Healthy Smile: My Bridge Fell Out!

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

The exclamation mark does not do justice to the concern and level of anxiety that this person felt. What was even worse than the loss of the bridge was the fact that it broke into pieces. Last but not least, this bridge involved the front teeth resulting in no smile for this holiday week. People are off from work, families are getting together, and we have no front teeth. I will give you a little background and then discuss how we stepped in to correct and fix the problem.

As we discussed in previous columns, there are two types of bridges. One type, also known as a partial denture, easily comes in and out of the mouth. The design of a removable bridge is such that the patient or doctor places it in the mouth for cosmetics and function, followed by removal for cleanliness. The second type of bridge is called a permanent bridge. The word permanent in this context means that we have no intention to remove the bridge. A special type of glue that we call dental cement attaches the bridge to the teeth underneath it. The latter version of a dental bridge is our subject today. We create a permanent bridge to stay in place for many years or even decades. You can imagine the surprise when the bridge fell out.

When a bridge dislodges from the underlying teeth, I want to determine the why of the situation. The problem could be as simple as weakening and dissolving of the dental cement for older bridges. I carefully examine the underlying teeth to make sure that they are healthy, clean the inside of the bridge and reattach it to those teeth. If the supporting teeth show damage or fracture, I enter into a different conversation with the patient about the future of those teeth.

The more complicated question comes when the bridge is damaged or broken, as in our case. The emergency goes down a notch if the bridge involves replacing back teeth. Our case has a cosmetic component. The bridge went all across the front teeth. My goal is to make something as fast as possible and then deal with the permanent bridge or its remnants.

In some cases, I carve and create teeth from a block of plastic to give a smile to a patient. This technique is time consuming and detailed as I can’t work outside the mouth as a dental lab can. If I am lucky and the patient is not new to the practice, I may have a mold to help me make a stopgap bridge. The bigger question is how do I recreate the perfect bridge that the patient lost, so their smile does not radically change in a short time.

Fortunately, I went digital with crown work several years ago. My lab has access to the previous work and design. Although he will require a new bridge, the excellent result that we achieved is a relatively simple task to repeat. That fact is great news for the patient and the doctor.

Blending proven techniques with new technology is my approach in the practice. Digital techniques allow me to do procedures that would have been impossible or, at best, complicated and time-consuming in the past. If you have bridges in your mouth for many years, it would be a good idea to check their health before you end up with a broken bridge and missing teeth. Call 440.892.1810. I wish all of you the best for the upcoming year.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com