Metal showing on my maryland bridge

I’ve had a Maryland Bridge for 20+ years. I’ve never had any problem with it. However, a week ago I needed a crown placed. In order to get a comfortable placement, my dentist had to adjust my bite a bit, which included grinding a bit on the Maryland Bridge. The next morning, I noticed a silver spot where the metal was showing through. I went back and he said the problem was likely because I grind my teeth. He bonded a composite filling on it, but that was gone by the next day. He still insists it is from my grinding and says there is nothing more he can do to fix it. I’m finding that hard to believe as I’ve not had a problem with this bridge until he messed with it. It’s a little intimidating to argue with him, though. What do you recommend here?

Penny

Dear Penny,

Diagram of a Maryland Bridge
Maryland Bridge

While I haven’t seen the tooth, I think you and I both know that he is the culprit here. However, he’s the dentist and therefore in the authoritative position which makes it tricky for you to confront him, especially if his pride interferes with his integrity.

One thing I’d like you to do is get a second opinion. Some dentists will even give you a free second opinion. They’ll be able to tell if he caused the damage. If you drag a metal explorer over glazed porcelain, it won’t leave a mark. However, if the porcelain has been ground on with a dental bur, a distinct mark on the porcelain will be visible.

Once the second dentist has armed you with the information you need, you may be able to get him to admit his error. In truth, every dentist has had this happen. The shame is more in not being willing to try and make it right.

A Possible Fix for Your Bridge

There is a possible way to fix this without having to replace the bridge. It is worth a try, though it doesn’t always work. When your dentist placed the composite filling. it doesn’t sound like he did anything to prepare the metal.

Here’s the procedure I’d recommend. You are welcome to show him this post. There is one bonding cement which will bond to metal— Panavia.

The first step will be to grind away more metal to make way for the materials needed. Then, use a micro-etcher to prepare the spot. From there, prime the metal and then add a thin opaque layer of Panavia over the metal and cure it. After that is when your dentist can place the composite.filling.

If that doesn’t work, your best option is to replace the bridge.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.