Bridges and Partials
The terms bridges and partials can be confusing. To simplify, the term bridge will be used if a missing tooth or teeth will be replaced by something that is not removable. The term partial, or partial denture, will be used to replace teeth with something removable. A bridge may be recommended if you are missing one or more teeth, but you have sound teeth on either side of the missing tooth or teeth. The teeth on either side of the missing tooth or teeth are reduced slightly in size (dentist call this prepping the tooth) to receive a crown. The missing teeth are replaced with artificial teeth that are attached to the crowns over the adjacent teeth. The finished bridge is actually a combination of crowns and artificial teeth. The bridge is usually made out of a metal base with porcelain over the metal base to make the teeth look natural. The bridge is actually one piece when completed. Patients can floss the gumline of the teeth around the bridge by using a device called a floss threader. When completed the teeth do not look like they are connected to each other, but in fact they are. There are photos of bridges in the photo gallery pull down menu.
Patients sometimes perceive the process of crowning teeth for a bridge as a negative. A crown or a cap is the same thing and it means that the tooth is completely covered with a material like porcelain or porcelain over metal. Crowns are usually individual restorations over a tooth, but in the case of a bridge, two or more dental crowns support the missing teeth. There are actually two potential advantages to doing crowns over teeth for a bridge. One advantage is that if the teeth already have large fillings, the crown is a good way to keep the tooth from cracking or splitting. In fact, crowns are usually the recommended treatment rather than large fillings to protect teeth. The second benefit of connecting teeth with crowns is they are made more stable. Teeth that have lost some bone support due to gum disease sometimes get slightly loose (dentist call this mobility). By connecting teeth together for a bridge, we make them less mobile because the connected teeth tend to support each other like fenceposts support a fence. In fact, we sometimes crown adjacent teeth and connect them together when we are not replacing teeth just to make them more stable. Dentists call this splinting.
Bridges may replace multiple teeth. Dentists refer to a bridge that replaces one tooth by crowning a tooth on either side as a three tooth or three-unit bridge. This is a potentially confusing term for patients because only one tooth is replaced, but when dentists are talking to each other this is the terminology used.
It is very common for a bridge to replace 2, 3, 4 or even more teeth as long as there are enough teeth to connect to with crowns. Also, implants can be strategically placed to be used to replace teeth, either as free standing teeth, or as support for a bridge using natural teeth and implants.
The need to replace front teeth is pretty obvious. Most patients do not want to be seen in public with missing front teeth. Back teeth should be replaced also. If teeth are not replaced, the surrounding teeth will drift around and the patients bite will gradually change. The patient may develop jaw joint (TMJ temporomandibular joint) problems because of the shifting teeth. Replacing teeth with bridegework is recommended, but we understand that many patients need to phase treatment like this over a period of time for budget reasons. We may recommend bridges to replace your missing teeth, but we will not pressure any patient into having missing teeth replaced by trying to frighten them with all the bad things that can happen if teeth are not replaced, because these bad things will happen slowly. Some families have to have orthodontics done for teenagers before comprehensive dental care can be done for the parents and we understand this.
Partials are completely different from bridges. A partial is a device that is removable and replaces all the teeth that are missing in either the upper jaw or the lower jaw. In fact, the dental term for a partial is removable partial denture. When dentists talk to each other, they use the term partials. A partial is usually recommended when there are not enough teeth available to do a bridge. A bridge is more natural since it does not have to be removed. In fact, a bridge is very much like having natural teeth.
There are basically two types of partials. One type is made of all plastic (acrylic) with wire clasps. Denture teeth are used to replace missing teeth and the acrylic rests on the gums to support the denture teeth. The other type of partial uses a metal framework as the main foundation for the removable appliance. Dentists call these metal framework partials. The use of metal allows the partial to be thin in the areas that the partial has to rest on to get support from the tissue, making the partial more comfortable for the patient. Partials need support from resting on the gum tissue where teeth are missing, but they also engage certain teeth to stabilize the partial. Thin wires called clasps are usually used to provide stability for the partials.
Partials are worn successfully by many patients and they are very often the best treatment for multiple missing teeth.
One of the reasons other general dentists refer potential implant cases to Douglas P. Clepper, DMD is that they know Dr. Clepper will evaluate whether implants are the best option to replace missing teeth, or whether a bridge or a partial is the best option. Dr. Douglas P. Clepper developed the laboratory over a period of 25 years because of his interest in bridges, partials, and implants. He has a good understanding of all three modalities, and he treats patients using all three modalities. Call us at Augusta Office Phone Number 706-738-8070
if you would like an exam and consult about missing teeth.