A dental bridge replaces one or more missing teeth, restoring function and appearance. This restoration consists of artificial teeth, called pontics, held in place by crowns cemented onto natural teeth or implants on either side of the gap. While bridges are durable, achieving a perfect fit and comfortable feel often requires further attention. Adjustments are a common part of ensuring the bridge integrates seamlessly with your mouth, whether immediately following placement or years later.
Identifying Common Issues That Require Adjustment
A bridge requiring modification presents symptoms affecting comfort and function. One immediate sign is an unbalanced bite, where the bridge contacts opposing teeth before your natural teeth do. This “high spot” can lead to localized pain in the abutment teeth and jaw discomfort. Sensitivity or pain in the anchoring teeth signals an issue with fit or alignment that is placing undue stress. Other concerns include food trapping, difficulty flossing, gum irritation if the margin is not flush, or minor aesthetic discrepancies in contour or shade.
Procedures for Modifying a Dental Bridge
The most frequent adjustment performed is an occlusal adjustment, which corrects a high bite interfering with the natural chewing motion. The dentist uses thin, colored articulating paper, which marks the bridge where premature contact occurs. These marked areas are carefully reduced using a fine dental bur, followed by polishing to ensure a smooth surface. This balances the forces across the entire bite, relieving pressure on the abutment teeth and the jaw joint.
Modifying the fit of the bridge near the gum line, known as marginal adjustment, is possible for minor discrepancies. If the crown edge meets the tooth preparation with a slight overhang or roughness, it can trap bacteria and irritate the gingiva. The dentist uses specialized instruments to smooth and polish these margins, ensuring the bridge surface is flush with the tooth structure. For aesthetic modifications, minor reshaping can be performed directly on the porcelain or composite material to improve contour or polish out slight surface imperfections. This contouring helps the bridge blend more naturally with the surrounding dentition.
When Replacement Is Necessary
While minor issues are correctable through adjustment, certain problems compromise the bridge’s structural integrity or the health of the supporting teeth, requiring complete replacement. Structural failure, such as a large crack or fracture in the porcelain or metal framework, is a significant reason for replacement if it cannot be repaired with bonding materials. If the bridge is visibly loose, it suggests the cement seal has failed or the supporting teeth have shifted, a problem far beyond simple adjustment. Decay affecting the abutment teeth necessitates removal of the entire restoration to treat the underlying tooth structure. Since the crowns cover the abutment teeth, recurrent decay is often hidden until it is too extensive to save the tooth without removing the bridge. Significant gum recession or bone loss around the anchor teeth can also compromise the stability of the bridge, making the fit inadequate and requiring a new prosthetic to ensure proper alignment and hygiene. When aesthetic issues involve a major color mismatch or the material has degraded after many years of use, a new bridge is often the only solution to restore a natural appearance.