A dental bridge is a fixed prosthetic device used to replace one or more missing teeth. It consists of an artificial tooth, called a pontic, held in place by crowns cemented onto natural teeth or implants on either side of the gap. While designed as a durable, long-term solution, a bridge can become loose or fall out entirely. Understanding the reasons for dislodgement allows for prompt action and effective prevention.
Why Dental Bridges Fail
The most frequent cause of bridge failure is the failure of the supporting natural teeth, not the prosthetic itself. This occurs because bacteria and plaque accumulate around the margins where the crown meets the tooth structure. This accumulation leads to decay, known as secondary caries, underneath the crown. As the abutment tooth structure weakens from this decay, the crown no longer has a stable foundation, causing the entire bridge to detach.
The luting agent, or dental cement, used to bond the crowns to the abutment teeth is another common factor. Over time, the cement’s bond strength degrades due to constant exposure to saliva, temperature fluctuations, and chewing forces. This degradation leads to microleakage, allowing bacteria to penetrate the space between the crown and the tooth. This compromises the bond and causes loosening.
Excessive or uneven forces from biting and chewing also play a significant role in failure. Habits like teeth grinding (bruxism) or clenching place immense mechanical stress on the bridge and supporting teeth. This stress can strain the cement bond or cause a fracture in the abutment tooth root. Chewing on hard objects or having an improperly aligned bite (malocclusion) can also cause premature wear or structural damage.
The bridge itself may fail due to material degradation or fracture, though modern materials make this less common. A primary element is the lack of adequate bone support for the abutment teeth, often due to periodontal disease. Without sufficient support, the teeth cannot sustain the load of the bridge, leading to instability and eventual loss. This structural failure is typically a slow process.
Immediate Actions When Dislodgement Occurs
If a dental bridge falls out, remain calm and safely retrieve the restoration. Rinse the bridge gently with lukewarm water to remove debris or saliva, taking care not to scrub or use harsh cleaning agents. Inspect the bridge and the exposed teeth for any visible cracks or damage. Do not try to force the bridge back into place if it does not fit easily.
Place the bridge in a clean, small container or a sealed plastic bag to protect it from being damaged or lost before your dental appointment. Contact your dental office immediately, as a dislodged bridge is considered an urgent matter that requires professional attention. Exposed abutment teeth are vulnerable to sensitivity, shifting, and further decay, which can make re-cementation more difficult or impossible.
While waiting for your appointment, avoid chewing food on the exposed area to prevent injury to the gums. Over-the-counter temporary dental cements are available, but use them with caution and only if the bridge fits without force. Never attempt to use household adhesives, as they are toxic and can permanently damage the bridge and the underlying tooth surface.
Ensuring Bridge Longevity
Preventing bridge failure begins with an elevated standard of oral hygiene, focusing on the areas around the abutment teeth and beneath the artificial tooth (pontic). Since a regular toothbrush cannot reach the space under the pontic, specialized tools must be used daily to remove trapped plaque and food particles. Regular brushing with a soft-bristled brush and fluoride toothpaste protects the remaining enamel from acid erosion and decay.
Routine biannual dental checkups and professional cleanings are necessary for monitoring the restoration’s condition. During these appointments, the dentist examines the crown margins for signs of cement degradation or microleakage, which are often invisible to the patient. They also assess the health of the abutment teeth and surrounding gum tissue, addressing early signs of periodontal disease that could compromise the bridge’s foundation.
Lifestyle adjustments also extend the functional life of the bridge. Modify your diet by limiting extremely hard foods, such as nuts or ice, and sticky, chewy items like caramel, which exert excessive pulling forces. If nighttime teeth grinding is an issue, wearing a custom-fitted nightguard absorbs the intense mechanical stress, protecting the bridge and underlying teeth from accelerated wear and fracture.