A dental bridge replaces one or more missing teeth by connecting artificial teeth to crowns placed on adjacent natural teeth (abutment teeth). Many people feel anxiety about the procedure, but modern dental techniques and local anesthesia minimize discomfort during treatment. While the process is not pain-free, the discomfort is generally manageable and temporary, mostly restricted to the recovery phase rather than the procedure itself.
Discomfort During Tooth Preparation
The most invasive step is the initial preparation of the abutment teeth, which are reshaped to accommodate the supporting crowns. Before starting, the dentist administers a local anesthetic to completely numb the area, ensuring the removal of enamel is painless. While sharp pain is absent, sensing pressure and vibration from the instruments is normal.
This preparation creates space for the bridge material, preventing the final restoration from feeling bulky. Once the anesthesia wears off, typically a few hours later, localized soreness around the prepared teeth and gums is common. This mild discomfort results from the physical manipulation of the surrounding tissues during the procedure.
Over-the-counter anti-inflammatory medications, such as ibuprofen, are usually sufficient to manage this initial post-operative soreness. The soreness should peak on the first day and then rapidly subside over the next 24 to 48 hours as the tissue begins to heal. During this time, a temporary bridge is placed to protect the abutment teeth while the permanent bridge is fabricated in a laboratory.
Immediate Post-Procedure Sensitivity
The period immediately following the placement of the temporary bridge often involves transient sensitivity. The gum tissue surrounding the abutment teeth may feel sore or tender due to the dental work. Rinsing with warm salt water several times a day can help soothe localized gum inflammation and promote healing.
Tooth sensitivity to temperature, particularly cold, is common while the temporary bridge is in place. This occurs because the temporary cement does not seal the prepared tooth surface as perfectly as the final adhesive. The exposed dentin can react sharply to thermal changes. This sensitivity generally resolves quickly once the permanent bridge is cemented with specialized dental cement at the subsequent appointment.
Patients may also notice discomfort when chewing or an unusual feeling when they bite down. This may indicate a minor issue with the temporary bridge’s height. If the bite feels uneven, a quick adjustment by the dentist is needed to ensure opposing teeth do not put excessive pressure on the temporary restoration.
Addressing Persistent Pain and Serious Issues
While mild, temporary discomfort is normal, pain that persists beyond a week or two, or suddenly becomes severe, signals a potential complication. A sharp, jabbing pain when biting down often indicates an occlusal issue, where the bridge hits opposing teeth unevenly. An ill-fitting bridge transmits excessive force to the supporting teeth, potentially causing nerve irritation or fracturing the abutment tooth.
Throbbing, constant pain, especially if accompanied by swelling or fever, may point to an infection within the abutment tooth. Preparation can sometimes irritate the pulp (nerve), leading to irreversible inflammation or requiring a root canal. If the final bridge does not seat correctly, microleakage can occur, allowing bacteria to cause decay beneath the crown and resulting in chronic pain.
Patients should immediately contact their dentist if they experience pain requiring increasing doses of medication or signs of infection like drainage or prolonged swelling. Ignoring persistent symptoms compromises the long-term health of the abutment teeth and threatens the success of the restoration. A prompt examination determines if the pain is due to nerve inflammation, decay, or a simple prosthetic adjustment.