Your Dental Bridge is Failing

What is a Bridge

A dental bridge, or a fixed dental bridge, is a method to replace a missing tooth by putting a dental crown on each tooth on either side of a space, and then connecting a missing tooth to the crown on each side. The bridge is then permanently cemented so that you don’t have to take it out every night like you would with a removable partial denture.

Bridge Problems

The problem with the bridge is that a problem can arise with one of the supporting teeth. If the nerve dies, root canal therapy can be performed through the affected tooth and the bridge can be salvaged. Yes, the tooth is weakened by the root canal in that some tooth structure is taken away to access the nerve chamber, and having no fluid inside the tooth makes it more brittle. However, I have seen bridges last several years after a root canal was performed.

If one of the abutment teeth (the tooth supporting the bridge) becomes decayed, the bridge is no longer salvageable and needs to be treated. One solution is to just remake the bridge. A more popular solution is to have the missing tooth restored with a dental implant and the 2 teeth that supported the bridge converted to single unit crowns.

Why Dental Implant?

Why is an implant superior? The additional force placed on the teeth supporting the bridge is significant and can lower the life expectancy of the tooth. I have seen patients who have a 3 unit bridge that fails, and one of the supporting teeth fails totally and must be extracted. Then the patient would need a 4-unit bridge which puts even more force on the supporting teeth, and it his harder to keep clean. At some point the span of missing teeth becomes too long and the patient is down to a removable option, or a multiple implant choice which can become expensive.

Case History

I had a patient come in within the last month. This patient is a 50 year old male, in relatively good health, who has had a dental bridge for roughly 20 years. He has suffered from periodontal disease and has had periodontal surgery within the last 3 years to help with that condition. On the x-rays, there was a change in the health of one of teeth holding up his bridge. I also noticed that his bone levels are much reduced from a normal healthy person due to this gum disease (periodontal disease is not cured, it just requires a lot of help to maintain it). In any case, the recommended treatment is to remove his bridge which is no longer salvageable, place a temporary crown on the decayed abutment tooth, and try to save the crown on the healthy abutment. Once the temporary is placed, the patient can receive a dental implant, then get a crown and done on the tooth which had decay, plus a crown on the dental implant once it has become integrated into the bone. The total period should be in the 4 month period.

Yes, this patient has the option of getting another bridge, but the 20 years of wear from the last bridge, plus the existence of periodontal disease, thought controlled, makes this a much inferior option.