Periodontal Treatment Options for Dental Bridge Issues

Q: Periodontal Treatment Options for Dental Bridge Issues

Hello Mr. <br>Rios： 1. <br>If the condition of the dental bridge is not ideal, such as poor marginal fit of the crowns, it is recommended to remove the bridge. <br>2. <br>If the periodontal condition is poor, such as bone resorption or gingival recession, you may consider consult

Regarding periodontal treatment issues?

Dear Dr.
Tseng,
I have a dental bridge on the far left side of my upper jaw consisting of four teeth, with the second to last tooth being missing.
Two weeks ago, I started experiencing significant pain in the gum of the outermost tooth whenever I ate.
I visited the clinic, and the dentist diagnosed me with gingivitis caused by periodontal disease, noting that there was gum recession around that tooth and destruction of the alveolar bone.
The root of the tooth that was originally covered by the bridge has become exposed.
Although the dentist scheduled me for cleanings and medication twice a week for a week, I still feel pain and swelling in the gums after every meal, making eating a painful experience and significantly reducing my appetite.
The dentist explained that due to gum recession, food debris gets trapped between the teeth and gums, so I should try to brush thoroughly after meals.
He suggested a "gum graft" or "periodontal regeneration surgery," but his clinic does not perform these procedures.
I also registered at the periodontal department of a hospital to see if the doctors there could treat this tooth surgically to preserve it.
However, the doctor's attitude was dismissive, stating he didn't know how to help me with periodontal treatment.
He mentioned that even if the bridge were redone, the tooth would not return to a healthy state, and that periodontal regeneration surgery would be a waste of money, as it wouldn't promote tissue growth.
He implied that I should just use the tooth for as long as possible before eventually extracting it.
I completely did not understand the dentist's meaning and felt he wanted me to give up on any treatment options, just wanting me to leave quickly to see the next patient.

On the other side of my mouth, the last three teeth are also missing, and I currently have three implants placed, with the bone integration process only halfway complete until mid-September.
Therefore, I have to rely on the four teeth of the bridge on the other side for eating.
I would like to ask the dentist:
1.
Does periodontal surgery require the removal of the bridge?
2.
Besides diligently brushing my teeth, are there any other treatment options or surgeries available that could help me preserve this tooth as much as possible? Is there a necessity to redo the bridge, considering it has only been in use for a little over seven months and has had multiple issues?
Thank you, Dr.
Tseng, for your answers.
Wishing you a pleasant and fulfilling life.

Rios, 40~49 year old female. Ask Date: 2023/07/11

Dr. Zeng Guanghui reply Dentistry

Hello Mr.
Rios: 1.
If the condition of the dental bridge is not ideal, such as poor marginal fit of the crowns, it is recommended to remove the bridge.
2.
If the periodontal condition is poor, such as bone resorption or gingival recession, you may consider consulting a periodontist for periodontal regeneration surgery.
Director Tseng Guang-hui, Dental Department, Nantou Hospital.

Reply Date: 2023/07/11

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your dental health, particularly the issues surrounding your dental bridge and periodontal treatment options. It sounds like you are experiencing significant discomfort and confusion regarding your treatment options, and I hope to provide some clarity.

1. Do periodontal surgeries require the removal of the dental bridge?
In many cases, periodontal surgery may necessitate the removal of a dental bridge, especially if the underlying tooth structure is compromised or if the surgery involves the area where the bridge is anchored. The purpose of periodontal surgery, such as flap surgery or regenerative procedures, is to address issues like gum recession, bone loss, and infection. If the bridge is contributing to the periodontal issues or if it obstructs access to the affected area, your dentist may recommend its removal to effectively treat the underlying condition.

2. What other treatment options are available to preserve the tooth?
Beyond diligent oral hygiene, which you are already practicing, there are several options to consider:
- Scaling and Root Planing: This deep cleaning procedure can help remove plaque and tartar from below the gum line, which may alleviate some of the inflammation and discomfort.

- Antibiotic Therapy: Your dentist may prescribe antibiotics to help control any infection that may be exacerbating your periodontal disease.

- Gingival Grafting: If gum recession is significant, a gum graft may be performed to cover exposed roots and improve the health of the gum tissue.

- Periodontal Regeneration: Procedures like guided tissue regeneration (GTR) can help regenerate lost bone and tissue around the teeth.

3. Is it necessary to redo the dental bridge?
The decision to redo the dental bridge should be based on a thorough evaluation of the current condition of the supporting teeth and the overall health of your gums. If the bridge is causing pain and contributing to periodontal issues, it may be worth considering a replacement. However, if the bridge is stable and the primary issue is with the gums, focusing on periodontal treatment may be more beneficial.

4. Communication with your dental provider:
It’s crucial to have open communication with your dentist. If you feel that your concerns are not being adequately addressed, consider seeking a second opinion from another dental professional, preferably one who specializes in periodontics. A specialist may provide more insight into your condition and offer additional treatment options that could help preserve your dental health.

5. Long-term considerations:
Given that you have other missing teeth and have undergone implant procedures, it’s essential to maintain the health of your remaining teeth and gums. Poor periodontal health can lead to further tooth loss, which may complicate your overall dental situation. Regular check-ups and cleanings, along with any recommended treatments, are vital to maintaining your oral health.

In summary, while periodontal disease can complicate the longevity of dental bridges, there are various treatment options available to help preserve your teeth and improve your gum health. It’s essential to work closely with your dental team to determine the best course of action tailored to your specific situation. If you feel uncertain about the recommendations you’ve received, don’t hesitate to seek a second opinion. Your comfort and health are paramount.

Wishing you the best in your dental journey.

Sincerely,
Doctor Q&A Teams

[Your Contact Information]

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