A dental bridge is a fixed dental restoration that replaces one or more missing teeth. It consists of artificial teeth, called pontics, that are supported by dental crowns cemented onto natural teeth on either side of the gap. While bridges are durable, cavities can form on the natural teeth underneath or supporting them.
How Cavities Form Under Bridges
Cavities develop under dental bridges when decay affects the supporting natural teeth, known as abutment teeth. The margins where the bridge’s crowns meet the natural tooth structure are vulnerable. Plaque and bacteria can accumulate in these areas, especially if there are microscopic gaps or an improper fit between the bridge and the tooth. These bacteria produce acids that demineralize the tooth enamel, leading to decay.
Gum recession can expose parts of the natural tooth root structure, making them susceptible to decay. Food particles can also become trapped in crevices around the bridge, providing a constant food source for cavity-causing bacteria. If the bridge does not fit precisely, it can create spaces where debris and bacteria can thrive, increasing the risk of decay.
Detecting a Cavity Under Your Bridge
Identifying a cavity beneath a dental bridge can be challenging since the decay is hidden by the prosthetic. Individuals might experience increased sensitivity to hot or cold temperatures, particularly around the bridge. Pain or discomfort when biting or chewing can also signal an underlying issue.
Persistent bad breath or an unpleasant taste may indicate bacterial buildup and decay underneath the bridge. Visible changes like discoloration or small pits might appear around the edges of the bridge or on the supporting teeth. A dental professional can use X-rays and visual inspection during regular check-ups to detect these hidden cavities early. If a bridge feels loose or unstable, it could also be a sign of decay weakening the supporting teeth.
Options for Addressing the Cavity
Once a cavity under a bridge is diagnosed, the treatment approach depends on the extent and location of the decay. If the cavity is small and accessible, a dentist might be able to clean out the decay and place a dental filling without removing the entire bridge. This conservative approach is possible if the decay is on the cheek or tongue side of the tooth and does not extend too far under the crown.
For more extensive decay, or if the cavity is located between the supporting teeth, the dental bridge often needs to be removed. After removing the decay, the tooth may receive a filling, or if the decay has reached the tooth’s pulp, a root canal treatment might be necessary. In severe cases where the tooth is too damaged to save, extraction may be the only option, requiring a new bridge or an alternative tooth replacement. Following treatment, the original bridge might be re-cemented if it is in good condition, or a new bridge will be fabricated and placed.
Protecting Your Dental Bridge
Maintaining a dental bridge requires consistent oral hygiene practices to prevent cavities from forming on the natural teeth underneath. Brushing teeth at least twice daily with fluoride toothpaste helps remove plaque and food particles from all tooth surfaces, including the bridge. Special attention should be given to the gumline around the bridge, where bacteria often accumulate.
Flossing around a dental bridge requires specialized tools because traditional floss cannot pass through the connected artificial teeth. Using a floss threader, super floss, or a water flosser can effectively clean beneath the pontics and around the abutment teeth. Regular dental check-ups and professional cleanings are also important, as they allow a dentist to monitor the bridge and detect any issues, such as early decay. Limiting sugary and acidic foods and drinks can further reduce the risk of decay.