Dental bridges are a common and effective way to replace missing teeth. It consists of crowns fitted over the teeth adjacent to the gap, called abutment teeth, which are then fused with one or more false teeth called pontics, to hold them in place and replace the missing teeth.
The bridge with crowns and pontics is custom made in a lab before being cemented permanently into place to give you a long-lasting dental restoration. However, without proper oral hygiene, the teeth supporting the bridge can develop tooth decay and other problems.
Tooth decay under a dental bridge often goes unnoticed until it reaches advanced stages. Early symptoms to watch for include tooth sensitivity to hot, cold, or sweet foods, pain when chewing on the affected side, bad breath from the bridge area, gum inflammation around abutment teeth, visible cavities or holes in bridge pontics, stains under the bridge, and looseness or a defective fit of the bridge.
Since decay under bridges is difficult to self-detect, it’s important to see your dentist every 6 months for exams. They can identify decay through x-rays and visual inspection even before you notice any problems. Catching decay early allows for simpler treatments like fluoride or fillings instead of needing full crown or bridge replacement.
Causes of Tooth Decay under a Bridge
Tooth decay, also called dental caries, occurs when oral bacteria consume sugars and produce acids that erode tooth enamel. This can happen anywhere in the mouth, including under a bridge on abutment teeth if plaque is allowed to build up.
Potential causes of tooth decay under bridges include:
Inadequate oral hygiene
Not cleaning properly around bridge areas allows plaque to accumulate. This plaque harbors decay-causing bacteria.
Food getting trapped
Food particles easily get wedged under bridges, giving bacteria food to feed on.
Reduced saliva flow
Dry mouth and reduced saliva causes less natural flushing of bacteria and acid.
Poor bridge fit
Gaps between the bridge and teeth allow food and plaque to become trapped.
High amounts of cavity-causing bacteria
Some people naturally have more streptococcus mutans and other bacteria that can cause extensive decay.
Frequent snacking
Frequent exposure to sugars from snacking or sugary drinks gives bacteria the fuel to produce enamel-eroding acid.
Symptoms of Decay Under a Bridge
Decay can occur on the abutment teeth under crowns or on pontics fused to the crowns. Symptoms you may notice include:
- Tooth sensitivity – Especially to hot, cold or sweet foods.
- Pain when eating – Mostly when chewing on the affected side.
- Halitosis – Foul odors from the bridge area caused by bacteria and decay.
- Gum inflammation – Red, swollen gums near the bridge.
- Visible holes or fractures – Holes appearing in the bridge material exposing inner metal.
- Stained or loose bridge – If the cement seal breaks down, stains and mobility can occur.
- Abscesses – Swelling and pus around abutment teeth indicating pulp infection.
The only way to confirm decay under a bridge is through dental x-rays or an examination by your dentist. Decay is often invisible and difficult for even the patient to detect, so dental visits every 6 months are essential. Let your dentist know immediately if you notice any symptoms or experience sensitivity, discomfort or bad tastes around your bridge.
Treating Decay under Bridges
If decay is detected under a bridge, prompt treatment is needed to prevent damage to abutment teeth and replacement of the bridge. Treatment options include:
Fluoride
Increasing fluoride through treatments, prescription toothpaste, or daily rinses remineralizes and strengthens enamel under the bridge.
Improved oral hygiene
Your dentist can instruct you on how to thoroughly brush and floss around the bridge to disrupt plaque. Water irrigation tools can also aid cleaning.
Dental fillings
If cavities are small, fillings placed under the bridge can restore abutment teeth. Porcelain fillings best match bridge color.
Crown replacement
If decay is extensive, the affected abutment crown may need replacement to stop decay and prevent loss of the tooth.
Bridge removal
In severe cases, the bridge will need to be completely removed to allow access and visibility for proper decay treatment. A temporary bridge can be placed while the permanent bridge is removed for repair.
Root canals
If decay infects the pulp of abutment teeth, a root canal procedure may be required to save the tooth.
Antibiotics
If infections are present in surrounding gums or tooth pulp, antibiotics may be prescribed.
Chlorhexidine rinses
Prescription antimicrobial rinses can help control bacteria levels in the mouth.
Diet changes
Reducing snacking frequency and avoiding sugary and acidic drinks prevents additional decay.
Preventing Decay under a Bridge
Practicing good oral hygiene and getting regular dental care can help minimize your risk of tooth decay under a bridge. Prevention tips include:
- Brushing carefully under the bridge at least twice daily. Use an interdental cleaner to remove plaque from around bridge areas.
- Flossing effectively each day, lifting the floss out from under the bridge instead of sawing back and forth.
- Seeing your dentist every 3-6 months for exams and professional cleanings.
- Using an antiseptic mouthwash to reduce oral bacteria.
- Receiving fluoride treatments and using prescription strength fluoride toothpaste.
- Having any defective edges of your bridge smoothed to eliminate food traps.
- Quitting smoking, as smoking increases risk for all dental problems including decay.
- Maintaining a healthy diet low in sugary and high acid foods and beverages.
Promptly seeing your dentist at the first sign of bridge problems can help catch decay early and improve outcomes. Avoid letting problems progress to the point of requiring full bridge replacement. With vigilant home care and dental visits, your bridge can last for many years.
