A dental bridge is a fixed prosthetic device used to replace one or more missing teeth by “bridging” the gap between existing teeth. A traditional bridge consists of an artificial tooth, called a pontic, held in place by crowns cemented onto the natural teeth on either side of the space. These anchor teeth, known as abutment teeth, are prepared by reducing their enamel surface to accommodate the crowns. While a bridge restores chewing function and aesthetics, patients often question whether this restoration negatively impacts long-term oral health.
The Specific Risks to Supporting Teeth
The primary concern regarding dental bridges is the health and longevity of the natural abutment teeth that anchor the restoration. Placing a traditional bridge requires the dentist to permanently alter these supporting teeth by removing a significant amount of the outer enamel layer. This preparation makes the teeth vulnerable to decay if the crown margins are compromised or cleaning is neglected.
The most frequent complication is recurrent decay (secondary caries), which forms underneath the cemented crown and erodes the remaining tooth structure. The seal where the crown meets the tooth is a trap for plaque and bacteria. If decay progresses unnoticed, it can compromise the bridge’s foundation, often requiring its removal and complex treatment, such as a root canal or extraction of the abutment tooth.
Abutment teeth also bear an increased mechanical load because they support the forces of biting and chewing for both themselves and the missing tooth. This added stress can lead to complications, especially with longer bridges. Excessive force can cause nerve issues or, rarely, cracks or fractures in the root structure. An improperly fitted bridge or an unbalanced bite can exacerbate this strain, leading to discomfort or jaw joint problems.
Essential Hygiene Practices for Dental Bridges
The increased risk of decay in abutment teeth requires specific and meticulous daily hygiene practices. Regular brushing is insufficient because a fixed bridge creates an inaccessible space between the underside of the pontic and the gum tissue. This area traps food particles and plaque, which must be manually removed to prevent gum inflammation and secondary decay.
Specialized tools are required to clean beneath the bridge and around the abutment teeth gum line. A common tool is the floss threader, used to guide traditional dental floss under the bridge. Superfloss is another effective option, featuring a stiff end for threading and a spongy middle section for cleaning the wide gap. Water flossers use a pressurized stream of water to flush out debris and plaque from hard-to-reach areas. Interdental brushes or soft-picks are also used to sweep away plaque. Daily use of these specialized tools is necessary to ensure the longevity of the bridge and the health of the supporting structures.
Impact on Gum Tissue and Bone Structure
A dental bridge can affect the soft tissues and underlying bone where the tooth is missing. If the space beneath the pontic is not cleaned correctly, bacteria accumulate, leading to localized gum inflammation (gingivitis). Chronic inflammation can compromise the gum tissue surrounding the abutment teeth, potentially causing gum recession and increasing the risk of decay on exposed roots.
Bone resorption naturally occurs when a tooth root is absent and no longer stimulates the jawbone. A traditional bridge replaces the visible tooth portion but not the root, so it cannot provide the necessary stimulation to the underlying bone. Consequently, the jawbone beneath the pontic gradually shrinks and resorbs over time.
This bone loss can cause the gums to recede, creating a gap between the artificial tooth and the gum line. This space traps food and complicates hygiene, sometimes necessitating a replacement bridge to correct aesthetic and functional issues. The bridge does not prevent the natural post-extraction bone loss that occurs without a natural root or a dental implant.