Any dentists or dental knowledgeable folks here?

I am missing the end tooth in the bottom left quadrant of my mouth. A few years ago, one dentist said I could not have a fixed bridge to replace the missing tooth put in place because there wasn't teeth in both sides to anchor the bridge. Recently another dentist said that was BS in that he could anchor it to the two adjacent teeth beside it. Said he's done it many times. He is the head dentist at the place so I would hope he knows what he is talking about. As two teeth have to be ground down for this to happen, I would hate to see it fail. It isn't quite so bad as one of the teeth has a deep filling and is nearly near in need of a cap as it is but I'm nervous that both dentists did not agree on the prognosis. The first dentist is long gone so I can't go back to him and explain what this current dentist said.

Any knowledge of this information? I suppose I should scour the net for dental forums. I imagine they must exist as I found toilet forums when researching a toilet purchase.

Can you live without that tooth? How much will you gain by having that tooth and at what price? I'm not being snide here, I just don't want ya to get ripped off for what could be minimal gain especially if its a back tooth.
Plus if you have to remove enamel from two other teeth to get it done then those teeth become more vulnerable as well. Just some thoughts.

Due to poor dental habits, I'm missing a few teeth and because of the missing tooth, I'm only chewing on one side so yes, it would be beneficial to get that tooth back. I'm just concerned with the torque and forces involved when biting down and the fact that the tooth would only be supported on one side although it would be from two, not one tooths.

It's a hard choice, no doubt about it. If you get it done you may want to stay on the softer things with food. I know I don't eat popcorn anymore because I have 5 crowns and they are just too expensive to replace. Or you can cut your food up more finely with your knife, things like that.

For what it would cost to get a bridge I would think an implant is the same or less. And you don't have to ruin two other teeth. Regardless of what any dentist said, I'd personally be a little leery of getting a bridge in the manner you described. I think it probably wouldn't last long.

If you have a tooth either side of the gap, a bridge is a good solution. If the missing tooth is the last one in the row, a bridge won't work. That is my understanding, anyway, and I've had bridge-work and all sorts done to my mouth over the years.

The whole point of the bridge is that it fills a gap between 2 teeth. You can't hang an extra tooth off one neighboring tooth – the leverage/twisting force on it would be too great. I think your first dentist was giving you good advice, and you should consider an implant instead.

One problem with leaving this gap unfilled is that the opposing tooth (the one the missing tooth used to bite against) now has nothing to bite on, so it will erupt (emerge) further, exposing the part that ought to be inside the gum-line. You will therefore eventually get problems with that tooth too, if you don't replace the other one.

We have at least 1 dentist who is a CPFer – DocPeter is one, so you could shoot him a PM or e-mail and ask what he thinks.

I guess I'd say the implant is the way to go. I'm not a dentist nor have I had any personal experience with this situation however, hanging a tooth onto another tooth adjacent to it (not onto two teeth, one on either side) seems to me to be akin to standing on one foot--if you catch my drift. That fact with the added aspect of grinding down other teeth to be able to construct the bride sure doesn't sound right to me. The molars are meant to grind food and that is accomplished by rubbing the rough surfaces of the teeth against one another---not just up and down, opening and closing of the jaw and pressing the teeth together. The grinding motions put a tremendous amount of lateral stress on the molars and, as a result, they need firm "grounding"---seating in the jaw and gums. Hanging one tooth onto another on only one side is hanging on for dear life--in my personal opinion. My advice is clear--don't believe it can be done---ask another dentist.

Karl

hi,
yes it is possible to construct a bridge using the adjacent teeth, this is mainly done for anterior teeth as the forces they experience are lower. The success of the bridge would depend on your occlusion and how your teeth function in excursive movements for example. The problem with bridges is that they put extra load on the supporting teeth which can cause problems. But if the dentist has examined you he must be satisfied that the bridge would be successful. Just ask him to explain the pros and cons to you on your next visit.

Well, sounds like there's a dentist in the house!


Karl

well dental student anyway.. only one more year thankfully!

Hmmm, well as I said originally, I'm no dentist (nor student of dentistry!:wave but, I'd seek another opinion before I'd go into this one. Sounds to me like some risky business that I wouldn't go for personally. To each his/her own however....


Karl

I just posted this in another thread ('my tooth hurts') but would be interested in any comments, especially about handling the charge for the 'flipper' or denture-- was it my fault not to ask for the price?

just had tooth #5 yanked yesterday. it had been capped too, so the cap and roots and all had to go..

I had a molar pulled at this same oral surgeon 2 years earlier and had had a bad time driving home as the shots wore off..so this time I had the doc shoot the tooth (already senseless) up before I left..that worked extremely well, and I didn't have to drive doped up on a vicodin (as I had planned to do).
As it is there was/is no pain, hardly any bleeding..

problem -- with my regular dentist who had a 'fake tooth' made up to replace the pulled one temporarily till the wound healed and the implant is fitted...
I thought it would be a simple CHEAP if not FREE simple plastic cast like they make for a bridge or something that just pops into place, (the dentist even referred to it as a 'little bit of plastic' -- he never used the word 'denture' or 'flipper') but nooo, after he gives it to me he says it's $650! The thing is like a denture, a thick plate sits on the roof of your mouth and the one tooth dangles from it..totally uncomfortable, makes me gag, and causes me to speak with a speech impediment.. I really squawked at him when he told me the price; them he immediately took $200 off the price, 'if I pay now' -- which I did. But the appliance is uncomfortable and useless..what should I do?

be forewarned: ALWAYS ask the COST of EVERYthing, FIRST!!

Thanks for yours and other advice. The pros are that even at 3 grand (insurance pays half), it's still considerably cheaper then an implant and he says the tooth next to it has a very deep filling and most likely will have to be capped one day as it is, so he's sorta killing two birds with one stone. The second tooth used for support however is quite healthy.

I'm not afraid to get the bridge, I have a very successful one on the other side (supported on each side by a tooth), I just can't quite see how it would work as when you bite down the center of gravity or fulcrum is going to be over the now capped tooth next to it and I would think it would be quite possible for forces to rip the cap right off.

There is an unopposed tooth above it so I should do something and will go this route if I'm reasonably sure it will work.

davedent said:

hi,
yes it is possible to construct a bridge using the adjacent teeth, this is mainly done for anterior teeth as the forces they experience are lower. The success of the bridge would depend on your occlusion and how your teeth function in excursive movements for example. The problem with bridges is that they put extra load on the supporting teeth which can cause problems. But if the dentist has examined you he must be satisfied that the bridge would be successful. Just ask him to explain the pros and cons to you on your next visit.

Click to expand...

Sorry to cut in, but I have a question about dentists. How should one find a new dentist when moving to a new city? Do people just use a phonebook for dentist? Does one just get referrals from friends and family?

geepondy said:

Thanks for yours and other advice. The pros are that even at 3 grand (insurance pays half), it's still considerably cheaper then an implant and he says the tooth next to it has a very deep filling and most likely will have to be capped one day as it is, so he's sorta killing two birds with one stone. The second tooth used for support however is quite healthy.

I'm not afraid to get the bridge, I have a very successful one on the other side (supported on each side by a tooth), I just can't quite see how it would work as when you bite down the center of gravity or fulcrum is going to be over the now capped tooth next to it and I would think it would be quite possible for forces to rip the cap right off.

There is an unopposed tooth above it so I should do something and will go this route if I'm reasonably sure it will work.

Click to expand...

I don't understand how you can say that it's cheaper than the implant.

I lost a single tooth due to an infection, and then had one of the most expensive dentists here (professor at NYU school of dentistry) do the implant for me... The implant and restoration cost about $5000 before insurance... and considering that it's forever, and the operation was difficult due to the angle and structure of my jaw bone, I'm very happy with it.

If your insurance will pay for half, you could probably find a good surgeon to do your implant for $4000, thus making your final cost around $2000... that's probably deductible from your taxes.

Considering that you will likely have to do followup dental work on the bridge later on, an implant might be a better deal in the long run anyway.

I forget the exact numbers but yes, the implant I think was somewhere between four and five K and insurance is capped at $1500.

i have so many teeth problems im afraid to brush em i think its my gums that are messed up im about to lose a front tooth im not happy because ill look weird

Hey raggie, take 500 mg of Vitamin C a day. Very cheap way to keep your gums in good shape. Lots of other health benefits too.

cool ill try that i used to take vitamin c but i quit i also used to take multi vitamin and quit to.im going to restart both

Co-Enzyme Q10 has really helped my gums and would recommend it for gum health.