A dental bridge is a fixed prosthetic replacement designed to span the gap created by one or more missing teeth. It consists of artificial teeth (pontics) anchored by crowns cemented onto the natural teeth on either side of the space (abutment teeth). While modern dental bridges are durable, they can become loose or dislodged. Although alarming, a dislodged bridge is a manageable issue that requires prompt attention. Taking the correct immediate actions can significantly improve the chances of a dentist being able to re-cement the existing restoration.
Immediate Steps Following Dislodgement
The first action is to remain composed and locate the dislodged bridge, preventing accidental swallowing or loss. Once retrieved, carefully inspect the bridge for cracks or damage before cleaning. Gently clean the prosthetic by rinsing it under lukewarm tap water to remove debris. You may use a soft-bristled toothbrush and toothpaste to lightly brush the interior of the crowns, but avoid harsh soaps or chemical disinfectants.
After securing the bridge, attend to the exposed abutment teeth and gum tissue. Exposed prepared teeth are highly sensitive to temperature and air, so gently clean any remaining cement and debris from the area. Rinsing the mouth with warm salt water can help soothe the exposed tissue. If you are experiencing acute pain, an over-the-counter pain reliever can be taken as directed.
Contact your dental office immediately to schedule an emergency appointment. Store the bridge in a clean, sealed container or bag until your appointment. Do not attempt to force the bridge back onto the abutment teeth, especially if it is cracked or if the underlying teeth appear damaged, as this can cause further injury.
Temporary Solutions and Precautions
While waiting for your dental appointment, a temporary fix may be necessary to protect the exposed teeth. If the bridge is completely intact and slides comfortably back into position without binding when you bite down, you may temporarily re-seat it. This measure is strictly for comfort and protection and is not a permanent solution.
To secure the bridge temporarily, use an over-the-counter temporary dental cement kit or a small amount of denture adhesive. Follow the manufacturer’s instructions precisely, applying a minimal amount to the inside of the crowns before seating the bridge. Ensure the bridge sits fully and securely without interfering with your normal bite, as improper seating can damage the abutment teeth or the restoration.
During this time, take precautions to protect the area. Avoid chewing directly on the side of the mouth where the bridge is located, focusing instead on soft foods. Hard foods (like nuts or crusty bread) or sticky foods (like caramel or taffy) must be completely avoided, as they can dislodge the bridge or cause further trauma. Continue to maintain gentle oral hygiene, carefully brushing around the abutment teeth and the temporary fixation.
Understanding the Cause and Professional Treatment Options
The failure of a fixed dental bridge is rarely sudden and usually results from an underlying issue compromising the bond. One common cause is the slow washout of dental cement over time, which loosens the seal and allows the bridge to shift. A more serious cause is the development of tooth decay (secondary caries) beneath the crown of one or both abutment teeth. This decay weakens the underlying tooth structure, causing the bridge to detach.
Other factors include excessive biting forces, such as nighttime tooth grinding, which can fracture the porcelain or metal framework of the bridge. Once the dentist evaluates the bridge and the abutment teeth, they determine the appropriate long-term solution. If the bridge is undamaged and the underlying teeth are healthy, the restoration can often be sterilized and simply re-cemented using a strong dental adhesive in a single appointment.
If the abutment teeth show signs of significant decay, the bridge must be removed, often requiring the old prosthetic to be carefully sectioned to access the decayed tooth structure. Following removal, the teeth are treated (which may involve a filling or a root canal) and then re-prepared for a new restoration.
If the damage to the abutment teeth is too extensive to support a new bridge, the dentist may recommend an alternative solution, such as replacing the missing teeth with dental implants, which do not rely on natural teeth for support. Minor repairs, such as bonding small chips in the porcelain, may be possible if the structural integrity of the bridge remains sound.