Q: When I was a teenager my teeth weren’t coming in properly so my parents took me to the dentist. After an exam and x-rays he found out I was missing some of my front teeth leaving a nasty gap where my upper eye teeth should have been. They had moved in beside my front teeth. I looked like Dracula so the dentist smoothed the points down a bit to make them more natural.
He said in a few years I would get permanent bridges to fill the gaps. I was about twenty-two when I got bridges on both sides. They weren’t works of art but they filled in the spaces and I had them for thirty-years. In my early sixties, my dentist told me the bridges were beginning to fail so I had one of them replaced. Shortly after, I started having trouble with the teeth holding the bridge so I had root canals.
About a year later while eating the whole bridge came out of my mouth. I saw the dentist and he said the teeth were broken so badly they had to come out so out they came and a partial was made. From the moment it went in I couldn’t eat with it. Even wearing it made me gag.
So here I am happy to be wearing a mask so no one can see my huge gap. I’ve been told my bone isn’t wide enough for implants so what am I to do? I saw another dentist and he said there are techniques that will allow for implants. I think I just want a fixed bridge—is that too much to ask? I have my front teeth then the gap starts and goes back to my first permanent molar. The doctor measured it and said three teeth will in the space. I’ve got to have something in there, tell me if I can have a bridge.
A: Fixed bridgework is almost always possible if there are teeth in front and behind the “gap”. When the space is large more of your natural teeth may be used as anchors for the bridge. In your case, you are missing the eye tooth which must take horizontal or shear forces as you chew and grind your food. Shear forces put a great amount of force on your bridge. It may well necessitate using both front teeth as the front anchors and depending on the strength of your first molar may require a second molar.
If this is the requirement another protective measure should be taken. Thin thimbles placed on each anchor tooth will prevent decay should one of the anchor teeth of the bridge lose its bond.
Bridgework has a long history of success. Healthy teeth in front and behind the gap will allow you to have a fixed bridge.