BRIDGE

When teeth are missing and there are teeth on either side of the space a bridge is the ideal way to replace the missing teeth. When there has been the loss of a tooth or teeth and there is a tooth on either side of the open space, replacement teeth can be attached to two crowns constructed for the 2 teeth on either side of the open space. This is called a bridge because it bridges the open space.
When a tooth is lost 5 or more other teeth may drift so it is essential to place a replacement tooth as soon as possible. The space left from missing teeth may cause one of several problems. Teeth may drift into the space changing your bite, this changed bite may result in sore jaws, gum disease, or decay (due to more difficult hygiene).
Afixed bridge is used to replace one or several teeth. The teeth on each end of the space is used to as anchors (abutments). Bridges are not removable by the patient. As with other types of crowns (caps), a bridge can be made of metal or porcelain, or a combination of these two.

To prepare a bridge, diagnostic models are taken to study the optimum way to perform this procedure. After studies are completed, the teeth used to attach the bridge are carefully reshaped. Impressions are taken and from these impressions, the bridge is made by a certified dental technician. This laboratory time is usually 2 to 3 weeks - during this time a temporary acrylic bridge is cemented to place.
CARE FOR BRIDGES
Brush and floss daily all areas around the bridge .It is not possible to floss between the replacement tooth and the attaching crowns (it is made as a solid piece). In order to solve this problem - it is necessary to use a special type of floss to go under the replacement tooth and keep this area of gum tissue healthy.

ATRAUMATIC RESTORATION TREATMENT

The Atraumatic Restorative Treatment (A.R.T.) is a procedure based on excavating carious cavities in teeth using hand instruments only and restoring them with an adhesive filling material (glass ionomer). This procedure was originally developed because millions of people in less industrialized countries and special groups like refugees and people living in deprived communities are unable to obtain dental care. Their teeth generally decay until removal is required. These people have not benefited from the developments that have brought about improved oral health in the industrialized world. The absence of electricity and the traditional idea that restorative dental care requires electrically driven equipment are the main reasons underlying this situation. In contrast the A.R.T. approach enables treatment of cavities in teeth of people residing in areas where electricity is not available, or where the community cannot afford expensive dental equipment.

The A.R.T. technique provides the oral health worker with a tool that supports the concept "Teeth for Life". Removing carious tooth tissue with hand instruments alone and restoring the cavity with glass ionomer will conserve as much tooth structure as possible and prevent further decay.

In developed countries, the ART Technique has found a place in the modern surgery. A patient with multiple carious lesions is treated with the ART Technique and the carious process stabilized before a more definitive restoration is placed. Dentists have found that this technique is useful for nervous patients who are scared of the drill, and restorative procedures are accomplished using hand instrumentation only. ART is also found to be useful in treating patients with medical or physical disability. The procedure may be carried out in the patient's home or in the hospital. Use of the ART Technique is also useful in introducing children to dental care and helps to overcome any fears of traditional dental treatment.

The two main principles of ART are:
¨ Removing carious tooth tissue using hand instruments only
¨ Restoring the cavity with a glass ionomer

The reasons for using hand instruments rather than electric driven handpieces are:
¨ it makes restorative care accessible to all population groups
¨ the use of a biological approach, which requires minimal cavity preparation that conserves sound tooth tissues and causes less trauma to the teeth
¨ the low cost of hand instruments compared to electrically driven dental equipment
¨ the limitation of pain that reduces the need for local anesthesia to a minimum and reduces psychological trauma to patients
¨ simplified infection control; hand instruments can be easily cleaned and sterilized after every patient

The reasons for using glass ionomers
¨ As the glass ionomer chemically bonds to both enamel and dentin, the need to cut sound tooth tissue to prepare the cavity is reduced
¨ fluoride is released from the restoration to prevent and arrest caries
¨ glass ionomers are biocompatible, does not cause any irritation to pulp and gingiva and has a coefficient of thermal expansion similar to tooth structure