A dental bridge replaces missing teeth, anchoring to adjacent natural teeth or implants to restore function and appearance. While durable, cavities can develop on the natural teeth supporting a dental bridge, known as abutment teeth. This requires prompt professional attention, as a cavity under a bridge compromises the underlying tooth structure and the restoration’s stability.
Why Cavities Form Under Bridges
Cavities can form under dental bridges due to several factors:
Inadequate oral hygiene around the bridge margins and supporting teeth leads to plaque and bacteria accumulation.
Food particles trapped in small spaces around the bridge provide a food source for bacteria, producing acids that erode enamel.
A poorly fitting bridge creates gaps where bacteria and food debris gather, increasing decay risk.
Wear and tear on the bridge or supporting teeth can contribute to the formation of these spaces.
Receding gum lines can expose abutment tooth root surfaces, which are softer than enamel and more susceptible to decay.
Recognizing the Signs
Identifying a cavity under a dental bridge can be challenging because the bridge obscures decay. However, several signs indicate a problem. These include sensitivity to hot or cold temperatures, or discomfort when chewing. A persistent bad taste or bad breath might also suggest bacterial buildup. Visible changes like discoloration on the abutment tooth, swelling or redness of the gums around the bridge, or a loose-feeling bridge can also indicate weakened supporting teeth due to decay.
What Happens if Left Untreated
If a cavity under a dental bridge is not addressed, decay will progress. It can deepen, reaching the tooth’s inner pulp containing nerves and blood vessels, causing pain and inflammation (pulpitis). Untreated decay can also lead to infection, forming a dental abscess—a pocket of pus causing swelling and discomfort. This infection can spread to surrounding tissues and bone, leading to bone loss. Ultimately, as decay weakens the supporting tooth structure, the tooth may become too compromised to support the bridge, resulting in bridge failure and necessitating its removal for more extensive restorative procedures.
Treatment Approaches
Treating a cavity under a dental bridge often requires removing the existing bridge to access the affected tooth. If the cavity is small and detected early, a dentist may clean the decay and place a dental filling. If decay has progressed to the tooth’s pulp, root canal therapy is necessary to remove infected tissue and save the tooth. For extensive damage, tooth extraction may be the only option. After resolution, a new dental bridge or alternative, such as a dental implant, will be needed to replace missing teeth and restore function.
Preventing Future Issues
Maintaining diligent oral hygiene minimizes the risk of cavities under dental bridges. This includes brushing twice daily with fluoride toothpaste, focusing on the bridge and supporting teeth. Specialized tools like floss threaders or water flossers help clean under the bridge where regular brushing cannot reach. Regular dental check-ups and professional cleanings are important for detecting early signs of decay or bridge issues. Limiting sugary and acidic foods and beverages reduces fuel for decay-causing bacteria, and for teeth grinding or clenching, a nightguard protects the bridge and abutment teeth from excessive force.