Should I Get a New Maryland Bridge If My Dentist’s Re-Bonding Attempts Failed?

I got a Maryland Bridge in 1998 from my previous dentist in Maine. Last year, the bridge loosened, but my current dentist can’t secure it well. The bridge has fallen off four times since last September. My dentist even admitted that the bridge is well-constructed. I’m concerned that a re-bonding issue has escalated to the point where I will need a new bridge. I don’t want to be suspicious about my dentist’s intent. Should I consult another dentist before asking my dentist to replace the bridge? Thanks. James from IL

James,

A Maryland bridge can be a conservative way to replace a missing tooth. However, it only works if a dentist completes every step correctly. When a dentist struggles to keep a bridge in place, the issue is often the bonding technique.

Why Bonding a Maryland Bridge Can Be Complex

The back side of lower teeth with a Maryland bridge replacing an incisor — Maryland bridge replacing a lower incisor

Bonding a Maryland bridge is more complex than it sounds. The process involves preparing both the tooth and the metal surface to form a strong, lasting connection.

For metal-wing bridges, proper bonding includes:

Thoroughly cleaning the metal surfaces
Etching the metal to create microscopic retention
Using a durable bonding agent, such as Panavia, designed for metal

If these steps aren’t followed closely, the bond can fail.

Why Your Maryland Bridge Originally Worked

A 28-year lifespan is superb for a Maryland bridge. That tells me the original dentist handled the preparation and design correctly. When the bridge came off, the problem occurred during the re-bonding process. The metal must be re-treated before bonding again. If not, the new bond won’t hold.

How to Find a Dentist to Re-Bond Your Maryland Bridge

You want a dentist who understands this type of bonding and uses the right materials. That doesn’t happen by chance.

Before scheduling treatment, ask:

Are you experienced with metal-bonded Maryland bridges?
Do you use systems like Panavia for bonding metal?
What steps do you take to prepare the metal before bonding?

You can also look for dentists affiliated with the American Academy of Cosmetic Dentistry or those with advanced training through the Academy of General Dentistry.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post. Read why many of his patients say he is one of the best dentists in town.