DENTAL CARE

Q: I Feel a Rough Spot on My Bridge

A: Bridges are used to replace missing teeth. Bridges really come in two flavors. Those that are fixed or cemented into place and those that can be removed by the patient. The first type of bridge is called a permanent bridge while the second style is referred to as a removable bridge. Our patient this week had the permanent form. It had been around for many years and served her well. Lately, though she noticed something unusual. Something was rough to her tongue. Let’s explore how a rough spot develops and what it may mean. As I mentioned, this bridge had been in her mouth for a good number of years. She had it in her mouth when she came to me a couple of years ago. It is well known that teeth take a tremendous amount of abuse. They need to tear, chew and grind our food. They are bombarded with all kinds of chemicals in food as well as those chemicals that the body produces. Teeth are the hardest tissue in the body. Teeth are harder than bone. They are meant to last a lifetime if we take of them. When a dentist makes a bridge for a person, he or she will utilize materials that should last for many years or even many decades. Dentistry studies the physical properties of many elements. In fact, there is also an approval process for the materials that we use for replacement teeth. It needs to hold up as well as our natural teeth do. With this understanding, I was curious to find out what the “rough spot” was. Bridges are highly polished and strong. “Rough spots” just don’t happen. Upon examination of the area, the rough spot was at a point where the bridge butted up to the tooth that was holding it in place. The roughness that was there was not a result of the bridge breaking down. Instead, it is a consequence of the tooth breaking down. This patient exhibited a root cavity that penetrated deep into the tooth. It was deep into the tooth and under the bridge. There is nothing in my skill set that would allow me to salvage that old bridge. The only way to eliminate the cavity in the root and its corresponding unhealthy bacteria was to remove the bridge. Now we have a new problem. My patient gags easily. On top of this, she is used to and entirely comfortable with something permanent. Once I remove the root cavity, not only does the bridge go but the supporting tooth, which is now infected, needs removal. What is she going to do? I suggested that she convert her permanent bridge situation to an implant situation. By doing this transformation, she could retain all the benefits of the permanent bridge and infuse new life into that section of her mouth. In this case, I could make as little waves as is possible in our treatment approach. The less that you change a situation that someone is accustomed to, the greater chance that you have for a pleased patient and a successful outcome. I still have to determine if she has enough supporting bone for an implant and then design the treatment details. However, she is delighted with the knowledge that she can stay with a permanent solution. A solution that she is comfortable with, rather than a whole different approach to her missing teeth. Once again, we are approaching the end of the year and the holidays. I have run a very successful campaign in previous Decembers offering all new treatment diagnosed with a 20% discount on all services. If you are in great shape and have a healthy mouth, then take advantage of our offer for complementary nutritional counseling with our affiliated nutritionist. Either way, you are in a win-win situation. Call Megan at 440.951.7856 and set up a time for us to meet. I look forward to helping you look and feel your best. Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

Jeffrey Gross, DDS, FAGD