Bryanna? Dental Bridge
 

Dear Bryanna, i have lost my first lower molar extracted about 2 months ago. its was a 25 year old root cannaled tooth which got infection. after that, dentist prepared a 3 unit bridge for me. I am now feeling very stupid that i filed my two healthy tooth to replace one missing tooth, get very scared when think that what if my abutment teeth get any cavity or needed root canal. to save my abutment teeth, i was thinking to remove the bridge and go for partial denture. what you say about that? please, i need your reply. I am 35 year old, healthy woman.

Also, what if i go for a mini dental implant securing a one tooth denture for my lower first molar, I like the concept of mini since it is less invasive.

Hi sara ali,

Your dentist should have offered you every replacement option before he went ahead and did the bridge. He should also have offered you explanations on the benefits of each option.

Since you have already had the two teeth cut down and the bridge placed, it would not make sense to remove it at this time. Both of those teeth would need to have crowns on them and the bridge might not be able to be cut off in a way that the current crowns would be stable enough to remain on those teeth.

Secondly, mini implants are great in certain circumstances. However, they are not adequate when replacing molar teeth. You need a larger implant to replace a molar so it can act as a long root just like the molar tooth would have naturally.

Thirdly, because that molar had been root canaled 25 years ago...... the bone in that area is compromised from the long term chronic infection from that tooth. Placing a dental implant in that bone would be risky to say the least.

Try not to beat yourself up over this. Just do your best the keep the area where the bridge is very clean. Use floss threaders every day and be thorough with your tooth brushing.

Bryanna

Dear Bryanna, thank you so much for your quick reply. its really very informative and helpful. just wanted to let you know that I live in Pakistan (third world country) and sometimes in Australia. the dentistry work in Pakistan is good and verrrrrrryyyy cheap. the dental bridge i just put in is $240. Due to the reason of low cost and good quality, I was thinking to replace the bridge (which was a mistake I regret) with two separate crowns to increase the longevity of the abutment teeth, and replace missing tooth with some flexible partial denture like valplast. thanks

I do not find my quick reply post in this thread. Anyway, I am writing it again.

Thank you so much Bryanna for this detailed, helpful and quick reply. Since, the cost of dental bridges and crown in my country is very cheap (a third world country), I was thinking to replace the bridge with a flexible soft denture, placing separate crowns on abutment teeth in order to increase the life of abutment teeth. after orthodontic treatment which extracted 4 teeth to pull back my front teeth into my mouth, I already have very few teeth in my mouth. I am afraid to loose the abutment teeth, especially since its on a premolar and 2nd molar, I am also afraid that the premolar couldn't withstand the force and crack. please let me know your valuable thoughts. Thanks again.

Hi sara ali,

You can remove the bridge and have two new crowns made for the abutment teeth. But as far as longevity, these two teeth are already compromised because they were cut down to accommodate the bridge. Removing the bridge and installing new crowns will not alter the longevity of these two teeth in any way.

The advantage to having separate crowns over the bridge are:
The teeth will be easier to clean.

Whether or not you keep the bridge or do separate crowns you would still be left with the same scenario if something were to happen to one of these teeth that required it to be extracted. You would either need a longer bridge to replace the then two missing teeth or an implant or a removable appliance.

Regarding the replacement of this one missing tooth....
Unless you have other teeth missing in the arch, you are not a candidate for a typical partial denture. Some dentists will make what is called a Nesbit appliance which is a very small plastic piece that holds one tooth, it is removable and it snaps into place using the adjacent teeth as anchors. However, this appliance is only used to keep the space open as a means of preventing the adjacent teeth from shifting and for esthetics. It is not meant to be used for chewing as it can be easily dislodged with food and become a choking hazard.

I think it would be helpful for you to make an appointment to consult with your dentist about what options you have that may be best suited for your particular case. I know you regret your decision to do the bridge, but in the long run it may be best to just leave well enough alone. But that is your choice and you have to be comfortable with it :)

Bryanna

Thank you so much for another detailed and helpful reply. I am sincerely thankful to you.

Dental Implant
 

Hello everyone & specially Bryanna,

I want to know your thoughts and experience about dental implants. Are they a safe choice to replace a missing tooth? what are its side effects or long term consequences like causing autoimmune diseases?

hanging tooth from upper jaw
 

is it always wise to extract a hanging, unopposed tooth from upper jaw? for instance, if one extracted an impacted wisdom tooth, why always dentist advice to extract the opposite tooth from the upper jaw?

Also, if a person lost first lower jaw molar and decided not to replace it with implant or fixed bridge, what options he has to stop eruption of unopposed tooth from upper jaw? Please advice.

Hello sarah ali
I have merged the 2 new threads you started into this one as it is less confusing when Bryanna or others want to reply to rather have one thread of your questions than many

Thanks Chemar

Bryana, I need help
 

Dear Bryana, As i have told you in my earlier posts that I have got a 3 unit bridge to replace my lower first molar. I recently experienced pain in my both abutment teeth, after going to several dentists and taking their opinion, its obvious that both healthy teeth are shaved too much and they now require root canal, what should i do now??

Hi sarah ali,

My heart literally sank when I read this post. When a dentist prepares a tooth or teeth for a crown or a bridge their first main concern should be to take every measure to preserve as much tooth structure as possible to avoid situations like this. In some cases the tooth is already badly compromised due to decay, etc and the tooth cannot be prepared conservatively. But in other cases where the tooth has been over prepped, it is the dentist who has the attitude that it's no big deal to root canal the tooth if a problem arises due to the over preparation. If I had a penny for every time I have seen this happen or know of this happening in my 35+ yr career.... I would be a millionaire by now!

I don't know the condition of these two adjacent teeth prior to the preparation of the bridge. So I cannot say as to which category you would be in with regard to these teeth being (over) prepped.

Unfortunately, if you have reason to believe that they are in trouble and that is what is causing the pain, then your two options are : root canal or extraction. To root canal them is an attempt to "retain" these teeth for an undetermined amount of time. It does not mean to "cure" them from disease at this time or in the future. To extract these teeth means you will then have 3 missing teeth in a row and replacement options would need to be discussed with your dentist. To leave that space open means the teeth above would slowly drift down towards the space. As that movement occurs bone loss and pocketing develops around those upper teeth and eventually they would need to be removed.

Please be certain that these teeth are not able to be restored with new crowns before you allow someone to root canal or extract them.

Bryanna




QUOTE=sarah ali;1043445]Dear Bryana, As i have told you in my earlier posts that I have got a 3 unit bridge to replace my lower first molar. I recently experienced pain in my both abutment teeth, after going to several dentists and taking their opinion, its obvious that both healthy teeth are shaved too much and they now require root canal, what should i do now??[/QUOTE]

Bryana, Those were perfectly healthy teeth before bridge preparation. I went to a new dentist and asked him to remove my bridge by cutting it through. He very professionally cut the bridge and remove it. Took the xray of the abutment teeth and said pulp is exposed and you need root canal of both abutment teeth, he then referred me to an endodontist. I showed the xrays to endodontist, and he said the same thing. Before going to the root canal, I went to a local dental college and ask the consultant to look at those xrays, since the consultation was free for public and they will not get any monetary advantage from hiding the truth from me, the consultant clearly said that NO, you don't need root canals, both teeth are saved, I asked then y i was having pain in my jaw and neck, he proved me that the bridge was not properly fitted. He gave me a muscle relaxant, Nuberol Fort, and now 80% of my pain is gone.

I lost respect and trust on every dentist. i am now going to crown the abutment teeth separately. and my only concern is now how do i stop super eruption of the opposing tooth in upper jaw, Can a daily use of night guard will prevent this to happen.

Thanks for your interest in my postings.

Hi sarah ali,

Although it is common for dentists to disagree on most things, it concerns me that 2 dentists say pulp exposures and someone at the dental school tells you a different story. Especially based on the information that you have given here in your previous posts about these teeth being over prepped. Is there any way you can post the recent x-rays of these teeth?

Regarding the issue with the empty space.... if the space opposing this tooth remains empty, the above tooth will drift and the adjacent teeth to the space with shift towards the open space as well.

The rate and degree of the shifting varies from one person to another.

The daily use of a night-guard may minimize the movement. But you would have to wear it diligently.

Bryanna