A dental bridge is a fixed prosthetic device used to replace one or more missing teeth. It consists of abutments (crowns placed over natural teeth or implants) and a pontic (the artificial tooth suspended between them). Unlike natural teeth, a bridge is a single connected unit, making the area beneath the pontic inaccessible to standard dental floss. Specialized cleaning is necessary because the micro-gap between the pontic and the gum tissue easily traps food debris and plaque. If this debris is not removed daily, bacteria accumulate, leading to inflammation, gum disease, and decay of the supporting abutment teeth, which can cause the bridge to fail.
Essential Tools for Cleaning Under the Bridge
Cleaning the inaccessible space beneath the pontic requires tools specifically designed to thread under the bridge structure. The most common manual device is the floss threader, a thin, flexible nylon loop used like a needle and thread. Traditional dental floss is passed through the threader’s loop, allowing the stiffened end to be guided into the tight space under the bridge. Specialized tufted dental floss, often sold as Superfloss, is another option. This product integrates three sections: a stiff plastic end for threading, a wide spongy filament for cleaning, and a section of regular floss for cleaning adjacent natural teeth.
Interdental brushes offer a non-floss alternative, especially useful for bridges with wider spaces between the pontic and the gum line. These small, conical brushes feature fine bristles attached to a thin wire handle and come in a variety of sizes. Selecting the correct diameter is important for effectiveness and safety. The brush should fit snugly, with the bristles engaging the tooth surface without forcing the wire, which could damage the restoration or irritate the gums.
Detailed Technique: Floss Threaders and Superfloss
The manual technique using floss threaders or Superfloss is often the most effective method for physically scrubbing the underside of the bridge. Start by gently inserting the stiffened end under the space between the pontic and the gum tissue, guiding it through until it emerges on the opposite side. Once threaded, pull the floss until the thick, spongy section (if using Superfloss) is positioned directly beneath the artificial tooth.
Use a gentle, back-and-forth “shoe-shining” movement to clean the entire underside of the pontic, removing trapped bacterial biofilm and food particles. The spongy filament effectively scrubs the concave prosthetic surface where debris collects. Next, wrap the regular floss section around the sides of the supporting abutment teeth, forming a “C” shape.
Slide the floss up and down the side of the abutment crown, moving slightly beneath the gum line to clean the junction where the crown meets the natural tooth. Also clean the side of the natural tooth adjacent to the bridge, as this area is susceptible to decay. Once cleaning is complete on the abutments and pontic, remove the floss by gently pulling it out from one side, avoiding an upward snap that could irritate the gum tissue.
Alternative Deep Cleaning Methods
Water flossers (oral irrigators) provide an excellent supplementary method for dislodging loose debris and flushing bacteria from under the bridge. These devices use a pressurized stream of water to clean difficult-to-reach areas. To clean under the bridge, use the Plaque Seeker tip or a standard jet tip, positioning it at a 90-degree angle to the tooth surface.
Direct the tip toward the gum line, tracing the path where the pontic meets the tissue to flush out accumulated matter. The pulsating water stream is effective at reaching the deepest parts of the bridge structure, but use a comfortable pressure setting to avoid tissue irritation. Water flossers are beneficial for individuals who have difficulty maneuvering manual floss or interdental brushes, especially in the posterior regions.
Interdental brushes are best used for cleaning larger, open spaces around the supporting abutment teeth or under high-arch pontics. Insert the brush carefully into the space, moving it gently back and forth two or three times to sweep away plaque and debris. Avoid forcing the brush into tight spaces, as this can lead to gum tissue trauma. This method ensures mechanical removal of plaque that may be missed by floss or water streams.
Maintaining the Overall Bridge Structure
In addition to specialized cleaning underneath, the entire bridge structure, including the crowns and pontic, requires dedicated daily brushing. Use a soft-bristled toothbrush and a non-abrasive toothpaste to prevent scratching the restoration’s surface. Position the brush bristles at a 45-degree angle toward the gum line and use small, gentle circular motions to clean the top and sides of the abutment crowns.
This technique, often referred to as the modified Bass method, helps remove plaque from the junction where the crown meets the gum tissue. The specialized deep cleaning routine, whether manual or with a water flosser, should be performed at least once daily, preferably before bedtime, to prevent plaque from hardening overnight. Monitoring the tissue surrounding the bridge is also important for early detection of issues.
Signs that the cleaning routine is insufficient include persistent bad breath, visible plaque or tartar deposits, or gums that appear swollen and bleed easily. Increased sensitivity to hot or cold temperatures or discomfort around the abutment teeth can indicate decay beneath the crowns. Noticing these changes indicates that a professional evaluation is necessary to protect the longevity of the bridge and the health of the supporting teeth.