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Follow up - with pics - advice on what I want to ask the dentist for

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Peaches626

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May 31, 2022
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Scarborough uk
Apologies for the photo - makes me cringe just looking at it. But this is what we’re working with!

After a week of shock and feeling absolute devastation after my accident I have now reached the pragmatic stage and researched my little socks off.

As you know from my last post I have a crippling phobia of even setting foot in the dentist so really need to find solutions that aren’t horrific and invasive… at this stage I just really, can’t. I know that makes me ridiculous, but I can’t help it.

My mouth is much less painful now, the antibiotics have kept everything clean and I’m healing up. The two chipped teeth are still tender to the touch forwards and backwards but not wobbly and I can put direct pressure from the bottom if I have to (I’m not) so really, really hoping they are just bruised and recovering.

My consultation to plan a repair is on 13th June and my proposal is to:

1) composite bond the chipped ones…. I understand this isn’t too painful and doesn’t need a needle?

2) request a flexible single tooth denture. The clinic I’m going to offers Valplast. I’ve done the research online and this seems like a good option for a single missing tooth.

I’ve soul searched and just can’t entertain the thought of an invasive repair such as a bridge or implant. Yet, anyway.

Does this sound reasonable, and like something the dentist will be happy to work towards? I don’t want to be horrifically disappointed on the 13th if she says “no, don’t be ridiculous you daft woman”.

As far as I’m aware the whole tooth came out including roots. If that makes any difference.

Thanks again for all replies and support 🙏🏻
 

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FrankieDoug

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Stockton
Hi,

I can only answer about composite bonding - I smashed my two front teeth when I was 10. I've suffered with dental anxiety throughout this time but honestly the only thing I would go back for would be to repair these teeth if they were ever damaged. There is no pain at all - no needles and its still completely fine. Don't worry about it - in your head it's much worse than actually going through with it.
 
Gordon

Gordon

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1) Composite bonding should be fine here but the fracture line on the lateral incisor (to your right next to the gap) looks quite close to the edge of the nerve. It might be quite sensitive without local during the bonding process. Get busy slathering sensitive tooth paste all over the fractures. Do it a few times a day and leave it on, just rub it in with a finger. That should stop it being sore during the bonding if you really don't want local.

2) I wouldn't do a Valplast denture so soon after the tooth came out. The gum is still healing and after a few months the denture won't fit properly. You can't reline Valplast so that means a new denture... a simple acrylic partial will work fine and can be upgraded later on. My lab could have done one for you while you waited...
A Maryland bridge would work well here instead though. No injections, no drilling, just impressions and glue it on at a second appointment.
 
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Peaches626

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Location
Scarborough uk
1) Composite bonding should be fine here but the fracture line on the lateral incisor (to your right next to the gap) looks quite close to the edge of the nerve. It might be quite sensitive without local during the bonding process. Get busy slathering sensitive tooth paste all over the fractures. Do it a few times a day and leave it on, just rub it in with a finger. That should stop it being sore during the bonding if you really don't want local.

2) I wouldn't do a Valplast denture so soon after the tooth came out. The gum is still healing and after a few months the denture won't fit properly. You can't reline Valplast so that means a new denture... a simple acrylic partial will work fine and can be upgraded later on. My lab could have done one for you while you waited...
A Maryland bridge would work well here instead though. No injections, no drilling, just impressions and glue it on at a second appointment.
Hi Gordon,

Thanks so much for the advice. I’ll start the toothpaste rubbing in today :)

In terms of a Maryland bridge, would that work even with the damage to the supporting teeth? How long would I need to wait for that to be an option? I had originally looked at MBs but thought the other two teeth, being repairs themselves, wouldn’t support?

In your opinion then, at my appt, what should I be asking for, particularly in terms of filling the gap (even temporarily), and what do you think the timescale I’m looking at is?

Thanks so much 🙏🏻
 
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Peaches626

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21
Location
Scarborough uk
Hi,

I can only answer about composite bonding - I smashed my two front teeth when I was 10. I've suffered with dental anxiety throughout this time but honestly the only thing I would go back for would be to repair these teeth if they were ever damaged. There is no pain at all - no needles and its still completely fine. Don't worry about it - in your head it's much worse than actually going through with it.
Thankyou, reassuring to hear… is it just pressure? I read they roughen the surface? Is this with a tool of some kind or a liquid - I’ve seen both on YouTube?
 
Gordon

Gordon

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Yes, a MD bridge would still work with the damage to the neighbour teeth. You only want 1 wing bonded on so in your case that would be to the other central incisor, i.e. the one to left of the gap.
In terms of when to fit it, you're kind of in the wrong time frame now, it's either do it as immediately as possible after the tooth comes out or wait a few months for the gums to heal, so you've missed the immediate chance and would be best now to wait for about 3-4 months.
You would ask for an immediate partial denture, just a wee acrylic one will be fine. Should take a few days or less if your dentist has a convenient lab. Obviously the fractures need repairing too.
In terms of roughing up the tooth surface, it's usually a combination of using a handpiece (a rotating tool thingy) and liquid etching agents. So long as the tooth isn't too sensitive (hence the toothpaste trick!) then neither will be anything more than a feeling of something touching your teeth. Plus a bit of water sloshing around.
 
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Peaches626

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Scarborough uk
Yes, a MD bridge would still work with the damage to the neighbour teeth. You only want 1 wing bonded on so in your case that would be to the other central incisor, i.e. the one to left of the gap.
In terms of when to fit it, you're kind of in the wrong time frame now, it's either do it as immediately as possible after the tooth comes out or wait a few months for the gums to heal, so you've missed the immediate chance and would be best now to wait for about 3-4 months.
You would ask for an immediate partial denture, just a wee acrylic one will be fine. Should take a few days or less if your dentist has a convenient lab. Obviously the fractures need repairing too.
In terms of roughing up the tooth surface, it's usually a combination of using a handpiece (a rotating tool thingy) and liquid etching agents. So long as the tooth isn't too sensitive (hence the toothpaste trick!) then neither will be anything more than a feeling of something touching your teeth. Plus a bit of water sloshing around.
You’re amazing Gordon, I wish you could be my dentist!

Why only one wing?

Does the glueing /bonding bit hurt?

How long do you think I’d have to wait for the fracture repairs to be done?
 
Gordon

Gordon

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No you don't I've been retired for 4 years now and my eyesight isn't what it was... :)

(Dad Mode) Because, that's why :)

(Techie answer) bonding to 2 sides will cause one side to fail eventually, the 2 support teeth will move in slightly different directions as you chew and bite and the stress will cause the bond on 1 tooth to fail. This is bad because the area below the de-bonded wing will decay like mad. It's also more likely to weaken the bond on the remaining side so it'll probably fail a bit sooner too.
Bonding to one tooth only is much better, in the very unlikely event that the bonding fails then you want the bridge to come off immediately (well you don't but the dentist does!).

No absolutely not. Here's what happens:
1) The back of the tooth gets a brush with some special dentist toothpaste to get it really clean
2) The surface to be bonded gets painted with a weak acid solution, this "roughens" the enamel so that little tags of cement can penetrate. Then it's washed away and the area blown dry with compressed air
3) Cement is applied to the wing of the bridge and the bridge is pressed into place, they fit very very precisely and you can't really mess this up
4) Excess glue is wiped off and then the assistant zaps the whole thing with a blue light (it's just a blue light, but I always like to make Star Wars light sabre noises in my head during this bit)
5) The bite on the bridge is checked and adjusted if necessary

I'd do them as soon as possible after you got into my surgery. If i had time I'd do them at your first visit.
 
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Peaches626

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Scarborough uk
No you don't I've been retired for 4 years now and my eyesight isn't what it was... :)

(Dad Mode) Because, that's why :)

(Techie answer) bonding to 2 sides will cause one side to fail eventually, the 2 support teeth will move in slightly different directions as you chew and bite and the stress will cause the bond on 1 tooth to fail. This is bad because the area below the de-bonded wing will decay like mad. It's also more likely to weaken the bond on the remaining side so it'll probably fail a bit sooner too.
Bonding to one tooth only is much better, in the very unlikely event that the bonding fails then you want the bridge to come off immediately (well you don't but the dentist does!).

No absolutely not. Here's what happens:
1) The back of the tooth gets a brush with some special dentist toothpaste to get it really clean
2) The surface to be bonded gets painted with a weak acid solution, this "roughens" the enamel so that little tags of cement can penetrate. Then it's washed away and the area blown dry with compressed air
3) Cement is applied to the wing of the bridge and the bridge is pressed into place, they fit very very precisely and you can't really mess this up
4) Excess glue is wiped off and then the assistant zaps the whole thing with a blue light (it's just a blue light, but I always like to make Star Wars light sabre noises in my head during this bit)
5) The bite on the bridge is checked and adjusted if necessary

I'd do them as soon as possible after you got into my surgery. If i had time I'd do them at your first visit.
Oh Gordon, you’re wonderful :) One more question…. The temp acrylic denture - how does that attach? Is it hooks?

I really do appreciate all your time and advice 💛
 
Gordon

Gordon

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It depends, a lot of the time they can work just fine by just extending them into the "undercuts" on the premolar teeth, sometimes they need a couple of little spring clasps for extra grip but mostly they don't.

Seems more common to use clasps in the US, here in the UK we mostly don't, especially for a single tooth.

Bit like this:

1654604262294.png
 
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Peaches626

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Scarborough uk
Update! Chipped teeth repaired today, feels so much better. Super brave and no pain, just a bit uncomfortable.

Booked in for impressions and prep work for a Maryland bridge tomorrow as dentist says my gum is really well healed. Will take a week-ish to arrive. So going to live without a temp solution for another 7-10 days, but then should be sorted. 🤞
 

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FrankieDoug

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Update! Chipped teeth repaired today, feels so much better. Super brave and no pain, just a bit uncomfortable.
Booked in for impressions and prep work for a Maryland bridge tomorrow as dentist says my gum is really well healed. Will take a week-ish to arrive. So going to live without a temp solution for another 7-10 days, but then should be sorted. 🤞
Hi,
I'm so sorry I've been away and just seen this! so glad it's sorted for you - best of luck with the rest
 
Gordon

Gordon

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Well done you (and your dentist). That's some nice composite work there. Fitting the bridge is much easier, so you've done the hard bit!
 
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Peaches626

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@Gordon …. the dentist said I need prep done to the support tooth for the MB tomorrow, what does this involve and is it going to be awful?!

I was super proud of myself for getting through the composite bonding today but now I’m psyching myself out again…. plus YouTube us showing me scary drills when I search it 🙈

Help! 🙏🏻
Well done you (and your dentist). That's some nice composite work there. Fitting the bridge is much easier, so you've done the hard bit!
 
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Jackieallen

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@Peaches626

They look great . A marylamd will not hurt they prep the tooth next to it to attched with a little wing ..i have 2 and in my expierence they are better attached to one tooth . They look feel like real teeth . So excited for u
 
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Peaches626

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Prep done, from what I can feel it’s like a notch / bit cut out of the back…. Impressions done which were just horrific but thankfully over. Appt booked for next Wednesday so 🤞 the lab get it back in time, or it’s another week as my dentist is on leave after Wednesday.

Tooth super sensitive now… hopefully that goes away?!
 
Gordon

Gordon

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I didn't use to bother prepping mine very often, seemed not to make any difference, but it's sometimes necessary if the bite is close and you need to get some more space for the wing of the bridge. They have to be a certain thickness or else they flex too much and break the bond.

Start slopping on some sensitive tooth paste on the area again, a few times a day and leave it in situ for as long as you can; the enamel has been slightly thinned down and will be exposing the dentine slightly.
 
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Peaches626

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Scarborough uk
I’m very relieved there is only the glueing on to go and that I’ve got a fixed option - more than I dreamed possible 3 weeks ago when it felt like my life was over.

Dentist has been really good, efficient but kind.

Impressions were the worst bit, felt like all my teeth and newly fixed bonded ones were coming with it 🤮🥴🤢

Added bonus that my horribly bitten nails (been doing it since childhood) are growing since I can no longer bite them! Bit of an extreme (and expensive) way to do it mind you! 💰😂

I’ll be back next week all being well to flash you my finished product! 🤞😬😁
 
Gordon

Gordon

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Great, looking forward to seeing it.
One of my trickiest ever cases was a professional sax player who got his 2 front teeth knocked out playing basketball.
Trying to get things so it was just "right" for him to play his instrument took the best part of 2 days by me and the lab. Unfortunately Marylands weren't around then so it had to be conventional bridgework. Lots of drilling involved :(
 
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Peaches626

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Bridge won’t be arriving until 27th now but at least it’s only a few extra days :(
 
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