Q: Dr. Crapo: I have a bridge glued onto four teeth on my upper right side. I lost a bicuspid many years ago and the bridge was put in with extra teeth to hold it in because two of the teeth weren’t strong enough to hold the bridge.
Over time one of the weaker teeth has undergone a root canal and then something didn’t work, so a root was taken off it.
That worked for a while, but now I’ve been informed that there’s new infection on one of the roots. I’ve seen several doctors. I know that one of the doctors said in passing that another root could be removed.
The problem is that the gum shrank so much the last time that it’s a big food collection site. It really drives me crazy digging stuff out of there. Is this such a hard thing to do?
I saw another dentist and he said if I was willing to redo the bridge the bad tooth could be taken out and another fake tooth made in the bridge, so I’d have three teeth holding the bridge and two fake teeth. I guess that’s an alright answer. Nobody has mentioned implants and that seems strange. I’ve got pretty good bone and I heal very well. I thought maybe implants could be used. My bridge goes from my eyetooth and the one behind it, then there’s the space where the bridge tooth is, then there’s the bad molar with the receding gums and then the last tooth is included. I want this infection gone!
A: It’s always difficult without two and three dimensional x-rays and without molds of your teeth, to give you a precise suggestion.
If the teeth on the front of the bridge are in good shape and the very last tooth is in good shape as well, you may be able to save the crowns on those teeth.
The next assumption is that you’ve got adequate or good bone as you say, where the tooth has been missing for years. Then let’s say you’ve got adequate bone where the defective molar now sits. If this is the case, implants could be placed in those areas after the bridge is reduced by cutting out the bridge tooth and the crown and roots of the bad molar. Implants placed at the time of extraction, is a good practice if the boney housing of the roots is in good shape and the infection eliminated.
One word of caution, these roots and the space in this area could be close to the sinus. With proper x-rays and molds of your teeth, that can be forecast and the appropriate measures taken. There are several other options that include implants but this is the most elegant if the right circumstances exist.