I have a three-piece bridge and the post in one tooth broke off. What kind of dentist can do this so I can get another post put in? These are my front teeth.
This bridge was only put in a couple of years ago and is on teeth numbers 7, 8, and 9. Number 8 is the false tooth. Number 7 needed a root canal and there wasn’t much left of the tooth, so my dentist put a post in there to help hold the bridge. But now that tooth has broken off at the gumline right through the post, and the bridge is being held on by only the one tooth.
(See Dr. Hall’s answer below.)
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The first question that comes to my mind when you tell me you want to replace the post that broke in your tooth is “What is going to keep the replacement post from breaking?”
I wrote a blog post about five years ago about removing metal posts from teeth. Both the person who asked me and the case I treated were dealing with possible sensitivity to the metal in the posts. That’s a very different situation than yours. They just wanted to get rid of the metal. You’re wanting to repair a break.
You’re dealing with several difficult problems here. First of all, with the post broken off at the gumline, there is nothing there to grab, which is going to limit the techniques that could be used to remove it. Sometimes an ultrasonic scaler instrument can be held to the post, which, given enough time, may loosen the cement and enable the dentist to twist it out of the tooth. But in your case, in order to grab the post to be able to twist it, the dentist would have to drill away a fair amount of tooth structure around the post. And this is tooth #7, which is the right lateral incisor—the smallest front tooth. Drilling around the post to be able to grab it would leave you with an even weaker situation for the new post because there would be that much less tooth to give retention to the post.
Second, in order to do any of this, the dentist would have to cut this crown off the bridge to be able to get enough access to the post. Once that is done, he or she may as well grind the entire bridge off because you would need an entirely new bridge That is one of the disadvantages of replacing a missing tooth with a bridge instead of an implant—if anything happens to any one of the teeth involved, the whole bridge needs to be replaced. Repair options are limited here.
Third, there is no reason to expect a new post to last any longer than the old one, and it would probably not last as long. I’m guessing that you have a bite that puts a lot of lateral stress on your front teeth.
My experience with patients that have heavy biting forces and teeth that have broken off at the gumline is that they will also break off dental work. I’ll give you my recommendation, with the disclaimer that I haven’t seen your case myself and don’t know everything about it, so I would defer to a qualified dentist who has examined you in person. But my guess is that in order to get a stable situation for your front teeth, you will need two dental implants—one to replace the missing tooth, and one to replace this lateral incisor (#7) that has broken off at the gumline. You could try to save #7 and go with a longer 4-unit bridge from the right canine to the left central incisor, but that will give additional stress to those two teeth, and given your history of breaking things off, would be too risky, in my opinion, again with the disclaimer that I haven’t actually examined you and don’t know the whole history here.
– 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.