DENTAL CARE

Jeffrey Gross, DDS, FAGD

Q: The Broken Bridge (Part II)?

A: I met a new patient this week who just happened to read my previous column. If you remember, we discussed the ability to fix a bridge and reuse it. Last week we discussed why a bridge may break and the role of dental decay in this process. This week we will discuss another type of broken bridge which hit home with this patient who read my article. However, the situation was actually different than what he read. Nonetheless, the title made an impact and he came to see me. Allow me to tell you the story. The case this week involved an upper removable bridge. Remember this is a bridge that the patient takes in and out on a daily basis for cleaning or whatever reason presents itself. The tooth replacement device has tooth colored teeth and pink acrylic to simulate and replace those missing parts in the mouth. Acrylic is everywhere as evidenced by all the plastic that is in cars today, both inside and outside. It is moldable, lightweight and easy to repair. In the mouth though, we have to keep it thin for comfort reasons. The thinness together with the tremendous forces that we apply to it during chewing makes it prone to breakage. Because of this metal is used to reinforce the bridge and allow it to stand up to normal wear and tear. So what happened with our patient? He had a bridge with the metal reinforcement on the upper. On the lower he had another bridge and some teeth left. He was able to produce so much force that he actually caused the metal on the upper to split in half. He showed me 2 pieces of his once whole upper bridge. He held the 2 pieces in his mouth with a lot of adhesive. Of course, during chewing this easily broke down. He told me that he likes to eat and this broken bridge was definitely cramping his style. The question that I had when I looked at him was why the metal failed. It didn’t take me long to figure it out. He only has 2 teeth holding the whole upper bridge. These 2 teeth are right next to each other. The result is a tremendous amount of stress on the teeth and on the bridge. One of these teeth is already somewhat loose and of course the bridge is cracked in half. So what did I suggest? One choice is to remove the remaining teeth and go to a full denture. He did not even want to consider this. Our other choice was to provide more supports so both the 2 teeth and the bridge are now protected. This would allow him to chew better and of course give him a nice and Healthy Smile. I recommended adding 3 implants to create this support. One would be placed on the side with the 2 teeth. The other 2 implants would be placed where he has no teeth at all. With proper spacing and alignment using computer guided techniques, I could create a stable structure. I also incorporated into design the ability to modify the bridge in case he lost one or both of the remaining teeth. His lower bridge was stable and I do not have alter that to allow me to fix the upper problem. Many times in dentistry the difference between success and failure in tooth replacement is dependent on correct design and utilization of proper engineering principles. Yes, besides learning about the human body we also study physical properties to help us create a case that will work. If you have some loose or broken teeth … or a loose bridge or denture, consider getting it looked at and corrected. Besides the inconvenience, the damage that it can do to you can be considerable. Give Megan a call at 440.951.7856 and schedule some time with me to evaluate your concerns. I look forward to meeting you. 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 34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com