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Pay Now—So You Don’t Pay Later


Dr. Crapo

Question: Dr. Crapo: I’m thirty-eight years old and have many dental problems. I’d have thought with my parents’ care as a child and teenager that I’d be completely dentally fit, but I must admit that during my young adult years I neglected my teeth, did street drugs and just let myself go. As a result I had little or no money for dental care. I’ve had root canals and crowns and a bonded bridge that has come off several times in the last few months, though it was pretty good in the beginning. I’ve seen several dentists and a specialist about my bridge. One said, get a proper bridge to replace your bonded bridge. Another said he has a bridge and an implant in his mouth and he chooses the implant “hands down.” Now I’m confused and really don’t know what to do. If I do the so-called best (the implant) for my mouth, I’ll incur expenses I can’t manage. If I do the second best (the bridge), I’ll be spending money that I’ll have to sacrifice when I’ve got the funds to do the implant, because the bridge will have to come out. I know I’ve got to act now because I’ve got a bad taste coming from under my bridge and one dentist told me I’ve got decay there. I’ve got a good dental plan, but I’m paralyzed by my options. Have you got a good idea that would help out? I need to know soon!


Answer: All of us want the best, especially in taking care of a tricky problem. Your “Maryland” bridge was popular in the 80’s. The idea was that you could bond a bridge to existing whole teeth without modifying them much. The concept was great in principle and when used in the right application worked fairly well, but it was never intended to be a long-term solution: it was developed to save teeth and to provide an alternate, inexpensive solution. In my experience, they debonded often, became a plaque trap, and resulted in a higher incidence of decay.

In your present state, you have decay in both teeth supporting your bridge. They now need to be crowned. If funds are short, but you have a good dental plan, do a bridge. The plan will help with the total cost of the bridge. In several years when you can afford the implant, the bridge tooth can be removed, leaving the supporting teeth crowned on either side, with a new implant crown filling the space. In this way you act now, you get a good service, and in several years your cost is minimized when you replace the pontic (bridge) tooth with the implant. At worst you have a great service that may last the rest of your life.


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