A dental bridge is a fixed prosthetic replacement for one or more missing teeth. It consists of artificial teeth, called pontics, which are held in place by crowns cemented onto the natural teeth on either side of the space; these supporting teeth are known as abutments. Although bridges are designed to be durable, discomfort or pain originating from the area is common and signals a problem needing professional attention. This pain indicates that the supporting structures may be compromised, requiring a proper diagnosis to maintain the bridge’s function and oral health.
Common Causes of Pain Under or Around a Dental Bridge
One of the most frequent reasons for pain is the development of tooth decay in the abutment teeth beneath the crowns. Even though the teeth are covered, bacteria can seep through tiny gaps at the crown margins, especially if the cement seal fails or if oral hygiene is inadequate. This decay can progress silently, eventually reaching the nerve, causing sensitivity and chronic pain.
Inflammation or infection of the gum tissue surrounding the bridge is a significant cause of discomfort. Plaque and food debris easily accumulate around the edges of the bridge and the gumline, leading to gingivitis or the more serious periodontal disease. The gums may become red, swollen, and tender, causing persistent soreness around the restoration. Without intervention, gum disease can weaken the bone supporting the abutment teeth, potentially destabilizing the entire bridge.
A dental bridge that does not fit correctly can cause chronic pain or localized irritation. An improper fit might be due to a change in your bite over time or a structural issue with the bridge itself. If the bridge sits too high, it creates excessive force on the abutment teeth when biting down, leading to trauma and discomfort known as an occlusal issue. Conversely, a loose fit allows the bridge to shift slightly, irritating the underlying gum tissue and exposing the sensitive tooth structure beneath.
Pain can also stem from nerve irritation within the abutment teeth, particularly if the original tooth preparation was deep. This pain is often felt as a sharp sensitivity to temperature changes or pressure. Over time, a crack in one of the abutment teeth can also be a source of pain. Since abutment teeth are under constant pressure, diagnosing a crack can be challenging without a professional examination.
Recognizing Urgent Symptoms and Immediate Care Steps
Certain symptoms signal an urgent situation requiring immediate contact with a dental professional. You should seek prompt attention if you experience severe, throbbing pain that affects your sleep or is not relieved by over-the-counter pain medication. Other worrying signs include noticeable swelling of the face or gums, a fever, or difficulty swallowing. These symptoms may indicate a spreading infection or abscess.
If your bridge feels visibly loose, has fallen out, or if you can see a crack in the material, seek immediate care, as the exposed abutment teeth are vulnerable to damage. While waiting for your appointment, you can take steps to manage the discomfort and protect the area. Gently rinsing your mouth with warm salt water helps soothe irritated gums and temporarily reduce inflammation.
You may use over-the-counter pain relievers, such as ibuprofen or acetaminophen, to manage the pain. It is important to avoid chewing hard or sticky foods on the side of the mouth with the painful bridge to prevent further trauma or damage. Contacting your dentist right away is crucial, as they can assess the situation. They will determine if you need an emergency visit or if a quick temporary solution is possible.
Professional Diagnosis and Repair of Dental Bridge Problems
A thorough diagnostic evaluation is the first step to pinpoint the exact cause of the pain. This process typically involves taking X-rays, which allow the dentist to visualize the abutment teeth roots, the surrounding bone, and look for decay beneath the bridge crowns. The dentist will also use a dental probe to check the gum tissue around the bridge margins for signs of deep pockets or inflammation.
Treatment pathways are highly dependent on the problem identified during the examination. If early decay is found in an abutment tooth, the dentist may be able to remove the bridge, treat the decay with a filling or root canal therapy, and then re-cement the existing bridge. When the pain is caused by gum disease, treatment will focus on deep cleaning procedures to remove plaque and calculus from below the gumline and around the supporting teeth.
For issues related to fit or bite misalignment, simple adjustments to the bridge’s surface may resolve the problem. If the cement has failed and the bridge is loose, it can often be cleaned and re-cemented. However, if the underlying abutment tooth is severely damaged, the bridge is structurally fractured, or the poor fit is substantial, a complete replacement may be necessary to ensure long-term stability and comfort.