Dental Bridges: Repair Options and Material Impact on Oral Health

Dental bridge reconstruction

Hello Doctor: Recently, my dental bridge has become loose (a bridge with 4 teeth, missing 2 teeth in the middle, involving molars 1 and 2, and premolars 1 and 2).
During my visit, the dental crown was removed, leaving only a small portion of the tooth.
Root canal treatment was able to save the tooth, and a post is needed for reinforcement.
Now, is it possible to remake the previous 4-tooth bridge for molar 2, or do I need to add an additional tooth for support? I really hesitate to grind down a healthy tooth for this.
Additionally, since I had the bridge placed, I have frequently experienced oral ulcers.
The material used for the previous bridge was quite standard, costing around $6000 per tooth.
Is there a correlation between the type of dental prosthesis material and the occurrence of oral ulcers? (I do not have any allergies.) I appreciate your assistance with these questions.
Thank you!

kekou, 30~39 year old female. Ask Date: 2017/08/08

Dr. Zeng Guanghui reply Dentistry

The feasibility of creating a dental bridge depends on whether the supporting teeth are sufficiently strong and whether the periodontal condition is stable.
It is advisable to consult a dentist for an evaluation.
Additionally, if the material of the bridge is a so-called base metal, it may lead to allergic reactions and corrosion.
Therefore, it is recommended to avoid using base metal materials whenever possible.

Reply Date: 2017/08/08

More Info

When considering dental bridges, particularly in cases where there has been a loss of supporting teeth, it is essential to evaluate both the structural integrity of the remaining teeth and the materials used for the bridge itself. In your situation, where you have experienced the loosening of a bridge that spans over two missing teeth, the first step is to assess whether the remaining tooth (the second molar) can adequately support a new bridge or if additional support is necessary.

Repair Options for Dental Bridges
1. Reconstruction of the Existing Bridge: If the remaining tooth is healthy and has undergone root canal treatment, it may be possible to reconstruct the previous bridge. However, the success of this option depends on the stability of the surrounding gum tissue and bone structure. If the tooth is strong enough, a new bridge can be fabricated to replace the missing teeth.

2. Adding Additional Support: If the remaining tooth cannot support the bridge adequately, it may be necessary to add another tooth as a support. This could involve placing a crown on the adjacent teeth to create a more stable foundation for the bridge. While it is understandable to be hesitant about altering healthy teeth, sometimes this is the best option for long-term success.

3. Material Considerations: The material used for the dental bridge can significantly impact both the durability of the bridge and the health of your oral cavity. Common materials include:
- Porcelain-Fused-to-Metal (PFM): This type offers good aesthetics and strength but may lead to gum irritation or darkening over time due to the metal base.

- Zirconia: Known for its strength and natural appearance, zirconia is less likely to cause gum issues and is biocompatible.

- Full Metal Bridges: While very durable, they may not be aesthetically pleasing and can sometimes cause gum irritation.

Impact of Material on Oral Health
The material of the dental bridge can indeed affect oral health. For instance, if a bridge is made from a material that causes allergic reactions or irritation, it can lead to inflammation of the gums, which may manifest as soreness or a tendency for the mouth to feel "broken" or sensitive. Additionally, poorly fitting bridges can trap food particles, leading to plaque buildup and potential decay in adjacent teeth.

In your case, if you have experienced frequent soreness or "breaking" in the mouth since the installation of the previous bridge, it may be worth discussing with your dentist the possibility that the material used was not optimal for your oral health.

Recommendations
1. Consultation with Your Dentist: It is crucial to have an in-depth discussion with your dentist about the best course of action. They can evaluate the condition of your remaining teeth and gums and recommend the most suitable materials for your new bridge.

2. Consider Hygiene and Maintenance: If you opt for a bridge design that allows for better cleaning (like a "hygienic bridge" that leaves a small gap for easier flossing), it may help prevent future oral health issues.

3. Long-term Planning: If you are considering dental implants as an alternative to bridges in the future, discuss this with your dentist as well. While implants can be more invasive and costly, they often provide a more permanent solution without compromising adjacent teeth.

In summary, the choice of material for your dental bridge and the structural integrity of your remaining teeth are both critical factors in ensuring a successful outcome. Open communication with your dental care provider will help you navigate these decisions effectively.

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