge Placement procedure Performed?
A Dental Bridge Placement procedure may be recommended by dental professionals for the following reasons:
- To improve one’s look, smile, and confidence
- To help or restore normal biting, chewing, and speaking ability
- The shape of one’s face (cheek, chin, and lips) is affected by missing teeth
- In growing children, adjacent teeth (to a missing tooth) may grow abnormally or out of position, due to the vacant space caused by the missing tooth
- Imbalance of teeth or abnormally-growing teeth can pose a higher risk for dental conditions including gum disease and temporomandibular joint disorder
What are some Alternative Choices for the Procedure?
Dental bridges are commonly used to address the concerns of missing teeth. However, in some cases, an implant may be used.
What are the Recent Advances in the Procedure?
The advances in the field of Dental Bridge Placement procedures are more to do with use of reliable and long-lasting filling materials. Presently, dental bridges are known to last for up to a decade.
What is the Cost of performing the Dental Bridge Placement procedure?
The cost of Dental Bridge Placement procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.
In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.
When do you need a Second Opinion, prior to the Procedure?
- It is normal for a patient to feel uncomfortable and confused by the information regarding Dental Bridge Placement procedure and on what needs to be done
- If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
- Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently
What are some Helpful Resources?
Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006
https://www.colgate.com/en-us/oral-health/cosmetic-dentistry/bridges-and-crowns/understanding-a-dental-bridge-procedure-1015 (accessed on 01/05/2018)
http://www.colgate.co.in/en/in/oc/oral-health/cosmetic-dentistry/bridges-and-crowns/article/what-are-dental-crowns-and-tooth-bridges (accessed on 01/05/2018)
Prior to Dental Bridge Placement Procedure:
How is the Dental Bridge Placement procedure Performed?
Dental Bridge Placements may be undertaken in the following manner: (usually a minimum of two sittings are necessary)
- A visual examination of the area of concern is made; an X-ray is taken to view the region
- Local anesthesia is applied to the region, to numb the gums and tooth
- Teeth that are going to receive the crowns are trimmed and shaped (on all sides), using special instruments
- Following the trimming and building-up of teeth (if necessary), an impression of the region is taken using a putty or paste (called impression material)
- The trimmed or reshaped tooth is washed and cleaned/dried and the impression putty spread around the region of interest
- After a few minutes, the composite material fuses and hardens to leave an impression of the teeth on that side of the jaw. Additionally, the biting jaw impression (jaw on the opposite side) is also secured
- The captured impressions are used to prepare a plaster cast, which in turn is then used to prepare the dental bridge. The bridge may be any of the following types:
- Traditional bridges: It is the most common type in use
- Cantilever bridges: When only one crown is possible (that attaches to the false tooth)
- Maryland-bonded bridges: Or, called a resin-bonded bridge, it bonds to the natural tooth on either side of the missing tooth
- This process may take anywhere from 7-14 days. Once, the dental bridge is ready, it is placed in position to check its fit
- The dental expert then checks the overall appearance, before it is permanently fixed using special adhesives
Where is the Procedure Performed?
Dental Bridge Placements are usually performed in an out-patient surgery center facility, a dentist or an oral surgeon’s clinic or office.
Who Performs the Procedure?
A dental professional typically performs the Dental Bridge Placement procedure.
How long will the Procedure take?
A Dental Bridge Placement procedure may take anywhere from 60 to 90 minutes, depending on the extent of tooth cavity. It may be carried out over two or more sessions, based on the assessment of the dental professional.
What do you need to tell your Physician before the Procedure?
It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Dental Bridge Placement procedure and helps avoid unnecessary complications.
- Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
- If you are allergic to any specific medication, food items, or the filling material used in the procedure
- If you are taking blood thinners such as aspirin, warfarin, herbal supplements, or any other such medications
- If you or your family members have a history of bleeding disorders, or if there is a tendency to bleed more than normal
- If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
- If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
- If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
- A list of all previous surgical procedures you have undergone, for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.
What Preparations are needed, prior to the Procedure?
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are currently being taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time before the procedure is performed
- Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
- Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
What is the Consent Process before the Procedure?
A physician will request your consent for Dental Bridge Placement procedure using an Informed Consent Form.
Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.
What Tests are needed, before the Dental Bridge Placement Procedure?
Before a Dental Bridge Placement procedure, the patient may have to undergo certain tests such as:
- Visual examination of teeth
- Routine blood and urine analysis, as required
- X-ray of the mouth
What are some Questions for your Physician?
Some of the basic questions that you might ask your physician are as follows:
- What is a Dental Bridge Placement procedure?
- Why is this procedure necessary? How will it help?
- How soon should I get it done? Is it an emergency?
- Who are the medical personnel involved in this procedure?
- Where is the procedure performed?
- What are the risks while performing the procedure?
- What are the complications that might take place during recovery?
- How long will it take to recover? When can I resume normal work?
- How many such procedures have you (the physician) performed?
- Are there any follow-up tests or periodic visits to the healthcare facility required, after the procedure?
- What are the costs involved?
During the Dental Bridge Placement Procedure:
What kind of Anesthesia is given, during the Procedure?
Local anesthesia may be administered for the procedure.
How much Blood will you lose, during the Procedure?
Typically, no blood loss is involved during a Dental Bridge Placement procedure.
What are the possible Risks and Complications during the Dental Bridge Placement procedure?
There are general factors that increase the risk of getting complications during surgery and they include:
- Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
- Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
- Advancing age
- Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
- Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
- Poorly functioning liver, as evidenced by increased blood liver function tests
- Hypertension (increased blood pressure), especially if it is poorly controlled
- Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
- Poor lung function, as evidenced by abnormal lung function tests
- History of bleeding disorders
- Longstanding illness, such as autoimmune disorders and chronic infections
- Poor immune system due to a variety of causes
The possible risks or complications that may arise during Dental Bridge Placements include:
- Anesthetic complications
- Allergic reaction to the material used in the dental bridge
- The dental bridge does not fit properly
- Damage of tooth during the procedure
What Post-Operative Care is needed at the Healthcare Facility after the Dental Bridge Placement procedure?
At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.
After the Dental Bridge Placement Procedure:
What are the possible Risks and Complications after the Dental Bridge Placement procedure?
The possible risks and complications that may arise after a Dental Bridge Placement procedure are:
- Bleeding from the gums
- The bridge does not match the profile of the teeth
What is the Prognosis after the Procedure?
The prognosis after a Dental Bridge Placement procedure is usually excellent, in a majority of individuals.
When do you need to call your Physician?
Do contact your physician if you notice any of the following symptoms:
- Pain or swelling around the gums and teeth
- Bleeding or fluid drainage from region
- Tooth sensitivity is observed
- The bridge is shaky or wobbly, or fits loosely
- Signs of an infection
- Fever, feeling sick
What Post-Operative Care is needed at Home after the Dental Bridge Placement procedure?
At home, the following post-operative care is recommended after a Dental Bridge Placement procedure:
- Avoid hard food items
- Avoid very hot or cold food items for a few days following the procedure
- Avoid smoking or chewing tobacco
- Brush and floss regularly after taking food, or twice daily
How long does it normally take to fully recover, from the Procedure?
There is no recovery time involved and individuals are able to resume full function of their teeth within a few hours of the procedure.
What happens to tissue (if any), taken out during the Procedure?
Generally, the procedure does not involve the surgical removal of any tissue.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
Usually, no tissue is sent for a pathological analysis.
Who will you receive a Bill from, after the Dental Bridge Placement procedure?
It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
- An out-patient surgery center facility, the dentist or oral surgeon’s clinic/office, or a hospital
- An anesthesiologist (if anesthesia was administered)
- A dental professional expert
The patient is advised to inquire and confirm the type of billing, before the Dental Bridge Placement procedure is performed.
Thanks and Gratitude:
We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.
Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA