I had a next to the front tooth extracted. My surgeon cautioned about an implant as I have been on fosamax for about 10 years. I am now wearing a flipper which annoys me and has a sour taste in my mouth. I read about the Encore Bridge or Maryland Bridge. The tooth next to the one pulled has a cap on it. Am I eligible for an Encore Bridge? My dentist hesitates to give a regular bridge as he would have to file down a front large tooth. Any advice?
– Susan in Massachusetts

Susan,
I have a couple of points that may be helpful.

First, taking Fosamax doesn’t mean you can’t have a dental implant. There is a slightly increased risk of serious local bone problems when you are taking Fosamax and you have oral surgery that involves the bone, which placing dental implants does. The risk is small, but the potential consequences are serious, so I wouldn’t ignore the risk. However, you can temporarily suspend taking the Fosamax and work around it, if your oral surgeon coordinates this with your physician.

If you don’t want to deal with that, then some type of dental bridge would be best. But I would leave it up to your dentist to choose the type of bridge. An Encore Bridge is a nice service and is esthetic and conservative. But I wouldn’t want you to be the first patient your dentist had ever done an Encore Bridge on. The procedure is very tricky and has some strength limitations. Stick to the types of bridges your dentist suggests, because then you can be fairly certain your dentist is comfortable doing that type of bridge.

If your dentist is a typical general dentist, I would recommend doing the conventional, tried-and-true regular bridge, filing down the front teeth like has been done millions of times before for other patients, and it works.

There is no perfect solution for you. Given the assumptions I have made in this answer, I think the conventional bridge has the smallest downside and the least risk for you.
– Dr. Hall