A “bridge” is a cemented device which can be used to replace a missing tooth. By connecting to a tooth on each side of a space or missing tooth, the gap can be filled to provide better function. Bridge fabrication is similar to that of a crown.
Crown and Bridge
Crowns and bridges usually take two or three appointments to complete. In the first visit, the teeth are prepared and impressions of the mouth are taken. Temporary crowns or bridges are placed to protect the teeth while the permanent custom restoration is being made. At the second appointment, the permanent restorations are cemented. Occasionally, a try in appointment, adjustments, or laboratory modifications are necessary, and may result in the need for a third appointment.
If anesthesia was used, the tongue, cheek, lips, and roof of the mouth may be numb. Please refrain from eating and drinking hot beverages until the numbness has completely worn off. If you need to eat before the numbness has worn off, use common sense. Eat on the side that is not numb, and only eat soft foods. Examples: yogurt, bananas, pasta, milkshake, smoothie, soft bread, cheese, cold soup. It is very easy to bite your tongue or cheek while you are numb, so make sure to be careful.
To keep your temporaries in place, avoid eating sticky foods, chewing gum, eating hard foods, and if possible, avoid chewing in the area where the work was done. It is important to brush and floss daily, but make sure to floss carefully. Don’t pull the floss towards the occlusal (chewing) surface of the tooth which may dislodge the temporary. Instead, pull the floss out from the cheek side of the temporary crown or bridge.
Occasionally a temporary crown or bridge may come off. If this happens, call our office right away. Make sure to bring the temporary crown or bridge with you to the office, so that we can re-cement it. It is very important for the temporary to stay in place, as it protects the tooth, and helps prevent tooth from moving. If the temporary was swallowed or destroyed, we can make a new one for you.
Normally, we do not give pain medication for crown and bridge procedures. If you are experiencing discomfort, anti-inflammatory medications like Advil and Aleve are best for you to take. If you are unable to take anti-inflammatory medication such as Advil or Aleve, you may take Tylenol. If your discomfort can not be relieved by an over the counter medication, please call our office. Sometimes, patients require a prescription strength pain reliever. It can be normal to experience some sensitivity to temperature and chewing. As long as the sensitivity is getting less frequent and less severe, the tooth is healing. If the sensitivity is getting worse, however, you should call our office immediately.
Temporaries are made of acrylic and composite resin and are not very thermally insulating, causing temperature sensitivity to be increased. The gum tissue is often aggravated by temporaries, staying red and inflamed. Even though it may be uncomfortable, brushing and flossing the area is very important. This will help the gums to heal, and your discomfort will decrease. If a toothbrush hurts too much to use around the area that was worked on, you can use a Q-tip to clean the teeth directly around the area, for a few days. When you come in the office to have your permanent restoration cemented, the healthier your gums are around the tooth, the easier the appointment will be for you (less time and less discomfort). Once you receive the permanent restoration, the sensitivity usually decreases tremendously and the gums heal quickly. Usually, within a few days to a few weeks, your tooth and gums will start to feel normal again.
If your temporary comes off, and you are not coming in to the office for your permanent crown that day, you should call our office. We will make an appointment for you to get it re-cemented. If you are out of town, or if you are not able to come in to the office, you can place the temporary crown or bridge back on with an over the counter temporary cement or temporary filling material found in the dental section of most drug stores. You may also use toothpaste, Vaseline, or Fixodent. However, these typically don’t hold the temporary as well as the drugstore cement. Even if you are able to get the temporary re-cemented yourself, you should see a dentist, as soon as possible. The proper placement of the temporary by a dental professional is extremely important.
If you must re-cement the temporary yourself, follow the directions as closely as possible. Please read all of the following directions for re-cementing a temporary before you begin the process:
Clean the cement out of the temporary, using a small object such as toothpick or a bobby pin. Place the temporary on your tooth, so that you can see how it fits correctly. This is a custom restoration and should fit precisely on your tooth. If it has been placed incorrectly, it will not seat fully on the tooth and may feel high in your bite. Make note of which side faces the tongue and which side faces the cheek. There is only one way that it fits correctly. Once you have mixed the dental cement together, you may only have about a minute to get the temporary placed correctly on your tooth, before the cement begins to set up. So, make sure that you know how the temporary goes on before you place the new cement in the temporary.
Dry your tooth as well as you can with gauze or a wash cloth. Then, place the cement in the temporary. Next, place the temporary on the tooth and bite down gently. Tap your teeth together and make sure that your bite feels normal. If you are able to bite all of your teeth together and you don’t feel extra pressure on the temporary tooth, place a gauze or washcloth over the temporary tooth and bite down firmly for about 5 minutes. If the temporary does not feel secure after this, DO NOT leave it in. It is possible that you could aspirate (go into the lungs), or swallow the temporary, especially while sleeping. If you cannot get it securely fitted on your own, please leave it out until you can come into our office, or see another dentist, to have it re-cemented.
It is important to make sure your temporary stays on for several reasons. If the tooth has not had a root canal treatment, it can be irritating to the tooth to be exposed to the texture and temperature of foods and liquids, and air. Also, the temporary not being in place can cause movement of the tooth and can increase the amount of adjustments needed to your permanent crown or bridge for proper placement.
If you have any questions or concerns, please call our office. We are happy to see you, or advise you, post operatively, for any reason.