Choices… Decisions…Not Always a Straight Line
Q: Some years ago, I lost a tooth due to my neglect. My dentist did a bridge and root canal to replace it. All was good. It served very well for many years. Then several months ago out of no where the root canal tooth holding the back part of the bridge got so sore I couldn’t stand it. Why, I thought, the tooth had a root canal I was good for life, but no.
I went back to my dentist and he sent me to a specialist who said it might need redoing but the tooth root might be cracked so it would have to come out. I didn’t want to hear that so I saw one other dentist and he told me that the root canal was well done and that it was for sure a cracked root.
He explained implants and bridges and my infection but to tell you the truth I was late for another appointment, and wasn’t listening well. He did draw a picture but I was between relieved, late for another appointment and had no idea what to choose so I think I need another run through. Is my bridge totally destroyed? Am I going to be without teeth? How long will it take? How did he know it was cracked?
A: You’ve given me lots to unpack so let’s start with your first question. Two thirds of your bridge may be lost. The part attached to the cracked tooth and the bridge tooth (replacing the previously missing tooth). This will leave the forward tooth covered with a crown.
You will be without two teeth for about four months if you have implants put into those spaces because they take time to integrate with your bone. If the infection has traveled through the bone and into your gums you will need a bone graft--another six months. Two implants placed where two teeth are missing is a very good and strong solution.
You will not be without teeth if you select the bridge option. The very back tooth will act as a retaining tooth but you will need to include the front tooth of your existing bridge and the one in front. Obviously, this is a case where your existing bridge is lost but you will have the temporary teeth (a plastic bridge) while you wait for the socket to heal. That will take about three months before a permanent bridge can be made to fit the area properly. Each person heals at a different rate so don’t be impatient, wait till you’re fully healed.
Lastly, the dentist knew it was a cracked root because of the disease location on the x-ray.
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Based on actual patient cases
Calvin Ross Crapo