Dentistry focuses on diagnosing, preventing, and treating conditions of the teeth, gums, and oral structures, supporting oral health and overall well-being.
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Maintaining oral hygiene around fiber applications is more challenging and more critical than with natural teeth. Fiber splints and bridges create connections between teeth that block the natural path of dental floss. Furthermore, the composite resin covering the fibers can attract plaque if not kept polished and clean. At Liv Hospital, we educate patients that the longevity of the fiber restoration is directly linked to their ability to keep it plaque-free. Failure to clean under a splint or bridge can lead to recurrent decay or the progression of periodontal disease, undermining the very purpose of the treatment.
Since you cannot floss down between splinted teeth, you must floss under the contact points.
Superfloss: This is the most essential tool. It has a stiff end to thread between the teeth at the gum line and a spongy middle section to clean. Thread it under the splint or bridge, then sweep it back and forth to clean the gum tissue.
Floss Threaders: If you use regular floss, you must use a plastic threader loop to pull the floss through the triangular space between the teeth and gums (embrasures) below the splint.
Frequency: This threading procedure must be done once daily, preferably at night. Neglect will lead to rapid inflammation of the interdental papilla (the gum between teeth).
Technique: Be gentle. Do not “saw” the gum. Curve the floss around the neck of the tooth to remove the biofilm.
The procedure for splinting mobile teeth involves integrating the fiber ribbon into the dental arch.
Measurement: The fiber strip (e.g., Ribbond) is measured to fit the lingual curvature of the teeth, extending from canine to canine or involving stable abutment teeth.
Interproximal Adaptation: A thin layer of flowable composite is placed on the teeth. The fiber is pressed into this resin, with special care taken to push the fiber deep into the interproximal spaces (between teeth). This creates a mechanical lock and prevents the splint from peeling off.
Polymerization: The splint is light-cured section by section. The fiber reinforcement prevents the shrinkage stress of the composite from pulling the teeth apart or causing sensitivity.
Covering and Polishing: The fiber is covered with a final layer of composite resin to protect it from wear and ensure a smooth surface for the tongue. It is then polished to prevent plaque accumulation.
For patients with periodontal disease, the spaces between teeth are often larger, making floss less effective and brushes more effective.
Size Selection: Use an interdental brush that fits snugly but comfortably into the space between the teeth under the splint. If it is too small, it won’t clean; if too large, it causes trauma.
Motion: Insert the brush and move it in and out several times. This mechanical action disrupts the bacterial colonies that accumulate on the fiber resin and the root surface.
Coated Wire: Ensure the brush has a plastic-coated wire to avoid scratching the composite surface of the splint or bridge.
Access: Approach from both the cheek and tongue sides to ensure thorough cleaning of the interproximal space.
Water flossers are highly effective for patients with extensive splinting or bridges.
Pressure Setting: Use a medium pressure setting. High pressure can sometimes damage the delicate gum attachment in periodontal patients, while low pressure may not remove sticky plaque.
Angle: Aim the tip at 90 degrees to the tooth, tracing the gum line and pausing between the teeth.
Subgingival Tips: Specialized tips (periodontal tips) can deliver water or antimicrobial rinses slightly below the gum line, which is beneficial for pockets around splinted teeth.
Debris Removal: This is particularly useful for dislodging food particles trapped under the pontic of a fiber bridge.
The surface of the fiber splint (lingual side) needs specific attention.
Angulation: Angle the toothbrush at 45 degrees to clean the junction where the splint meets the gum. This is a prime area for plaque stagnation.
Lingual Focus: Patients often neglect the tongue side of the teeth. Spend extra time brushing the splint itself to prevent calculus (tartar) buildup, which adheres easily to resin.
Soft Bristles: Use a soft toothbrush. Stiff bristles can abrade the composite resin over time, exposing the underlying fibers. Exposed fibers act like a wick, drawing bacteria into the splint and causing discoloration and failure.
Non-Abrasive Paste: Avoid harsh whitening or smokers’ toothpastes, as they can scratch the resin surface, making it rougher and more prone to staining.
When mechanical cleaning is difficult due to the bulk of the splint, chemical agents help.
Fluoride Rinses: Daily use of a neutral sodium fluoride rinse helps prevent decay on the root surfaces covered by the splint.
Chlorhexidine: During acute flare-ups of gum inflammation, a chlorhexidine rinse or gel applied with an interdental brush can reduce bacterial counts. However, prolonged use can cause staining that adheres tenaciously to the fiber splint.
Anti-Tartar Rinses: Rinses containing zinc or pyrophosphates can help prevent plaque from crystallizing into tartar, keeping the splint smoother between professional cleanings.
Patients should be aware of the signs of splint failure.
Roughness: If the splint becomes rough to the tongue, the composite layer may have worn down, exposing the fibers. This requires a quick polish and reseal by the dentist.
Staining: Brown margins around the splint indicate leakage. This is a sign that the bond is failing and bacteria are entering underneath.
Movement: If one tooth in the splint starts to move independently or clicks when you chew, the bond to that specific tooth has broken.
Sensitivity: New sensitivity to cold or sweets on a splinted tooth suggests a cavity forming under the loose bond.
Send us all your questions or requests, and our expert team will assist you.
You cannot pass floss down between the teeth; you must use a floss threader or “Superfloss” to thread the floss under the contact point at the gum line.
The composite covering the fiber can stain over time like a white filling, especially if you smoke or drink coffee, but it can be polished back to its original color.
Yes, electric toothbrushes are safe and recommended, as they are very effective at removing plaque from around the margins of the bridge without damaging it.
If the splint feels rough or scratchy to your tongue, visit your dentist; the protective resin layer may have worn down and needs to be refreshed.
Water flossers are excellent for flushing out food and plaque from under bridges and splints where a toothbrush and regular floss often cannot reach.
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