Bridge to replace missing tooth

[ScaredyCat22]

If a person chooses to get a bridge to replace 1 missing molar I understand the tooth behind and in front of the extraction are crowned and attached somehow to a fake tooth. But what happens if either of those real teeth ever decay under the crown or require root canal? Is the whole bridge and all 3 teeth lost because of it? And does the fake tooth in the center of the bridge sit right on the gum and cause any pressure or pain?

It was my intention to just keep my gap from my extracted first molar and live without that tooth, but the gap is so large that my tongue spreads into the space and gets scraped up on the edges of teeth it would not normally touch. I have been through so much I don't want to go through the expense of a bridge if it will just lead to more pain.

 

[ScaredyCat22]

also how long do you need to wait for an extraction to heal before getting a bridge?

 

[rob wain]

Hi Scaredycat

In a conventional bridge, the teeth in front and behind the gap are prepared for crowns and the bridge then links the two teeth together, filling the gap. The false tooth in the gap, called a pontic, rests on the gum, but because it is well supported on either side, there shouldn't be excessive pressure on the gum.

When you drill down a tooth for a crown there is a risk (5-15%) that the tooth will develop an abscess requiring a root canal either now or in the future - bear in mind that you would be drilling down 2 teeth.

If decay develops under either tooth then the bridge has to be replaced.

Typically the bridges last 10-12 years on average. It's a reasonable choice if the adjacent teeth would actually benefit from being crowned anyway. If the adjacent teeth are strong and healthy, then it's a big gamble with the long-term health of these teeth.

Alternatives to consider are adhesive bridges (difficult for first molars) or an implant.

Best of luck choosing!

 

[ScaredyCat22]

Thank you. My second molar is already not in the greatest shape, has a large filling and would probably be better off crowned, but my premolar in front of the extraction has never had so much as a cavity and I do hate the thought of risking its health.

 

[carole]

Hi I had a rct'd tooth that needed a crown, next to it I had a gap that needed something to fill the gap, I had the same problem as you and my tongue was trying to escape through the small gap. My dentist made a crown with a tooth attached as Rob has said but she only used the rct'd tooth to anchor it and it is fine. I do have a bridge on the other side of my mouth that is anchored using two teeth but this one has a tooth, a gap, a tooth and another gap so it is quite big consisting of 4 teeth in all. I have had my large bridge for about 20 years and the smaller one I have had for about a year. I do have a slight gap under the bridge's but you cant see it, I only know because I slip my floss under it to clean the area. My large bridge teeth haven't had rct's.

I hope this makes sense to you and helps you come to a decision, if I have not explained clearly let me know and I will try to clarify things. Also if you have a bridge or crown then ask the dentist to physically show you how to floss the area as I have not been cleaning mine correctly for years. I was never told how to clean it, different dentist just kept saying keep it clean which I thought I was but when my dentist showed me how to floss the area properly it has been much better.

Good luck

 

[rob wain]

There is a bridge design that uses a crown on the second molar and an adhesive bridge wing on the second premolar. The false tooth is attached to the molar crown. The adhesive wing is separated from the main structure by a stress breaker. The bridge design would be called a fixed moveable hybrid adhesive conventional bridge. It has the benefit of crowning the molar but minimal drilling of the second premolar.

The downside is there is visible metal on the palate side of the premolar and you need a good dentist/technician combo to make it work.

 

[Spike 1969]

Hi Scaredycat

Rob is spot on there.

I have a tooth missing and asked the same question, since the teeth next to it are healthy my dentist said he was not happy working on them and the best solution was an implant (subject to the site being suitable), normally a good dentist will be unwilling to do unnecessary work on a healthy tooth.

 

[ScaredyCat22]

thanks everyone for all the info. teeth can be overwhelming at times!

 

[ScaredyCat22]

Hi I had a rct'd tooth that needed a crown, next to it I had a gap that needed something to fill the gap, I had the same problem as you and my tongue was trying to escape through the small gap. My dentist made a crown with a tooth attached as Rob has said but she only used the rct'd tooth to anchor it and it is fine. I do have a bridge on the other side of my mouth that is anchored using two teeth but this one has a tooth, a gap, a tooth and another gap so it is quite big consisting of 4 teeth in all. I have had my large bridge for about 20 years and the smaller one I have had for about a year. I do have a slight gap under the bridge's but you cant see it, I only know because I slip my floss under it to clean the area. My large bridge teeth haven't had rct's.

I hope this makes sense to you and helps you come to a decision, if I have not explained clearly let me know and I will try to clarify things. Also if you have a bridge or crown then ask the dentist to physically show you how to floss the area as I have not been cleaning mine correctly for years. I was never told how to clean it, different dentist just kept saying keep it clean which I thought I was but when my dentist showed me how to floss the area properly it has been much better.

Good luck

Do you know if it was called a cantilever bridge? I have just been reading about those and it seems they can be attached to just one tooth. but it also said they are not great for molars

 

[carole]

Hi I think that is what they are called in the USA but as I am in the UK mine is how Rob described. When my dentist fit it she said that it was only for the look and wouldn't be much good for actual chewing but I have no problems with it at all. It feels exactly like my own teeth. I chew on it and it doesn't pull the crown or anything. You do as I have said need to get the dentist to show you how to clean it properly, it is hard to describe and I was doing it wrong, the dentist had told me but as soon as she showed me with a piece of super floss I knew straight away what I was doing wrong.

Good luck to you with getting your tooth done, whatever you decide. Do you know what you are going to do yet and do you have an appointment?

 

[ScaredyCat22]

Hi I think that is what they are called in the USA but as I am in the UK mine is how Rob described. When my dentist fit it she said that it was only for the look and wouldn't be much good for actual chewing but I have no problems with it at all. It feels exactly like my own teeth. I chew on it and it doesn't pull the crown or anything. You do as I have said need to get the dentist to show you how to clean it properly, it is hard to describe and I was doing it wrong, the dentist had told me but as soon as she showed me with a piece of super floss I knew straight away what I was doing wrong.

Good luck to you with getting your tooth done, whatever you decide. Do you know what you are going to do yet and do you have an appointment?

I still haven't decided what to do Carole. It's so overwhelming but I appreciate all the info. Even if I decided I am not sure if it's too soon to go ahead yet? I don't know how long extractions need to heal before you do anything to replace teeth. I'm still having some pain too and I don't want to do anything without knowing if this pain is serious and whether I am going to have to lose another tooth. I need to deal with whatever is causing this pain first before I replace a tooth. I wish I could just have some pain free days. It's so easier to make decisions when pain isn't always clouding your judgment. I do have an an appointment but it isn't to actually do anything. It's a cleaning and exam and to discuss options. I know I don't have the tolerance to go to all the implant appointments so that is out of the question. My appointment isn't until next month.

 

[rob wain]

Hi ScaredyCat

You said - "I know I don't have the tolerance to go to all the implant appointments so that is out of the question".

Personally, I would rather have an implant than a bridge performed.

The worst part of treatment is tooth removal and that's the same for either treatment.
Placing an implant is really quite easy, even with a bit of minor grafting. The follow-up visits are a few months later and are a breeze - not even an injection.

Compare that to a bridge where there is extensive drilling with water spray, anaesthetic to prepare teeth, trying the bridge and again to fit it.

Please don't make the decision based on the appointments, base it on finance, longevity, clinical advice etc.

 

[ScaredyCat22]

Thank you Rob, I will take into consideration whatever the dentist thinks is best for me, I have not decided anything yet. I still have some on and off pain and I need to deal with that first before tooth replacement.