[Hkarlsen]

Hi there,
Thanks in advance for advice. I had a 3 unit bridge done in 2006 and this year I ended up with problems in both anchor teeth. The molar on bottom left just got a root canal unfortunately, but now the Wisdom tooth feels like it's full of tin foil. The X-ray of the wisdom shows possible infection starting but dentist says it's borderline and will follow my lead on what to do. He thinks the only decision to be made is to root canal the wisdom tooth. I do not have another 2 grand to spend on problems under this bridge. Also I cannot stand the bridge as it seems impossible to get clean. There is always some terrible feeling and taste of bacteria in the cracks and my gum under the extracted tooth has receded and now there a space there under the bridge which is a very aggravating sensation. To this my dentist says the only thing I can do is redo the bridge. I'm at my wits end with this and I have no money for these procedures. Any advice would be helpful. Can a wisdom tooth be removed under a bridge? Should I just remove the bridge and get mini implants and partial? I can't stand the dirty bridge feeling anymore. What is the healthiest choice?

Thanks so so much,
Heidi

[Bryanna]

Hi Heidi,

Permanent bridges that involve lower wisdom teeth as an anchor tooth often have short term life spans. Most wisdom teeth are not angled properly in the jaw bone which creates an unnatural curvature and unnatural bite pattern to occur if they are used for a multi unit bridge. The bridge causes undue pressure on the other anchor tooth causing it to become chronically inflamed and eventually infected. It is typical for the anchor teeth of these 3 unit bridges, using the wisdom tooth, to end up with root canals. However, doing the root canal on either or both anchor teeth does not solve the cause of the problem, the occlusion, it just creates further inflammation and infection. These bridges are often difficult to clean and the anchor teeth tend to become decayed also leading to further problems.

If you are seeking patch up treatment with no long term prognosis, then root canaling the wisdom tooth and keeping the bridge would be the typical recommendation. This treatment option will eventually lead to removal of both anchor teeth and in the meantime further infection which leads to more bone loss.

At this point, the wisdom tooth is sick and having it root canaled and/or just removing the bridge and crowing that tooth will not solve the infection brewing with that tooth. Unfortunately it is inevitable that the wisdom tooth will need to be extracted at some point as well as the other anchor tooth. It is just a matter of how quickly and progressive the infections become or when you are ready to remove them.

The area where the tooth was already extracted has bone loss as described in your post by the amount of recession that has occurred there. This means that it is most likely not an ideal area for a dental implant. You may be a candidate for a dental implant in the molar anchor tooth site, but not the wisdom tooth site. It's important to know that dental implants require healthy and substantial bone to integrate properly. Areas where an implant is replacing a root canaled teeth can be less successful due to the chronic infection in that resides in all root canaled tooth. If the tooth was recently root canaled and the original infection was not massive, then the success of extracting that tooth and placing an implant is higher than if the tooth had been badly infected and/or the root canal was done more than a year or so ago.

A removable partial denture could be done to replace those 3 teeth on the lower left side and any other teeth you have missing in the lower arch.

I hope this information has been helpful to you and please let us know if you have other questions.

Bryanna

Originally Posted by Hkarlsen

Hi there,
Thanks in advance for advice. I had a 3 unit bridge done in 2006 and this year I ended up with problems in both anchor teeth. The molar on bottom left just got a root canal unfortunately, but now the Wisdom tooth feels like it's full of tin foil. The X-ray of the wisdom shows possible infection starting but dentist says it's borderline and will follow my lead on what to do. He thinks the only decision to be made is to root canal the wisdom tooth. I do not have another 2 grand to spend on problems under this bridge. Also I cannot stand the bridge as it seems impossible to get clean. There is always some terrible feeling and taste of bacteria in the cracks and my gum under the extracted tooth has receded and now there a space there under the bridge which is a very aggravating sensation. To this my dentist says the only thing I can do is redo the bridge. I'm at my wits end with this and I have no money for these procedures. Any advice would be helpful. Can a wisdom tooth be removed under a bridge? Should I just remove the bridge and get mini implants and partial? I can't stand the dirty bridge feeling anymore. What is the healthiest choice?

Thanks so so much,
Heidi