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Dear Dr. Hall,
My 9-year-old daughter has lost her left front permanent tooth in a scooter accident. The tooth is gone completely. One dentist suggested a clip-on tooth until she can have an implant but we saw a specialist and he suggested a Maryland bridge (zirconia with 1 wing) that is connected to the other front tooth.
What do you think?
If she would not bite with front teeth could it still damage the other tooth? Is there another solution because she is only nine and we have to wait about 10 years for implant
Thanks for you answer in advance.
Oh no, this would be a very bad idea to do a Maryland bridge attached to just one tooth. The dentist suggesting that doesn’t know what he is doing. Number one, It won’t stay on. There would be too much stress on the false tooth. Even when a Maryland bridge is attached on both sides it is hard to get it to stay. Attached to one side I would be surprised if it lasted a month.
Besides that, it would produce unnatural stresses on that other front tooth, possibly leading to the loss of that tooth also. As a minimum it will require irreversible grinding on that other front tooth. No, do the removable clip-on tooth.
But it would be even worse if the Maryland bridge did stay on, because it would create a rotating force on the tooth it was attached to and you would end up with the false front tooth sticking out and the natural tooth it’s attached to would be rotated. This is called a cantilever bridge, because it is suspended from only one side. To be stable, a cantilever bridge needs to be supported by at least two other teeth. Attached to just one tooth it will have the problems I mentioned. Her next little accident would result in the loss of both teeth.
Do a removable clip-on tooth. Because of the way her teeth will be changing over the next few years, you will probably have to replace that removable tooth at least a couple of times until she is old enough for an implant, but that is the only reliable way to replace that tooth right now. ANYTHING you do will have to be replaced the same. Just go with the removable tooth.
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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.