Pocket of 5mm on supporting the bridge tooth

[Moonandthestars]

SRP done on bridge tooth.

Hello, on Monday I had SRP done on the upper left 4 (root filled) which is a supporting tooth of 4,5,6 bridge upper left bridge.

All 24 teeth are crowned.

Reason why I had SRP done was that the xray revealed bone resorption on the 4 upper left. Pocket was 5mm.

Every time I put the tongue by the 4 tooth I feel metallic taste which could indicate increased iron hemoglobin in blood which happens when infection is still present. I keep flossing, waterpiking, using interdental brushes and keeping it very clean, brushing after each meal.

When I use interdental brush or superfloss to clean by the 4 tooth area it hurts by the root where the bone loss is. But bleeding had decreased significantly. Slight throbbing is felt too but it was felt before the SRP too.

The pain is kind of like "touching raw".

Is this because its still inflamed or could the root be broken? No fistulas present on the gum which I understand ate usually presenr if the root is fractured.

Is lack of or significantly reduced bleeding a good sign?

I am concerned that SRP hadnt worked or the root is broken. My dentist is saying its not broken but the tooth has ben root filled for quite a while (years) but crowned so assuming bite impact reduced? Worried of it being brittle.
The gum portion betwen 4 and 5 goes "in and out" whem I suck or swish mouth wash and feels like its not reattached yet.

I am worried it will not start to reattach as its meant to, especially as I keep superflossing daily when still raw.
Any positive reassurances about this tooth and that root isnt cracked or fractured please.

Its a bridge, 3 teeth to be potentially lost in play

 

[Moonandthestars]

anyone please?

 

[Dr M]

So there is a lot of possibilities here. The location of the bone loss around the root ( lateral ) , might be an indication of a crack, but the CBCT images provided does not provide a clear enough image in order to say so for certain. The fact that root canal treated premolar was the only anchor on one side, might have increase the risk of fracture over time due to the forces on the tooth. The reduced bleeding might be an indication of a decrease of inflammation, but a follow-up in 6 weeks or 3 months is needed in order to evaluate the area again and to look out for more bone loss. Keep in mind, if bone was already lost in this area, it might influence the soft tissue as well, creating an area underneath the bridge where food will keep getting stuck.
That being said-worst case scenario, the tooth is cracked. I would follow up and if I see it worsens, then you can consider sectioning the bridge in the area of the molar, which means you end up losing 2 teeth only. The root canal treated tooth and the pontic. This can then be replaced with implants if bone allows with/without bone augmentation.

Use the bridge for as long as possible, but just make sure that you follow up on a regular basis.

 

[Moonandthestars]

Thank you for your response. Why does the gum feel so raw, burning, metalic tasting especially when superflossing and i/dentally brush cleaning underneath the bridge by the root of the 4? When I dont put superfloss or interdental brush underneath the bridge near the number 4 tooth, it seems less metalic tasting and raw.
Is it because of the gum inflammation being prodded?
Dentist said she heard high pitch when doing SRP root cleaning saying its a good sign.
What does that mean pls?
Could the affected tooth last few more years?
I am so worried. Thank you

 

[Dr M]

The metallic taste is common when you are cleaning between amalgam fillings or metal bridges. The gum might feel raw, because it is still irritated in that area. You can try a disinfectant mouthrinse as an adjunct to normal flossing and see if it helps. In my opinion, I would use the tooth for as long as possible. How long is dependant on how clean you keep the area and if you try and keep to softer foods on that side.