Dr. Hall,
My dentist is planning a six-tooth bridge, from tooth #6 to #11. (Note – 6 and 11 are the canines, 7 and 10 are the lateral incisors, and 8 and 9 are the central incisors.) Implants are #9, #10, and #11; #8 is missing; #6 and #7 are crowns on natural teeth.
I broke my front teeth playing basketball years ago. I am now 60 years old, very healthy and active, no medical problems. Would you recommend that I get a removable partial plate for #9 instead of a 6 tooth bridge? Or, would it be best to divide the bridge into two or three parts? What material would you recommend? Should there be a space between a bridge and the gum for proper cleaning?
I have obstructive sleep apnea. When this process is completed, I would like to get an oral sleep apnea device. What do you think about that possibility?
– Lois
(See Dr. Hall’s answer below.)
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Lois,
I’m not going to get too much into specifics of various treatment options. Without personally examining you, there are some limitations in trying to evaluate specific treatment plans. But let me comment on the situation.
They’re talking about tying two natural teeth to three implants with a fixed bridge. This is a controversial subject area. Teeth are attached to the bone with ligaments, which affords them some limited movement. Implants, however, are fused directly to the bone and so are completely rigid. Can they be joined together by a rigid bridge? While most researchers conclude that this can be done, others question that. But even if it is done, everything I have read on the subject suggests that it needs to be done very carefully in order to not compromise the natural teeth.
In addition, tying all your front teeth together in a single bridge carries other risks. If anything goes wrong with any one of those teeth, the bridge will have to be completely re-done. Keeping them separate avoids this complication.
Another difficulty is keeping the teeth clean. If the teeth are attached together, flossing can be accomplished only with the annoying and time-consuming use of a floss threader.
I’m not understanding why your dentist doesn’t suggest the option of just replacing the missing tooth with a single, unattached implant. This would be the most straightforward, least complicated, easiest to maintain solution. A removable partial with the one tooth, which could be a flipper partial, would be the least expensive solution and would also be acceptable.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.