Dental Bridges

What are the Risks and Potential Complications of having a Dental Bridge?

As with any treatment, the dental bridge is not without its risks.

The potential problems of a traditional fixed bridge are pretty much the same as the risks of having a crown only proportionally greater because a bridge involves more crowns. If a problem occurs with one of the abutment teeth it can potentially compromise the whole bridge putting you back to square one, or even further behind if it means another tooth gets lost.

The bigger the bridge, the more teeth are involved, the larger the stresses placed on it and therefore the greater the likelihood of something going wrong.

You can potentially get a problem with one or both of the adjacent teeth - both would be severely unlucky!

In summary, the risks are:

  • Wear of opposing teeth
  • Nerve problems
  • A dark line at the gum (see aesthetic problems below)
  • A chip or fracture
  • A bridge coming off because:
(i) The cement fails – this is good because it means generally it can just be stuck back in

(ii) The core fails- generally a pretty bad sign- the bridge is likely to need replacing with some extra modifications (and expense).

Additional Issues include:

  • Hygiene problems
A bridge does not allow normal floss to pass through and requires special cleaning instructions. This means that the potential for plaque to collect around it and lead to decay or gum disease is higher than an individual crown or an implant.

  • Aesthetic problems
Assuming you have no functional problems with the bridge you may find in 10-20 years because your gums have shrunk it just doesn’t look like it used to. If it is at the back of the mouth then this will actually make cleaning easier and is unlikely to be a major problem. If however, it is your front teeth, then if the looks are no–longer acceptable to you, the only option may be to replace it.

For more information about these points see- Risks and problems in crowns

Resin retained bridges (aka sticky or bonded bridges) are more prone to coming off than a normal bridge. More commonly they are of the cantelever type, meaning they are only attached on one side because if the cement fails, it will cause the bridge to fall out. If it has wings on both sides, one side can de-bond and you can get caries underneath without noticing, which if this goes undetected for some time, could land you with a large problem.

If this type of bridge fails repeatedly, you can progress to a more traditional fixed bridge or perhaps an implant crown.

Does my Bridge need Replacing?

A dentist will need to see you in order to make this decision.

The problems stated above can lead (if left untreated for a number of years) to the whole bridge needing to be replaced. It is important you understand this is a possibility if you don't look after it properly and get regular dentists check ups . If this happens, you most likely will be charged again.

If they feel there was some error in planning or execution on their part, they will use appropriate discretion when it comes to the amount they charge you- (at least I would hope so). Unfortunately, it is almost impossible to guarantee things in dentistry, because what happens after leaving the surgery is beyond the dentist’s control. That said, I personally think it is important to make every effort to look after patients who make the considerable financial investment of having a dental bridge or other more extensive dental treatment.

It is worth bearing in mind that dental bridges for one reason or another may need replacing between 10-20 years down the track, though they may last considerably longer. Whilst implants are not without their problems, an implant would be expected in most cases to outlive a bridge. Each case is quite different so when you are talking time frames you can only ever generalise and give ball park figures.

The importance of regular check ups cannot be stressed enough- that's why I am mentioning it twice in this section! If problems such as gum disease or decay can be detected early, they can hopefully be rectified without affecting the bridge.

Can my Bridge be Repaired?

Your dentist will be able to tell you whether it is possible to repair your dental bridge or the whole thing is going to need to be replaced.

A small amount of decay or slight deficiency at the margin of the bridge can often be repaired with a bit of white filling material. Small fractures can sometimes be repaired with composite or just smoothed if they are not an aesthetic problem and of concern to you.

If the nerve plays up and a root canal treatment is needed in one of the supporting teeth, it can sometimes be performed through the bridge without the bridge needing to be replaced. This is a bit more tricky than normal and will slightly affect the integrity (strength) so we try as best as possible to avoid this situation. It does happen though and following the root canal, the access (hole) in the top can just be filled with white or silver filling material to restore the crown.

A glass- fibre reinforced composite bridge is much easier to repair should problems occur and rarely would it be necessary to replace the whole thing.