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A Silent Abscess?

Q: Dr. Crapo: I have had a very good and long life. My
health is a great gift and when my age comes up it becomes a talking point. I’m 95. Life is great but I do have some dental needs. Over the years, I’ve had bridges and implants and crowns. All was going good until I felt some movement on my upper left bridge. I saw a dentist and he told me that the front anchor tooth of the bridge had broken right in half. He said it was a complicated
issue because one of the other anchor teeth holding the bridge had lost a lot
of bone and had an abscess – can that happen, I don’t feel a thing. Anyway, he
said there wasn’t enough bone around the roots of that abscessed tooth, so it
would make for an even more complicated issue. He told me I have only two good
teeth on that side, the very back tooth, I think he said it was my twelve-year
molar and then a front side tooth next to my very front teeth, which is an
implant. So, if I lose the bad teeth in the bridge, I’ll have a tooth way back
and then a front side tooth - I’ll have a huge gap when I smile. I can’t manage
with no back teeth. What can be done? I thought of implants but he wasn’t sure
if I had enough bone. The broken tooth on the front of the bridge is my
eyetooth if that helps. My two upper front teeth need

new crowns as well, so what am I to do?

A: To answer your question about abscesses –
yes, a person can have what is called a silent abscess. A tooth can die without
one being aware or it being painful. Regularly, we see “silent abscesses” when
we take x-rays. 

Another piece of information that will help in your situation is this – if you have an
existing tooth – even if it has broken, you will be able to use that spot once
it’s removed, for an implant. Often an implant can be placed the same day the
tooth and its root is removed. If there are bone issues, that socket can be
grafted and six months later, sometimes earlier, an implant can be placed

If your back tooth is in good shape a bridge could be extended from the back tooth
to the new implant (in the eyetooth area) and the existing implant. That would
give you two front implant anchors and a strong molar tooth to anchor your

During the healing time your two front teeth and the implant tooth can act as front
anchors to the temporary bridge. In the final stage when the new bridge is
made, the two front teeth would get permanent crowns, separate from the new


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

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