HEALTH Focus

Q:My Bridge Keeps Dropping. What Can I Do?

A:We have discussed bridges before. Just to review for those who may have missed that talk, let’s see why we have a bridge. There are times that despite the best efforts of modern dentistry, a tooth or teeth may be lost. We now have a space in our mouths. Sometimes these spaces are large and other times these are small. Whatever the size of the space that is present, the solution is the same. We need to fill the space and stabilize the entire mouth and the teeth in it. This is done with various types of replacements. One way to replace missing teeth is with implant dentistry. That is not our focus today. Our focus for this column is the use of a bridge to fill a space and replace the missing teeth. Bridges can come in two varieties. The first style is a fixed or permanent bridge. This is something that the dentist places with a special type of glue. Both the patient and the dentist do not plan on removing it. It is in place “permanently.” The other type of bridge that is used is one that comes in and out. It is a removable bridge. Sometimes it is called a partial denture. This one can be removed by the patient and the doctor. The difference between them is rather obvious. The first one does not move at all. It is glued into place and is rock solid. The second one can not be locked in so intensely. After all it has to be removed for cleanliness of the teeth and of the bridge. This is the one that my patient was talking about. Now let’s explore his issue. Bridges that come in and out are anchored to one or more of the remaining teeth. They grab the teeth with some type or wire or plastic. This all depend upon the design of the bridge. So what is going on over here? The bridge has to grab the tooth or teeth that it connects to, but it can’t grab so tightly that we can’t get it off. How does this work? The concept behind it is dependent on two factors.

The first factor is using a metal or plastic that has some give or spring to it. When forced it will move just a little bit. After the force is removed, it goes back to its original shape. This elasticity can be controlled by the shape of the connecting part as well as the material. The second factor is what applies the force to the connector and keeps that force consistent. This is accomplished by that actual shape of the teeth. Teeth have bulges and depressions. The bulge part of the tooth applies the force to the connector to make it spring. The depression is what allows the connector to go back to its original shape. However once it’s in it’s final position it has to hold the bridge to allow the patient to talk and chew.

The patient that I saw this week had a bridge with excessive depressions. The result was a very loose bridge which flopped around. When I first looked at his situation, I was hard pressed to find a solution. Even a brand new bridge would still have the same problem. The problem was not the bridge. It was the shape of the tooth. I decided to modify his grabbing teeth with some simple bonding. No drilling … no shots… no pain. I was able to change the appearance of his teeth to create a great grab on his bridge. He could remove it with ease, yet when in place, it afforded him the stability that he wanted and needed. This was a very easy fix for a very frustrating problem. There are so many times that basic dentistry can be a real challenge for both the patient and the doctor. So much of our current education focuses on the latest and greatest digital solutions that many of the fundamen- tal principles are forgotten. If you are struggling with a situation in your mouth, why not call Megan and set up visit for a second opinion. I may not be able to offer any more help than your first opinion, but oftentimes I can come up with something \creative to help you. Call us at 440.951.7856. I would love to talk with you.

Lastly let me not forget to wish all of my readers a Happy Thanksgiving. Be grateful for all that you have as we all know someone who is not as fortunate and blessed as we are. Getting up every day is the greatest gift that we have. Everything else that icing on the cake.