Front teeth - Crowns and bridge

[ScaredyChick]

I am looking for some facts and advise as my planned treatment fast approaches (November 27th)
I have been unhappy with my smile for my whole life and have finally decided to go ahead and do something about it. My front teeth are crooked, crossed and slightly protruded and following illness I have some gum problems that are thankfully now fixed but my teeth are still unsightly (in my opinion)
The dentist has suggested that I have the worst tooth at the front removed as this tooth crosses my other front tooth and would not have a good result with a crown, he has suggested that they then crown the other 4 front teeth and bridge the gap. My worry is how the crown and bridge will look and feel. As the tooth being removed is crooked I am thinking the cavity when its removed will be visible even with a temp crown/bridge in place? How do I go about keeping this area clean during the healing time? I dental hygiene more challenging with a crown and bridge to the front teeth? I'm a big baby at the dentist and need to be numb to even have a good clean every year so am worried how this will go. Also, will my speech be affected. Any help, reassurance and advise very welcome!

 

[Steve In Cleveland]

I'm very excited for you!! It's probably kind of scary right now, but your smile is going to look SO much better after you're done.

I have six crown on my top front teeth (from canine to canine), so most of my visible teeth when I smile are actually not even my teeth. They're color-matched and look and feel just like regular teeth-- and about ten times prettier than the original teeth were.

When I was having the work done, there were a few weeks between prepping the teeth and getting the permanent crowns back from the dentist. The temporaries that my dentist made looked really good-- I was actually showing them off to friends, because I was so proud of my new teeth! When the permanent crowns came, they looked even better!

I'm not 100% sure how the temporary bridge works. I think they can still make a pretty good looking partial or temporary right away. Most of the critical healing time for the extraction site is the first couple of days; you'll have to talk to your dentist about how that all goes down, or maybe someone else here has experience with an immediate crown or partial and can explain.

Long term, the bridge and crowns will look like much nicer versions of your teeth. They'll probably look much straighter and fuller. For front teeth they take care to make the crowns fit up under the gumline, so there's no visible line or anything (this is also the reason they usually want to wait for a month or two after the extraction to let the gum heal back for a good bridge fit).

Ongoing hygiene is pretty close to normal. You'll brush these just like normal, and floss the crowns just like normal. For the bridge, you'll need to use something called a floss threader. It's a stiff piece of nylon thread that you push through the gap at the gumline of the middle tooth so that you can floss around there. Like flossing itself, it's a little uncomfortable at first but not all that big a deal after a week or so.

It's a little uncomfortable getting the crowns/bridged prepped and fit, but it'll be such a huge improvement for your smile and overall health. Good luck!!

 

[ScaredyChick]

Thanks for that.

I am excited about the seeing the finished result (end of January) but must admit I'm very nervous and worried about the initial appointment (approx 3 hours) This will involve having my front tooth removed and then 4 teeth 'prepared' for crowns. Apparently I will leave the dentist office with temporary crowns and a bridge in place. As my front tooth is protruding slightly and crooked I am worried how the temporary bridge will look, will the cavity be visible while my gums heal? I've also read that we should try and keep the clot in place when a tooth is removed for faster/better healing, is this possible if I have to clean with some kind of thread around that area?

Will all this affect my speech?
I have told my employer that I wont be at work on the day of treatment but am I likely to need longer than one day to recover or should I be fine?

I have always had a deep rooted mini meltdown when even thinking about the dentist so for me to consider this treatment is a huge step but I'm not sure now tht I can actually go through with it for worrying about the immediate hours/days afterwards and whether i will be happy with the final result.

 

[Steve In Cleveland]

No no, you won't be flossing or cleaning the extraction site at all immediately following the extraction. The basic instruction for taking care of the extraction and letting the clot form is "leave it alone". My dentist told me not to even brush or floss anywhere near the site for a couple of days, and only very gentle saltwater rinses to keep the area clean. Your dentist will give you instructions on what to do/not do, and for how long.

I doubt the extraction will be visible with the temporary in place. The gums might be a little inflamed, and you will notice because you'll be staring at it in the mirror trying to notice. But really it will look just like normal (but straighter) teeth to everyone else. There won't be a big gaping visible hole above the bridge like you're thinking. It also won't affect your speech. Losing a large number of teeth can do that, but just extracting one and placing a couple of crowns won't make much difference. Unless you're an opera singer or a trumpet player. Are you an opera singer or a trumpet player?

For the first couple of days, you'll be extra conscious of the fact that your tooth feels different, because there's now a straight tooth where there used to be a sideways one. Your tongue will return to it a lot, like, "wow, that feels kind of weird." But after a couple days your tongue will accept it.

Plan on being just completely tired and wiped out after the procedure. It's a long time to spend in the chair, and you'll be all stressed out and tense, so you'll be exhausted after. There's not really anything painful, although some of the steps are kind of uncomfortable. Take some painkillers right away when you get home to handle just some general soreness. After a good long sleep you should be just fine. I wouldn't schedule a major speaking engagement the next day, but otherwise you can go about your normal day.

You should also plan on eating a pretty soft diet for a couple of days. I stocked up on pudding, yogurt, and applesauce, and just ate lots of that until day three, when I started eating soft breads, pasta, etc. I suspect the temporary bridge will actually protect the extraction site a little better than just an open gap, but it helps not to make your teeth do any real work while the clot forms.

Here's a bit of logistical advice. Because you'll be in the chair for a few hours, you may need to get up to use the bathroom, or even just to stretch your legs and take a five minute break. You can do that. There's nothing going on that can't be paused while you take care of business. Just don't look in the mirror, seriously. Your temps will look just fine when you leave the office, but crown prep looks really weird while it's going on. My six crowns took something like five hours, and I was really worried about "what if I have to pee?" but it really turned out to be no big deal to stop and go to the loo.

I know, because I've been there, how hard it is to turn your brain off and stop obsessing about what it's going to be like, what you're going to look like after, will you be hideous, etc. But trust me, the day after you have it done you'll love how your "new" teeth look, and then when you see how much better the permanent crowns look from that, you'll be even happier. You won't look terrible in the intervening weeks-- you'll look better. I thought I'd look like some buck-toothed idiot with huge teeth, but actually I was super-proud right away.

(Oh, one last thing to file away for the day of. The immediate hour after the procedure, you won't like the way your mouth looks. You'll be a little puffy from the anesthetic, and your gums will be a little inflamed, and there will be some powder and a little gunk from the impressions. It's not like you'll look like a monster. But when you go right up to the mirror and pull your lips back to see (which we all do), it will look a little rough. Within a couple hours your saliva and whatever you drink will wash away the gunk, and your gums will calm down, and it will all look okay. By the next morning it will look way better. So, don't run to the mirror right after you get home and think, "Steve lied to me." I didn't, it just takes a few hours and a little water.)