Dear Dr. Crapo: I’m in my early forties and have never had good teeth. I’ve had decay, it seems, since I was a young child. We couldn’t afford regular care so when things got bad enough my teeth were just pulled. It’s my upper teeth I’m most concerned with. Four years ago I had a root canal on my upper left tooth behind my eyetooth and a crown. Last week the crown fell off and now I have an ugly space. I have a root canal and crown on that eyetooth that has lasted twenty-five years. I also have a root canal on the small tooth right beside it but it has been only built-up to look like a tooth. Behind the space created by the fallen crown, is another tooth that is falling apart. I don’t have any molar teeth on that upper left side. I thought crowns and root canals are supposed to last a long time. I have insurance but I don’t know what to do. My income is a bit sporadic. At times it’s good, other times I have to budget tightly. I saw a dentist and he said the root was gone on the four year old job – I was quite upset, given the eyetooth has been there for twenty-five years. He said I needed an implant after the root was pulled out. When I asked what that would cost he didn’t know exactly, because he doesn’t extract roots and put in implants but he does the crowns. I looked around and saw that implants are expensive and my dental plan doesn’t pay much of the total cost. Why not? Anyway, is there a different approach? I’ve got to get something done. I can’t walk around with a hole in my face. I have a very good plan but no implant coverage.
Your research is correct. Dental plans don’t get involved with implants until it’s time to fix the crown to the implant. It has ever been thus and there is nothing to say that policy will change.
Another approach is to use a fixed bridge. This means that like a crown, it stays in your mouth permanently and you clean it like your own teeth.
The procedure would look like this. Removal of the crown on the eyetooth, removing the decay on the second bicuspid, then preparing the teeth for a bridge. While a temporary bridge is made, the root can be removed and bone placed in the socket so there is no collapse of the gum and bone during healing. Once the socket has healed, final impressions can be made to construct a permanent bridge. Done well and cared for, you can expect many years of service.
If we can help, we’d like to. Call 778-410-2080 for a consultation.