Tag Archives: Dental Bridge

dental bridge or implant

I have to replace two teeth and get a dental crown on another one. I’m trying to decide between dental implants and a dental bridge. What do you think would best work?

Kevin

Dear Kevin,

Both a dental implant and a dental bridge are good tooth replacement options. Which one you get will depend on a couple of things. First, I’ll go over how both of them work. Then, we’ll discuss which to choose.

An illustration of a dental implant among natural teeth
A Dental Implant

With dental implants, a prosthetic tooth root is surgically placed into your jaw. There is a time of healing after the surgery and to allow the bone to integrate around the implant. After that time period, a dental crown will be placed on it

There are benefits to dental implants. They’re completely secure and the closest thing to having a healthy, natural tooth in your mouth again. Additionally, the root form signals to your brain the jawbone in that area is still necessary, thereby preserving it.

Illustration of a dental bridge
Dental Bridge

With a dental bridge, a false tooth is suspended between two crowns. This is secured by being bonded onto the adjacent teeth. It makes more sense when one of the adjacent teeth already needs a crown. Without that, you’re just grinding down healthy tooth structure.

Implant or Bridge?

If you need a false tooth next to the tooth which needs to be crowned, then it would be a good idea to get the bridge. If the tooth which needs a crown is elsewhere, I’d get the dental implants to replace the tooth and then get the single tooth crowned.

I hope this helps. This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

lumineers trouble

I had Lumineers placed on both my top and bottom teeth. The top ones did absolutely fine. It’s the bottom ones I am having trouble with. They’re in massive pain and I’ve already lost one tooth when a root canal didn’t help. My dentist is going to put on a bridge free of charge. He doesn’t know why there is so much pain. He’s trying to help but I’m living on pain killers right now. I don’t want this to be the rest of my life, especially knowing how addictive they are. Can you help? Have you heard of this happening before?

Margie

Dear Margie,

There are a couple of things going on here. First, Lumineers are often advertised to inexperienced cosmetic dentists as being easy to place. That gets many well-intentioned dentists in over their heads.

A lot of this is because the Lumineers’ company promotes them as being no prep. Sometimes that can work out well on top teeth, though not always. Many patients complain about them being bulky. The bottom teeth, however, are a completely different story.

Second, when you’re talking about a no-prep technique, the teeth are about two millimeters longer as well as sticking out a tad. On bottom teeth, this can throw your teeth out of their proper occlusion and cause lots of pain for you.

That is likely what is going on in your case.

Cosmetic Work on Bottom Teeth

When it comes to smile makeovers, unless there is something which needs to change structurally with your bottom teeth, we’ll put porcelain veneers on the top teeth, but only whiten the bottom arch. Though, there are times veneers make sense. In those cases, however, tooth prep is necessary.

It does sound like your dentist is trying to take responsibility and make things right for you. That’s a sign you have an ethical dentist who just happened to do a procedure he wasn’t ready for. Don’t be too hard on him. We all start somewhere with procedures that are new to us. It’s a good sign that he’s stretching himself and adding to his field of knowledge.

Make sure you are out of pain before the bridge is placed. If he’s having trouble with that, you can suggest he talks to an expert cosmetic dentist, who’s studied occlusion as well. I’d look for an AACD accredited dentist in that case. Feel free to show him this post.

This blog is brought to you by Lafayette, LA Cosmetic Dentist Dr. Mike Malone.

Dental bridge before implant?

I’m a little concerned about what my dentist is recommending for a missing tooth on my 15-year-old daughter. We’re planning on getting her a dental implant when her jaw is developed enough for one. I was looking at some temporary replacements. I thought a flipper would be a good option, but my dentist wants to give her a dental bridge. I think that’s a bad idea, but he said flippers are too temporary. What do you think?

Mandy

Dear Mandy,

woman smiling with a dentist
It’s always okay to get a second opinion from another dentist

I’m glad you wrote about this. While a dental bridge is a more secure fit, I don’t think it is a good fit for a teen aged girl. There are two reasons for this.

First, just like her jaw is still developing for her dental implant, she will need new bridges. That is too expensive to keep replacing as she grows.

Even though the flippers are meant to be temporary, you can replace those in a much more affordable way than the bridge.

There is another reason too which has nothing to do with cost. A dental bridge requires her adjacent teeth to be crowned in order to support and suspend the false tooth. That will mean those teeth will always have to be crowned for the remainder of her life.

If those teeth are healthy, you won’t want to grind down the healthy structure.

It’s Okay to Get a Second Opinion from Another Dentist

A good dentist will give you all of your options. Even then, they will make a recommendation. if you don’t like their recommendation and they’re pressuring you to go with their option, I recommend getting a second opinion.

If your dentist refuses to do the treatment you want you can go to another dentist for that procedure. That means you could get your daughter a dental flipper elsewhere. You don’t have to switch dentists to do that, unless you want to.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Help! My Front Tooth is Loose

I am terrified. I discovered my front tooth is loose. I don’t remember hitting it and I don’t think the other teeth are loose. Can a dentist fix this? What if it can’t be fixed? Do they make dentures for one tooth? Help me!

Samantha

Dear Samantha,

A woman with a gorgeous smile created by cosmetic dentist Dr. Mike Malone
A gorgeous smile created by cosmetic dentist Dr. Mike Malone

First, I want you to take a deep breath. You will not end up with a space where a front tooth should be for the rest of your life. The first thing you need to do is schedule an emergency appointment with your dentist. If the tooth is loose, regardless of the cause, it needs to be splinted to keep it secure.

Next, your dentist will need to determine why it’s loose. Do you have gum disease? Was there trauma? He’ll want to do some x-rays to see if the pulp was damaged. If so, you’ll need a root canal treatment.

Dental Solutions for a Missing Tooth

If you do end up losing this tooth, which would surprise me if this is the first sign of a problem and you don’t remember any trauma, there are solutions. We’ll go over each of them, from the least desirable (and least expensive) to the highest quality replacement, which is also more pricey.

Removable Partial DentureYes, there are “dentures” for a single tooth. It’s called a removable partial denture. It connects onto your other, healthy teeth, with a false tooth attached. It does put pressure on the teeth it hooks to so it’s not the ideal solution, but depending on your budget, you might use it as a temporary solution while you save up for one of the more preferable treatments.

Illustration of a dental bridgeThe next best solution is a dental bridge. This suspends a false tooth between two dental crowns. In reality, this makes more sense if your adjacent teeth (which will receive the crowns) need work anyway. In that case, it’s like knocking out two problems with one. However, if they don’t need work, I wouldn’t want to remove any healthy tooth structure.

Dental Implant DiagramThe top of the line replacement is to get a dental implant. It’s like having a healthy, natural tooth back. If your budget allows, this would be the treatment I’d choose. A prosthetic root is implanted where the natural root was, then a porcelain crown is placed on top. You can eat, brush, and floss just like you normally would. They’re very strong and last for many years.

Getting a Beautiful, Natural-Looking Tooth

You’re talking about replacing a front tooth, so you want to be certain the dentist is also a skilled cosmetic dentist. Whatever crown he creates for your front tooth needs to look just like the adjacent tooth. Above all else, make sure they give you an all-porcelain crown and not a porcelain-fused-to-metal crown.

This blog is brought to you by Dr. Mike Malone.

Do I Get a Dental Implant or a Dental Bridge?

I lost a tooth. It’s my own fault. I waited too long to deal with it and now I have to replace it. My dentist is suggesting a dental implant, but I’m not too keen on the idea of surgery. Would a dental bridge do something close?

Kevin C.

Dear Kevin,

It depends on how close you’re wanting to get. Both a dental implant and a dental bridge are acceptable tooth replacement options. Both are permanent and secure. There are important differences though. I’ll explain both options. Then, you can discuss with your dentist what fits your situation best. His job isn’t to pressure you into an option, but rather to give you your options and a recommendation. The final decision is yours.

Dental Implants

Dental Implant DiagramYou already knew that a dental implant required surgery. The diagram on the left shows why.

As you can see, the implant is placed directly into your jawbone. The benefits to this are it’s like having your own natural tooth back, it preserves your jawbone, and no other teeth need to lose tooth structure for its placement.

Dental Bridge

Illustration of a dental bridgeA dental bridge is also permanent however, in order to bond them, it requires grinding down the adjacent teeth. Additionally, if part of it breaks the whole unit will have to be redone. They also do nothing to preserve the bone underneath.

When Does a Dental Bridge Make More Sense?

While it may sound like I’m suggesting dental implants are the better option, there is a time when a dental bridge makes more sense. For instance, if the adjacent teeth need to be crowned anyway then it’s like getting two procedures in one. Then, you’re not grinding healthy tooth structure.

The key is good communication with your dentist. He or she knows your teeth. If finances are a consideration as well, many dentists will let you pay out a procedure like dental implants which are a little more costly than simple procedures like a filling.

Who Should Do Your Tooth Restorations?

When you’re looking at replacing teeth, it’s important you choose the right dentist. The especially important when the tooth is in a visible part of your smile. You want it to look natural and beautiful. Not every dentist can pull that off.

Look for a dentist who’s accredited with the American Academy of Cosmetic Dentistry (AACD). These are the top cosmetic dentists in the country. One other thing to consider. Once your implant crown or dental bridge is made, the color cannot be changed. If you want a whiter smile, be sure to have your teeth whitened before your tooth replacement procedure is done. That way your restoration will match your bright white smile.

This blog is brought to you by Dr. Mike Malone.

Could CEREC Crown Have Saved My Tooth?

I needed a root canal treatment and dental crown. I wanted to do a CEREC crown, but my dentist doesn’t have the machine. I considered going elsewhere, but felt guilty about going to another dentist. So, I thought the traditional crown would have to suffice. After he made the temporary, I had to go out of town for work. While I was gone, the temporary crown broke. I called my dentist and he said it would be fine, though to try and eat on the other side of my mouth. I was super careful. When I got back, I immediately went to the dentist but he told me that a crown would no longer work. First, the crown would no longer fit and we’d have to start over. But, that part of my tooth broke and the rest was brittle, so he’d have to do an extraction. Is this really my only option? Now what? I’m over $2000 into this crown which I can’t even have and now I’m losing the tooth. Should I have gone to a CEREC dentist?

Minnie W.

Dear Minnie,

A tooth receiving a CEREC crown

There are some things that bother me about what you’re saying. I’d like you to get a second opinion to see if your tooth can be saved. Preferably to a dentist who does provide CEREC crowns. Some dentists will even do free second opinions. While certainly, a CEREC crown would have saved your tooth, because it would have been protected from day one, there’s more at issue here.

If he’d have suggested you see an emergency dentist when your temporary broke, this would also have protected your tooth. It would also have allowed your permanent crown to fit. When you leave the space empty, it doesn’t always take very long for your teeth to shift leading to the crown not fitting properly. This was your dentist’s fault.

Something else which bothers me is how quickly the tooth became brittle. That’s uncommon.

If You Can’t Get a CEREC Crown and Lose the Tooth, What then?

If it turns out you can’t save the tooth, I’d first ask for a full refund from your first dentist. Then it’s time to decide on a tooth replacement. The two best options are dental implants or a dental bridge. A dental bridge would make more sense if either of the adjacent teeth need to be crowned.

If they don’t, then a dental implant would be a better option. It’s a great tooth replacement, but you don’t want just any dentist to do it. It’s an advanced procedure. Be sure to ask the dentist how many they’ve done and what their success rate is? It needs to be at least 98%.

This blog is brought to you by Dr. Mike Malone.

Can CEREC Crowns Handle Night Grinding?

My dentist recently purchased a CEREC machine he’s very excited about. I have a cavity that he feels is too large for a filling. He wants to me have a crown done using the machine. I just wanted to get a second opinion as to how they hold up as well as normal crowns. My dentist said I grind my teeth at night. I’m assuming he would only give me a crown that would hold up against that, but just wanted to double check.

Lizza

Dear Lizza,

Machine for CEREC Crowns

This is one of those yes and no answers. CEREC crowns are every bit as strong as traditional crowns. The biggest difference is they’re able to milled at the time of your appointment, eliminating the need for either a temporary crown or a second appointment.

However, I’m truly concerned about your grinding. When your dentist mentioned to you your teeth showed evidence of nighttime grinding, did he suggest anything to you, such as a nightguard? Your teeth need protecting. The stress of grinding will not only wear down the enamel of your teeth down, but can also lead to your teeth cracking and breaking.

When your enamel wears down it leaves you vulnerable to decay. With decay, you’ll be looking at a mouth full of fillings. Even worse, would be the possibility of losing a tooth. Then you’re looking at getting a tooth replacement, such as dental implants or a dental bridge.

While your choice of crown is fine, just like your natural teeth, it won’t stand up under grinding without you having some type of nightguard to protect both your natural teeth and your crowns.

This blog is brought to you by Dr. Mike Malone.

Can a General Dentist do Dental Implants?

I need to replace a tooth. Everyone says dental implants are the best replacement. Are there implant specialists or can a general dentist do them?

Max L. – Connecticut

Max,

First, I’ll say, yes, dental implants really are the top of the line tooth replacement. Be aware that not everyone is a candidate for dental implants. There are some conditions which are contra-indicative, like gum disease. Or, if you’re a smoker, you’ll be hard-pressed to find a good dentist willing to go forward with the procedure. If it turns out you’re not a candidate, there are other good options which we’ll discuss momentarily.

As to whether or not you need a dental implant specialist, that’s a yes and no. There isn’t actually a recognized specialty in implants, so any dentist who does them is a general dentist. However, it takes some additional training than what they get in dental school to be skilled in this procedure.

Dental Implants are an advanced procedure, with potentially severe complications if things go wrong. Because of that you’ll want to be bold in asking the dentist some blunt questions. Some things to ask are “What type of implant training have you had?” “How many implant procedures have you performed?” “What percentage of them are successful?”

So, what if you’re not a good candidate? Whatever dentist you go to should give you all your options. For instance, the next best procedure would likely be a dental bridge. In fact, if your adjacent teeth need a crown, a dental bridge might make more sense for you.

The important thing is you find a dentist you trust and then have them explain all the procedures you’re a candidate for.

This blog is brought to you by Dr. Mike Malone.

I Want an Implant and My Dentist Wants Me to Get a Bridge

I have two teeth that need work. They’re right next to each other. One needs a crown. The other needs to be extracted. I want to do a dental implant and a crown. My dentist wants to do a bridge. I’d think he’d be more excited about a dental implant because they’re more expensive, but he seems pretty insistent about a bridge.  Is there a real medical reason for this?  I’m not too excited about the idea of a bridge.

Brenda C. – Michigan

Brenda,

My guess is your dentist isn’t comfortable with dental implants.  It’s an extremely advanced procedure. I wouldn’t push your dentist if that’s the case. When it’s not done perfectly, there can be serious complications.  It’s a credit to your dentist that he’s not just taking your money and doing the procedure halfway.

A bridge is fine in your case. You already need work on one of the adjacent teeth, so it’s like getting two procedures knocked out in one—no pun intended. However, your other tooth is healthy so you might not want to grind down healthy tooth structure. I understand your desire to go with an implant and crown.

My suggestion would be to get the implant and crown, but with another dentist. I’m not saying leave your current dentist, just have this particular procedure done with someone else. Then, you can continue with your current dentist for general treatments and cleanings afterward.

This blog is brought to you by Dr. Mike Malone.

What are some decent tooth replacement options?

I have to get a tooth extracted. I wanted to get a second opinion on some good tooth replacement options. Money is no object. I want the best. What are your thoughts?

Martin C. – Albany, NY

Martin,

My initial thought is if you want the top tooth replacement option, than just about any dentist would tell you to get dental implants.  They’re the most like having your own natural tooth.  If you’re in good general health, than you are likely a candidate.

There are times when a dental bridge makes more sense. That’s generally if the adjacent teeth to the missing tooth happen to need dental crowns. If that’s the case, a dental bridge will take care of two procedures at once.

You didn’t say what your dentist suggested. If he’s not adequately trained in dental implants, then he wouldn’t be likely to suggest them.  But, it is the ideal treatment if you’re a candidate.

There are other options, as well, aside from implants and bridges, such as a removable partial denture, but you asked for the top treatments.

This blog is brought to you by Dr. Mike Malone.