A dental bridge is a fixed prosthetic device consisting of one or more artificial teeth, called pontics, held in place by crowns cemented onto natural abutment teeth. Maintaining a bridge requires specialized cleaning techniques, especially focusing on the pontic. Unlike natural teeth, the pontic rests against or slightly above the gum tissue, creating a unique hygiene challenge. This space underneath the pontic is highly susceptible to plaque and food debris because standard brushing and flossing cannot reach it effectively.
The Anatomy of the Pontic Area
The design of the pontic creates an area that is naturally difficult to clean, demanding a specialized daily routine. In a natural tooth, the tooth structure is surrounded by a cuff of gum tissue that is attached to the tooth, creating a seal. A pontic, however, is suspended between the abutment crowns and sits either touching the gum lightly or with a small space beneath it.
This small, concave space between the underside of the pontic and the gum tissue, sometimes referred to as the gingival embrasure, becomes a prime location for the sticky biofilm known as plaque. If not regularly removed, this trapped plaque hardens into calculus, leading to gum irritation and inflammation. The accumulation of bacteria in this area can cause decay on the abutment teeth that anchor the entire bridge, which is the most common reason for bridge failure.
Specialized Cleaning Tools
Maintaining the area under the pontic requires specific tools designed to navigate the structure of the bridge. The most common and foundational tool is the floss threader, a simple, semi-stiff plastic device with a loop that acts like a large needle. This threader is used to guide dental floss under the pontic, making the area accessible for cleaning.
An alternative to the threader is Superfloss, which features a stiffened end for easy threading and a thick, spongy segment for effective cleaning. Interdental brushes, sometimes called proxabrushes, are small, tapered brushes that can be inserted into the gap under the pontic to physically scrub the concave surface. Finally, an oral irrigator, commonly known as a water flosser, uses a pressurized stream of water to flush out loose debris and bacteria from these hard-to-reach areas.
Step-by-Step Cleaning Techniques
The daily cleaning routine for a dental bridge must integrate these specialized tools to ensure the health of the supporting tissues and abutment teeth. A primary method involves the use of a floss threader or Superfloss to clean the underside of the pontic. To begin, a length of regular dental floss is threaded through the loop of the floss threader, and the stiff end is then gently guided beneath the pontic, pulling the floss through to the other side.
Once the floss is positioned under the pontic, a gentle back-and-forth motion is used to clean the entire underside of the artificial tooth, a technique sometimes described as a “shoe-shining” motion. This action physically breaks up the plaque biofilm and removes food particles that have collected in the space. For the supporting abutment teeth, the floss should be curved into a “C” shape around the tooth and moved gently below the gumline to clean the sides.
Interdental Brush Use
Interdental brushes offer a method to physically clean the concave surface under the pontic, especially where there is enough space to fit the brush. The user must select a brush size that can be comfortably inserted without forcing it against the bridge or the gum tissue. The brush is then gently inserted under the pontic and moved in a subtle in-and-out motion to scrub the area between the gum and the bridge.
Water Flosser Application
Water flossers provide a non-contact method of debriding the pontic area, which is effective for dislodging food particles and bacteria. The reservoir should be filled with lukewarm water, as cold water can cause sensitivity in the abutment teeth. The tip of the device is then aimed at the margin where the pontic meets the gum tissue, typically at a 90-degree angle, and the pressurized stream is used to trace along the base of the bridge.
The Role of Professional Dental Care
While diligent home care is necessary, professional dental maintenance is equally important for the long-term success of a dental bridge. Regular appointments, typically every six months, allow the dental hygienist to remove hardened calculus (tartar) that cannot be eliminated with home tools. The hygienist uses specialized instruments to clean the hard-to-reach surfaces under the pontic and around the abutment teeth.
During these visits, the dentist assesses the integrity of the bridge, checking the margins where the crowns meet the natural teeth for signs of leakage or wear. Monitoring the health of the abutment teeth is the most important task, as they remain susceptible to decay and gum disease. Early detection of problems in these anchor teeth is crucial, as their failure can ultimately lead to the loss of the entire bridge.