I have a bridge on my upper right side and my dentist said I need to replace the bridge because one of the teeth holding the bridge is cracked below. I have no pain or symptoms, and replacing the bridge and crowns will be very costly.
Is there another way?
– Meredith from Newport Beach, CA
(See Dr. Hall’s answer below.)
We thank our advertisers who help fund this site.
Thanks for your question.The first thing that occurs to me about your situation is that your case is a great illustration of one of the chief advantages to replacing a missing tooth with an implant rather than a bridge. While a bridge may be less expensive up front, if anything goes wrong with any tooth that is part of the bridge, you will probably need to replace the entire bridge. With a dental implant, if anything goes wrong later with an adjacent tooth, it won’t affect the implant. (See my page on dental implant vs bridge for a discussion of these advantages.)
So, assuming that one of the abutment teeth in your bridge is cracked, that tooth would need to be extracted and you would need a new, longer bridge that is now replacing two teeth.
Having said that, I am skeptical of this diagnosis for a couple of reasons.
First, you aren’t having any symptoms. If this tooth is cracked, it would be the root that is cracked, and there would ordinarily be some sharp pain when you bite anything hard.
Second, it would be very unusual for a tooth that has a crown on it to crack. When a tooth is weak or cracked and in danger of splitting, the proper treatment is to place a crown, which will prevent the crack from growing and destroying the tooth. I have had patients with a strong bite that is sometimes called a gorilla bite who have broken off teeth at the gumline, but I have never seen a tooth with a crown on it develop a crack in the root.
To emphasize the preservative nature of a crown on a cracked tooth, I published research a number of years ago showing that even if a tooth is completely fractured through the root, under proper conditions the pieces can be forced back together, the tooth crowned, and the tooth can be saved.
Anyway, I’d recommend getting a second opinion before you do anything. But be careful of how you do this. Don’t go to Dr. Jones and say, “Dr. Smith said one of the teeth in my bridge is cracked and I need a new bridge. What do you think?” No, don’t identify your dentist because he or she may be friends with the other dentist. Also, give as little information as possible about what you were told, so that the opinion given will be completely independent. Don’t put the idea in their head that another dentist said the tooth is cracked. If the second dentist asks, just tell them you don’t want to say until they give their opinion. Go and say, “Dr. Jones, I want a second opinion. Do you see anything wrong on my upper right?”
If your dentist’s diagnosis comes from an x-ray, you could even send me a copy of the x-ray and I’ll tell you what I think.
– Dr. Hall
Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.