Dear Sir/Madam,
My question concerns a dental bridge. Seven months ago my dentist fitted a bridge. The upper left lateral incisor was missing, so the upper left canine (which was healthy, of course) was prepared and now supports the missing unit. The bridge is metal-ceramic. My problem is the following: even after seven months, the canine to which the bridge is attached still hurts when I bite, when it comes into contact with cold or very hot substances, and sometimes it even hurts when I breathe cold air. Because of these problems I have already been to my dentist three times, and the answer is that this is normal because the tooth underneath is vital and because the metal beneath the ceramic is a strong conductor of heat, cold and the pressures created when chewing food; he also says that I will have to get used to the foreign body, but he does not tell me how long this adaptation takes. I would not be writing to you if I were not already very worried that something had gone wrong with my bridge, and if I had not already been to my dentist three times because of this. With all due respect, I ask you to tell me what I should do and how to proceed. I should add that all my other teeth are fine and that only this lateral incisor, now replaced by the bridge, had caused me problems for 15 years, which is why my dentist had to extract it last year because I had developed a hidden granuloma.
Thank you for your answer.
Gabrijela

Question

Dear Sir/Madam,
My question concerns a dental bridge. Seven months ago my dentist fitted a bridge. The upper left lateral incisor was missing, so the upper left canine (which was healthy, of course) was prepared and now supports the missing unit. The bridge is metal-ceramic. My problem is the following: even after seven months, the canine to which the bridge is attached still hurts when I bite, when it comes into contact with cold or very hot substances, and sometimes it even hurts when I breathe cold air. Because of these problems I have already been to my dentist three times, and the answer is that this is normal because the tooth underneath is vital and because the metal beneath the ceramic is a strong conductor of heat, cold and the pressures created when chewing food; he also says that I will have to get used to the foreign body, but he does not tell me how long this adaptation takes.  I would not be writing to you if I were not already very worried that something had gone wrong with my bridge, and if I had not already been to my dentist three times because of this. With all due respect, I ask you to tell me what I should do and how to proceed. I should add that all my other teeth are fine and that only this lateral incisor, now replaced by the bridge, had caused me problems for 15 years, which is why my dentist had to extract it last year because I had developed a hidden granuloma.
Thank you for your answer.
Gabrijela

Accepted Answer

Dear Sir/Madam!
The condition you describe is very common. The canine was considerably affected during the preparation procedure. Removing enamel with burs is a radical procedure that can leave temporary or permanent consequences on the tooth. As long as the tooth is hypersensitive to temperature stimuli, we speak of a pre-inflammatory condition of the dental pulp. The condition may improve on its own because a vital tooth forms tertiary dentin inside the pulp chamber, which protects the pulp from external stimuli. The time required for sufficient self-protection can be up to one year. If the tooth becomes sensitive to biting, this indicates a consequence of inflammation of the dental pulp, which most often requires root canal treatment of the tooth, that is, removal of the dental pulp.
Have a nice day!

Dentist Tomaž Rotar answers: