Bridge vs Implants

Q: Dear Dr. Crapo: Almost 50 years ago while expecting my second child, I was travelling with my husband. His business took us all over western Canada and the U.S. We ended up one day in a small town and went out to lunch. During my meal, I bit down hard on a crusty piece of bread and heard a crack. It sounded like an explosion in my mouth. I knew right away something was wrong. I excused myself and went to the washroom to spit out the contents of my mouth. Once rinsed, I explored my mouth to find I’d broken, quite badly, my second to last molar on my lower right side. Fortunately, or not, we found a dentist in this town. He took one look, froze me up and pulled the tooth. Since that time, I’ve just learned to deal with no tooth there. However lately, the tooth behind the extraction area is wearing significantly and the tooth in front of the extraction area has started to decay. Though it has been fifty years, I’ve only changed fillings when it’s been necessary but now it looks like I need crowns on both teeth, so it was suggested that a bridge would be a good way to go. I’ve been told that in those years that the tooth that was hitting the extracted one has descended down, so if I do a bridge the top tooth must get cut back to put it in it’s original position. I’m told it will need to be crowned. I should have acted sooner but it hasn’t hurt and I’ve gotten by just fine, but now what to do.

A: You’ve got at least three options. The option we would ideally suggest is to put an implant in the space and then crown the other teeth (two on the bottom on either side of the implant and the one above, so your bite is even). Another option is to bridge the two lower teeth so they are protected, the decay is eliminated and you have greater chewing ability. Of course, the upper tooth would also have to be crowned. Both of these options require a good analysis before proceeding, to make the best result. The last option is to simply crown the lower teeth and leave the space. This is not the best option but in the short run it is the simplest – and you are used to the space. Option one is the best because it can be cleaned and maintained better than a bridge. It is better than option three because it provides greater chewing function and prevents further bite changes.

If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

Based on actual patient cases

 Calvin Ross Crapo

Victoria Implant Centre

778-410-2080

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I Looked In The Mirror And...

Q: Dr. Crapo: As a child I had an accident where I lost my two front teeth. When I was old enough, a dental bridge was placed to replace the loose partial flipper. It worked okay. I got married, had a family, then about twelve years ago I had a problem with an upper left back tooth. The dentist was young and inexperienced and took out a tooth. It took two hours. I was in such a state that I saw a specialist who said it was unfortunate I hadn’t seen someone with more experience – but it cost me two more teeth. I have no back teeth on the upper left and so much bone was removed, that I don’t have enough for implants. Three years later it was necessary to replace my bridge. It wasn’t a perfect job but my family said it was fine. The other day I was looking at my adult daughter and realized she had my exact teeth and my bridge of nine years wasn’t close. I was really upset because I knew that from the start it wasn’t me. I saw a dentist and he told me that from a technical point of view the fit was fine and wasn’t a bad job appearance wise. He said the gums had shrunk under the teeth that were knocked out and that the tooth proportions could be better. When I told him about my daughter, he said something better could be done and maybe a picture would help. The dental bridge is attached to the side teeth, (the teeth beside the ones knocked out) and he pointed out that they could be made smaller, but then the front ones might be too large. I’d like something done but I don’t like the hook on the upper left eyetooth. I’ve been told that I’ll have to get a new partial if my bridge is changed. It’s all confusing and seems like I’m at an impasse.

A: The first thing is to decide what is most important to you. If it’s the front teeth, get pictures of your daughter if you like her teeth and if possible, return to your dentist with her. Molds of her teeth are useful too, then a mock-up of “your new teeth” on your molds to resemble your desired look, should be made. When that is done it may be discovered that the eyeteeth will have to be included, so the proper tooth size can be made for each tooth. Make sure you’re happy with the mock-up. From there, a new dental bridge can be done to your satisfaction. Your existing partial can be made to fit it – it’s done all the time. If your left sinus is healthy, bone can be added so that implants can be placed to eliminate the partial. You can always count on Dr. C Ross Crapo & Associates for protecting your oral health. We specialize in family dentistry, cosmetic dentistry, implant dentistry and restorative dentistry.

If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080

www.VictoriaImplantCentre.com