How to best care for of a fixed bridge?

By Lawrence Spindel D.D.S., Thursday, July 05, 2012


Many people do not know how to clean properly around their fixed bridge. Some don’t even understand why they would need to. After all their teeth are covered with connected crowns so they must be protected, right?

This is a major misconception. Although teeth covered with crowns or fixed bridges are covered, they are still vulnerable to tooth decay and especially periodontal disease. The margins around bridged teeth are never as smooth a natural tooth and can, at least on a microscopic level be plaque traps. Plaque accumulated around the margins of a crown can cause demineralization of the adjoining tooth structure and washout of the permanent cement holding a crown or bridge. For the same reason, fixed bridges can be more prone to developing gum disease and bone loss.  The connections between the units of a fixed bridge make traditional flossing impossible. Instead patients with fixed bridges need to know alternative ways to clean the interproximal areas of their fixed bridges.

Patients should be taught the proper use of floss threaders, small interdental, or Stimudents (orange wood triangular tooth picks). With the proper homecare a person can make it much more likely to keep the teeth holding their bridges in healthy shape for the long haul.

Often patients should consider using a good quality electric toothbrush, since these can facilitate cleaning and do improve most patients ‘oral hygiene in general.  Oral B or Sonicare make good models that have rechargeable batteries and are reliable.

Water Piks can be an extremely useful tool for a patient with a fixed bridge to employ. Although they are definitely not meant to replace the methods of cleaning previously mentioned, they are an extremely effective adjunct since they are very good at flushing out food trapped food particles and do help cause a flushing out of their crevicular fluid (the fluid found in the crevice between marginal gingiva and a tooth) around teeth holding a bridge.  This fluid can be seeded with harmful bacteria and the gingiva seems to benefit from frequent use of a Water pik. Most periodontists find less gingival inflammation in patients using a Waterpik than those who do not.

Having professional and regular cleanings at a dentist office can be crucial to dental health., This is especially important since bridge margins are often not entirely flat or smooth. Many bridges have margins that act like tiny ledges for plaque to hide under and can be difficult to keep clean with regular tooth brushing alone.   Dental hygienists are expertly skilled in cleaning around crowns and bridges and will be able to get them clean. Also, they will be able to pin point any areas that are being missed by a patient and will be able to suggest ways of a patient doing a better job.