Q: About eight years ago I needed some dental work on my upper front teeth. I was missing the side front teeth; I had ugly gaps there and large fillings and root canals from my front teeth to my molars. At the time, I was told about implants for crowns to replace my missing front side teeth. I thought about it then decided against implants. I was nervous about them and decided that bridges were better for me. Bridges were faster and made all my teeth look nice. The bridges served me well until about a year ago. Then one day as I was dutifully flossing I got a gross smell and foul taste. I swished my mouth, got the taste out and flossed again. I thought to my self “what was that?” Two days later it happened again and then it was every day. I made an appointment with my dentist and he told me that I had bad decay under the front tooth that was smelling and that the tooth couldn’t be saved. The bridge would have to come out and either an implant put in or both bridges come out and one big new bridge put in for proper anchorage.
Without that front tooth, the bridge would have nothing to hold it in place. A new implant can’t hold the bridge right away so what am I to do? I wish I’d gone with implants in the first place.
A: There is no question about the complexity of your situation. However, there are avenues that may prove helpful and ensure long lasting results.
First your dentist must determine if the teeth on the other side of the failing bridge are in good shape. If they are, he must evaluate removing the bridge without damage to those good teeth. If removing the bridge is possible the extraction of the unsalvageable tooth and grafting the socket is straight forward. You are then left with the good anchor teeth.
Once the grafting is done the bridge can be reattached with strong temporary cement that will fix it to the good anchor teeth. The crown of the bridge where there is no tooth support (it was extracted) is secured by bonding it to the tooth it was originally adjacent to. This is done to secure the bridge during healing. In six months when the bone is fully hardened, the bridge is removed and the implants placed. The bridge is then reattached as before until the bone has healed around the implants. At that point crowns can be made for the implants.