In the late 1990s, my cosmetic dentist in NJ gave me a beautiful Maryland bridge. It’s held up well even though I grind my teeth at night and rarely wear my night guard. I’m not bragging about going without my night guard – my former dentist’s work is impressive. Even my current dentist in CT admitted it. In mid-April, I had some dental work completed. I couldn’t delay getting two crowns.

In the process of trying to adjust my bite with the new crowns, my current dentist reduced the Maryland bridge tooth. A few days later when I was looking at my teeth in the mirror, I noticed a silver dot showing through that same tooth. I scheduled an appointment for my dentist to look at the tooth, and he said the metal is finally showing through because I don’t wear a nightguard. He covered the dot with composite filling, but the metal is showing again. Could the metal suddenly show through the Maryland bridge tooth, although I didn’t have any problems before? Thank you – Tamar

Tamar,

Your dentist doesn’t want to admit that grinding down the tooth in your Maryland bridge caused the metal to show through. If he admits it, he’s obligated to replace your bridge. It is possible that after he thinned the bridge that your teeth-grinding habit exposed more of the metal. But the evidence suggests that the problem occurred after your dentist adjusted your bite.

When Your Dentist Grinds Your Crown Down to the Metal

Get a second opinion – Many dentists will give you a second opinion at no charge. How will a second opinion help?

• Ask the dentist if there are signs of grinding on the porcelain where the metal is showing. A dental bur leaves distinct marks on porcelain, and it will be easy for the second-opinion dentist to see the marks.
• Return to your dentist with the report form the second-opinion dentist. But don’t accuse your dentist of intentionally grinding down the porcelain. It’s a mistake that many dentists have made in the past.

Below is a photograph of three crowns on back molar teeth. The porcelain was adjusted so much that the metal shows through.

Will You Need a New Maryland Bridge?

Your dentist bonded composite over the metal, but you didn’t mention if he prepared the surface of the metal first. Without preparation, the composite won’t hold.

Panavia is a dental cement that bonds to metal if a dentist takes these steps:

• Grind away a little of the metal to allow room for the cement
• Etch the metal with a micro-etcher, or small sandblaster
• Prime the metal, coat it with a thin layer of opaque Panavia, and cure it
• Place the correct shade of composite would over the cement and shaped and polish the composite

There is no guarantee that the composite will adhere to the metal for an extended time. But perhaps an advanced cosmetic dentist can use composite to resolve the issue with metal showing through on your Maryland bridge Schedule an appointment with an accredited cosmetic dentist to discuss your options.

Lowell, MA, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.