Q: Dr. Crapo: A year and a half ago, I had to have my right upper front tooth pulled. I had previously, some years before, had my molars pulled, so after the front tooth was pulled I have nine upper teeth left. The dentist decided to give me a partial denture to replace the front tooth and the molars. It didn’t feel quite right when he put it in so he adjusted it the best he could and told me I’d get used to it. My problem is that after a year and a half I can’t eat with it. I have to take it out to eat. Another problem is that one of my back teeth, the one just in front of the molars (that I don’t have) is loose and the dentist said it would have to come out one of these days. When I told him I couldn’t eat with the partial in, he didn’t have anything to say other than I could get an implant for my front tooth. He doesn’t do them, so I saw someone else who said I didn’t have enough bone and I’d need bone added before I could get it done. I’ve paid for a partial, it doesn’t work and I’ve got a loose tooth that might have to be pulled. I feel like I’m up a creek. Can you offer some suggestions? Oh one last thing, the dentist said I couldn’t do a bridge in the front because one of the roots wasn’t strong enough to hold the bridge.
A: If you are a non-smoker and have no debilitating disease, three ideas come to mind. The least expensive idea is to make a bridge and include more teeth. Instead of anchoring the bridge with one tooth on either side, use two; almost always this produces a very stable bridge. Your loose tooth may be loose because of pressure from your partial. Adjust the loose tooth when you put in the new bridge. This will allow it to firm up. Though not ideal, many people operate without molars at all.
In a more comprehensive light and only if the x-rays reveal adequate bone around each tooth, temporary bridge work can be put in place to splint together all your upper teeth. After six months an evaluation is made to ensure every tooth is solid, ready for the permanent bridge work.
A final idea that is more expensive but is faster, easier for you and instantly fixes your problem, is the “teeth-in-a-day” route. This is a wonderful solution when teeth are loose but you have adequate bone for implants. You go home that day with beautiful teeth fixed in your mouth.