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.