Expert: Rafael Mosery,D.D.S. - 12/4/2006

Question
I just got a second opinion from another dentist and he said that the bridge looks fine and that smoking is the cause of my pain. If that's true, then I'll take full blame. Can you explain the relationship of smoking cigarettes to the pain I'm experiencing? He also said my bite was a 'little off' but not so much as to be causing any problems.

Thanks,
Caroline
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The text above is a follow-up to ...

-----Question-----
I recently had to have my two front tooth crowns removed. I was given a removable denture (what the dentist called a 'flipper') until the extractions were healed and now I have a temporary 6-tooth fixed bridge for three weeks, at which point I will get my permanent bridge.

I am experiencing a lot of pain with the temp fixed bridge. I've been back to the dentist three times and he's trimmed around my gums but says there is nothing much more he can do. My bite is completely off and I think the bridge isn't placed correctly.I think perhaps it's sitting too far back and pinching my gums but the dentist says no.

My question is should a temporary bridge be causing me this much pain? Should I perhaps have the dentist take it out and do another one? I've lost time of work and can only eat soft foods.
Thanks for your help,
Caroline
-----Answer-----
What you're describing is disturbing. The provisional or temporary bridge should be a comfortable functional restoration. The only allowable discrepancy should be the shade perhaps. I would want to be pain free and fully functional BEFORE the final restoration is cemented with a final cement. This means that it gets cemented with a temporary cement until all your issues are resolved .Your bite should be completely comfortable, you can't expect any relief if your bite is off. Adjustments have to made to get you comfortable in the temp.You could justifiably ask the doctor "if the temp is painful how can I expect to function with the finished bridge. You have to be comfortable before this work is completed and don't settle for less.
Good Luck,
Dr.Rafael Mosery

Answer
Smoking could be responsible for the gums being inflamed and tender. you could even see a decrease in healing rate from extractions from smoking. Sensitivity and discomfort from a temporary bridge is more likely due to fit and bite discrepancies. If the bite is off then lets get the bite adjusted so that you're comfortable. I never had a pt complain about a temporary bridge where smoking was to blame.Get the bite adjusted and you should feel better.
Good Luck,
Dr.Rafael Mosery