Dental Bridge Issues: Causes of Decay and Sensitivity

The natural tooth under the dental bridge has developed decay?

The situation is that I had a dental bridge made in August of last year, using titanium alloy.
However, the dentist advised me to monitor it for any food trapping, so the bridge was not fully cemented.
Recently, I noticed that the bridge was loose and upon examination, I discovered that the underlying natural tooth had decayed significantly.
I was shocked! It has only been a year and a month, and now it’s hollow inside, which explains why the bridge is unstable.
The dentist advised me to avoid sugary foods and to maintain good oral hygiene, but I can't completely eliminate sweets from my diet.
I brush my teeth properly and use dental floss for each tooth, and I also use interdental brushes to clean the bridge (though I usually don’t find anything).
When I'm out and it's inconvenient, I at least rinse my mouth with water.

I want to understand why there are gaps that allow food debris to get trapped inside, leading to decay from within.
Is it normal practice not to fully cement a dental bridge? Does not cementing it lead to gaps? Could it really be that I’m providing too much nourishment (from sweets) for bacteria? The dentist mentioned that the material for dentures should be of high quality, but I really can't afford "premium" options.
Moreover, I previously had a cheaper dental crown that lasted for 10 years.
If this is my fault, I should change my dietary habits, but I want to understand if there are other possible reasons.
Recently, I have another crown with the same issue, which also developed gaps and decay after just over a year.
Is it due to insufficient sealing, or as the dentist suggested, is it because of gum recession causing the gaps?
Additionally, I have recently started experiencing sensitive teeth, and another dentist indicated that I have bruxism, which has led to exposed tooth roots.
They suggested that I get a bite guard to help with the sensitivity.
Will I need to spend more money on a bite guard? Is the sensitivity due to gum recession, which is also causing the short lifespan of my dentures and the gaps that lead to decay from within? Thank you, doctor, for your help.
I really want to understand the situation better and avoid spending unnecessary money, as my finances are quite strained.

Anna, 30~39 year old female. Ask Date: 2015/09/12

Dr. Zeng Guanghui reply Dentistry

1.
After more than a year, the titanium alloy dental bridge became loose due to decay of the natural teeth underneath, which may be attributed to the gradual loss of the temporary adhesive used for the bridge.
This resulted in a gap between the bridge and the natural teeth, allowing food debris or bacteria to accumulate.
Increased consumption of sugary foods can further exacerbate the risk of cavities.
It is recommended to seek further evaluation and treatment from a dentist.
2.
The causes of sensitive teeth include gum inflammation leading to gum recession, improper brushing techniques over an extended period resulting in abrasion at the tooth neck, excessive consumption of sugary or acidic foods leading to dental erosion, or excessive occlusal forces causing wear on the occlusal surfaces.
It is advisable to consult a dentist for a thorough examination and treatment.

Reply Date: 2015/09/12

More Info

When it comes to dental bridges, understanding the underlying causes of issues such as decay and sensitivity is crucial for maintaining oral health and ensuring the longevity of dental restorations. Based on your description, several factors may contribute to the problems you are experiencing with your dental bridge, including the material used, the fit of the bridge, oral hygiene practices, dietary habits, and potential underlying dental conditions.

Firstly, the fact that your dental bridge was not fully cemented can lead to gaps between the bridge and the underlying teeth. These gaps can trap food particles and bacteria, creating an environment conducive to decay. If the bridge is not securely bonded, it may also allow for movement, which can exacerbate the issue. While some dentists may choose to leave a bridge uncemented for various reasons, it is generally advisable to ensure a proper seal to prevent food accumulation and bacterial growth.

The material of your dental bridge, titanium alloy, is known for its strength and biocompatibility. However, the longevity of any dental restoration also heavily relies on how well it fits and how well you maintain it. If there are any discrepancies in the fit, such as poor margins or inadequate adaptation to the underlying teeth, this can lead to decay at the margins. Regular check-ups with your dentist are essential to monitor the condition of the bridge and the health of the supporting teeth.

Your concern about dietary habits, particularly the consumption of sweets, is valid. Sugary foods can contribute to the development of cavities, especially if oral hygiene practices are not sufficient to remove plaque and food debris. While it may be challenging to eliminate sweets entirely, it is important to practice good oral hygiene, including brushing at least twice a day with fluoride toothpaste, flossing daily, and using an antibacterial mouthwash. These practices can help mitigate the effects of sugar on your teeth.

Additionally, you mentioned experiencing sensitivity in your teeth, which could be linked to gum recession. Gum recession can expose the roots of your teeth, making them more susceptible to sensitivity and decay. If your dentist has suggested a bite guard due to grinding (bruxism), this could be a beneficial investment. A bite guard can help protect your teeth from the damaging effects of grinding and may alleviate some of the sensitivity you are experiencing.

In terms of the longevity of your dental restorations, it is important to recognize that factors such as oral hygiene, dietary habits, and the health of your gums and teeth play significant roles. If you are experiencing recurrent issues with your dental bridges, it may be worthwhile to seek a second opinion from a different dental professional. They can assess the fit of your current bridge, evaluate your oral hygiene practices, and provide recommendations tailored to your specific situation.

In conclusion, while the issues you are facing with your dental bridge may stem from a combination of factors, addressing them through improved oral hygiene, dietary adjustments, and regular dental visits can help enhance the longevity of your restorations. If you continue to experience problems, consider discussing your concerns with your dentist to explore potential solutions, including the possibility of re-evaluating the fit and material of your dental bridge.

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