A fixed dental bridge is a prosthetic appliance designed to replace one or more missing teeth by spanning the gap in the dental arch. It consists of a false tooth, known as a pontic, which is fused between crowns placed on the natural teeth or implants on either side; these anchor teeth are called abutments. The primary challenge in cleaning this restoration is the slight, inescapable space that exists between the underside of the pontic and the gum tissue below. This forms a protected niche where plaque and food debris easily accumulate. Regular brushing and standard dental floss are unable to access this unique area, meaning specialized tools are necessary to prevent the buildup of bacteria in the sub-pontic region.
Specialized Devices Required for Bridge Cleaning
Cleaning beneath a fixed bridge requires a shift away from traditional flossing methods, as the pontic is permanently attached to the abutment crowns, blocking access from above. Floss threaders are common and simple tools, acting as a flexible, plastic loop with a stiff end that functions like a needle to guide regular dental floss underneath the bridge. This tool allows the user to pull the floss through the small gap between the pontic and the gumline, enabling the manual cleaning of the undersurface.
An alternative to the floss threader is specialized floss like Superfloss, which integrates the threading mechanism directly into its design. Superfloss has a stiffened end for easy threading, followed by a wide, spongy section designed specifically for sweeping away plaque from the broad surfaces of the bridge and around the abutments. This spongy material is highly effective for cleaning larger areas where traditional thin floss might not provide enough surface contact.
Interdental brushes, sometimes called proxabrushes, are small, tapered brushes that feature a thin wire core surrounded by bristles. These devices are useful for cleaning beneath bridges, especially where the space is slightly wider, as they allow for a scrubbing motion directly on the underside of the pontic. It is important to select the correct size, which should fit snugly but without needing to be forced into the space, to avoid irritating the gums or damaging the bridge.
Water flossers, or oral irrigators, use a pressurized stream of water to dislodge food particles and disrupt plaque from hard-to-reach areas. While they do not replace the mechanical plaque removal achieved with floss and brushes, they are highly effective for flushing out debris from the sub-pontic space and around the abutment teeth. They are particularly beneficial for individuals who find manual dexterity challenging, offering a simpler method for daily maintenance.
Step-by-Step Instructions for Sub-Pontic Hygiene
The most thorough method for cleaning the sub-pontic area involves using a floss threader or Superfloss to manually clean the tissue-facing surface of the false tooth. Begin by threading the stiff end of the tool from the cheek side underneath the bridge and pulling it through until the floss emerges on the tongue side. This positions the section of floss, preferably the spongy part of Superfloss, directly under the pontic.
Once the floss is underneath, use a gentle back-and-forth motion, often described as a “shoe-shining” technique, to scrub the entire underside of the pontic and the adjacent gum tissue. This motion physically scrapes off the bacterial plaque film. After cleaning the pontic, wrap the floss in a C-shape around the side of the abutment tooth nearest the gap. Move it up and down gently along the tooth surface, reaching slightly beneath the gumline.
If the space under the bridge is wide enough, an interdental brush offers a direct way to clean the area with a scrubbing action. Gently insert the brush into the space, ensuring the bristles touch the underside of the pontic and the adjacent gum. Move the brush back and forth several times to disrupt and remove the debris before carefully withdrawing it.
A water flosser provides an effective supplemental cleaning step, using fluid dynamics to flush out loose matter. Fill the reservoir with lukewarm water and select a comfortable pressure setting. Position the nozzle tip at a 45-degree angle to the gumline, directing the stream toward the sub-pontic space and around the abutment teeth. Allow the pulsating water to run for a few seconds on both the cheek and tongue sides of the bridge for comprehensive rinsing.
Risks of Failing to Clean Under Your Bridge
Neglecting to clean the space beneath the pontic allows plaque and bacteria to thrive in the protected environment. This accumulation can lead to halitosis, commonly known as bad breath, as the bacteria produce foul-smelling volatile sulfur compounds. The constant presence of bacterial plaque irritates the gum tissue directly beneath the bridge, often resulting in gingivitis, which is characterized by inflammation and bleeding.
A more serious consequence is the risk of tooth decay, or caries, on the natural abutment teeth that support the bridge. Since the crowns covering these teeth are sealed near the gumline, plaque buildup at the margin can cause secondary decay to form on the supporting tooth structure. If this decay progresses, it can compromise the structural integrity of the abutment teeth and ultimately lead to the failure and potential loss of the entire bridge restoration. Maintaining a rigorous daily cleaning routine is therefore necessary to ensure the longevity of the bridge and the health of the underlying tooth structure.