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Old 08-13-2002, 09:34 AM   #1
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antoni HB User
Post Leave whole or have bridge put in

Hi,

My tooth that is in front of first molar(top)(medium size tooth) needs to be pulled and a bridge put in.

However, I have had a bad bite since having multiple ill-fitting fillings put in under which I am seeing a prosthodontist for bite adjustment. Even with my current treatment my bite feels "different" but not better I must say.

I really don't want to undergo having a bridge put in although my prosthodontist recommends it - it can be done but needs alot of patience??!!!!! Also my sister had a bridge put in and it feels to her like a foreign object which she never got use to.

My question is has anyone left a space(the tooth is right before the upper first molar) and I was wondering if the teeth really shift or if people have found they can live with the hole without the bite problems that a bridge may potentially cause.

Any experience with pulled teeth and leaving the hole there would be appreciated.

Thank you

 
Old 08-13-2002, 11:45 AM   #2
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simmie HB User
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Antoni,

!! I'm sorry. I've never had a bridge, but here's the experience of my parents, who have worn them for many years. My mom had fixed bridges for nearly 35 years, on both front upper sides of her mouth. She was pleased with them. When she had to have them redone, she was never happy with the new ones, and last Friday, she had an upper denture put in instead. She's thrilled with it; first time in years she hasn't had to worry about her teeth. With the first fixed bridges, she said it was just like having her teeth. Apparently, they fit very well. However, she never got used to the second set of bridges, and they aggrevated her every day for over 5 years. This is why she's so happy with the denture. Also, FWIW, the advice she has given me is to avoid crowning otherwise healthy teeth for a bridge--decay will almost always result under the crown.

My father, on the other hand, is fairly new to bridges (compared to her), and is so-so about them. He has, however, had teeth removed and not replaced them, despite dentists' warnings that teeth will shift, there will be uneven wear, etc. The biggest one was an upper molar, which was 12 years ago. It hasn't caused major problems with his bite or with the tooth underneath. He says he has not had problems, nor has he really noticed the tooth's absence.

Can you get a single-tooth removable bridge made up? Maybe until you decide if you want a permanent one...at least you'd be able to keep your bite from shifting around again until you decide.

Good Luck!
Sim

 
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Old 08-13-2002, 11:46 AM   #3
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Subie HB User
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Hi Antoni,

I have been reading your posts and I must say I feel so badly for you. I have had my share of dental problems and will for life, but I feel bad for you as you have SO much going on at one time. I had to have a bottom 1st molar pulled and now I'm in the same dilema. Do I get a bridge, implant or leave it alone and hope my wisdom tooth shifts everything over. A bridge scares me because I don't want to have two other teeth shaved down and capped and then deal with the after effects of getting used to the bridge. An implant just scares me. I don't know what to do. Actually, one step at a time. I have an appt. tomorrow to have a back molar shaved down and capped because it has soooooooo many fillings on it and it's sensitive from time to time so my dentist is going to cap it. I'm soooooo scared to have this done. All other caps I've had have been root canaled teeth, so I'm just scared that by working on this tooth it's going to blow up in my face......ugh HELP! Some days I really think about getting dentures so I won't have to deal with the pain. I think about my teeth CONSTANTLY....it's pretty sick. Well, sorry I couldn't be of much help. Thanks for letting me vent. I hope someone out there has some good suggestions for us. take care!

 
Old 08-13-2002, 01:26 PM   #4
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Thanks Simmie and SUbie(a duet)

SImmie, that's interesting about your father. I have a friend that has alot of teeth missing except for her front and you know what she has experienced NO TMJD symptoms from a bad bite. She lost her teeth over a period of years. She has a bridge in process but do to financial considerations she is not doing anything for a while. I think maybe you are better leaving what nature had in the cards rather than focusing on these dentists that can make mistakes and really do alot of damage to your teeth/bite or otherwise.

Crowns come with risk but a bridge involves a few teeth that can get screwed up. The thing that got me angry was when I saw all the dentists complaining of my bad bite from bad dental work they act like it's nothing and they don't say anything which leads me to believe that they see alot of it??!!!

A detachable bridge is a good idea(it's cheaper too) and less risk involved in messing up the bite. That way if it feels uncomfortable it can be removed thank goodness.

Subie, that's too bad 1 molar going and another needing a crown. I hope you have a good dentist!!!!

I didn't really post about this but just for future reference if you feel alot of your teeth are "off", my prosthodontist took a model of my teeth and he said alot of the fillings were still "too high" after like 6 dentists checked them????!!!1 So he adjusted(occlusal adjustment its called) and shaved a couple of the natural teeth down but he said he had to do it and that it was very little and that it wouldn't irritate the teeth which it hasn't. I must say unfortunately the same old jaw discomfort/tmjd related symptoms came back a little then they went away???!!!! I see him Friday. The bite feels different but not better I must say. I may just stop at this point -- he could refill a couple the fillings with gold but who knows the whole nightmare of stuff being off could start again. That;s why I say if you have work done just do it on one teeth at a time that way maybe they won't screw up the bite!!!!

With the dental also the money goes like water. I feel like I have blown $1500 in addition to my regular insurance for practically nothing to show for it.

 
Old 08-27-2002, 04:50 PM   #5
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working in the field of dentistry, I admit I am shocked by some of the posts I've read. I knew there were unskilled dentists but I had no idea there were so many! Heres the deal: If teeth on either side of the missing tooth are "virgin" teeth, the best option is an implant which is actually a small titanium(will last longer than you will) cylinder the resembles a tiny bolt. A specialist will be the best choice for such a procedure. After the implant stage, your general dentist can make a crown that is made to fit an implant. Single implants have a high success rate and patients love them because it feels so natural. the down side of an implant is cost (very expensive and most insurance companies still classify them as cosmetic) also the length of time involved in completeing the treatmant is 3-6 months. But it is still the best and healthiest treatment for replacing a single tooth.
Second- if teeth on either side of the missing tooth could benefit from crowns because of cracks, large fillings, etc, then a fixed bridge is a good choice, you'll be replacing the tooth, plus fixing two other teeth. It is less expensive than an implant and most insurance will pay for half. As far as messing up someones bite, your bite should be adjusted before it is cemented. That is standard. No dentist that is worth anything would intentionally mess up your bite or leave it "high" unless he just can't figure out where it is coming from and that is another topic by itself. There is another option which is called a "Maryland Bridge". It is a bridge used to replace a missing tooth without crowning two healthy teeth on each side. The dentist will take away just a millimeter or two of tooth , most people aren't even numbed for this it is so slight, and the fake tooth will be made with little metal "wings" that will wrap around the insides of the tooth where they aren't visible. I have two of them and am very satisfied. the bad points about a fixed bridge is that a little extra cleaning is involved to clean under them but only adds seconds to your routine. And of course food gets trapped under them. Unavoidable. But most people adapt and it isn't like the world can see it. It just something you have to take care of.
Also, just because a tooth is crowned doesn't mena it is more prone to decay. The problem is usually in that when a tooth is crowned the person feels it is indestructible and doesn't clean it properly. The simple fact is if you brush your teeth hopefully twice but at least at bedtime and floss BEFORE brushing, you can prevent decay, whether the teeth are crowned makes no difference. Of course regular visits to the dentist are essential to get the calculus. Also Listerine helps with bacteria. Now about partials and dentures, the good thing is they are not expensive, and there is a reason why. partials use metal hooks to hang onto the teeth and these hooks over time will abrade teeth and/or slightly loosen them. And you run the risk of sore spots that can be very aggravating and eventually you may need to have them replaced with new ones. dentures are bad on the upper because, your tongue will feel crowded at first, you will have trouble speaking, you will get sore places and you will lose the ability to taste food like you use to. Most people don't realize that you use the roof of your mouth to taste. Also you will never be able to comfortably chew any food you wish. Steak,lettuce,corn on the cob, etc... The list is a long one. There are more cons than pros for dentures. Unfortunately for some people that is the only option, but it should always be the last option. I hope I have helped clear things up and I hope you don't have a migraine now from reading all this!

 
Old 08-28-2002, 08:33 AM   #6
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Hi Lola.......your information was very, very helpful. With regards to an implant, I've heard that if a person smokes the implant is less successful? Also, where do you have your Maryland briges? Would it be bad to have one on a bottom first molar?

Thank you!

 
Old 08-28-2002, 06:28 PM   #7
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Subie
You are very welcome! The reason an implant can fail because of smoking isn't really a huge factor. The reason is that smoking affects the gum tissue. Smoking, alcohol and bad hygiene all can contribute. But the reason is because all of these things can contribute to gum disease. Gum disease is the one way that an implant can fail. If you have an implant, you must continue to floss and brush it just as you would all your other teeth. The reason flossing is so important is because it is the only way you, at home, can get between your teeth. Here goes:
A tooth has five sides, most people only think of the front back and top and forget the sides. Around each tooth, or implant, there is whats called a sulcus, which is basically a little "moat" around your tooth. It is an area around the tooth where the gum is not attatched to the tooth/implant and normally will be 1-3 millimeters deep. Bacteria love this area because some bacteria do not want or need oxygen to thrive so they hide out there and when sugar is added it mixes with this bacteria and becomes acidic and eventually creates what is know as calculus. It is hard crunchy stuff that can only be removed by your hygenist. You deter it by flossing and lessen the actual build-up. Some people who floss religiously hardly develope calculus, but most people have at least a little. As this calculus buils around the tooth in that sulcus it needs more room so it begins to infect the gums around the tooth and push it out of the way, creating deeper 4-6 millimeter pockets, then starts the early stages of gum disease. 4 being early 6 being time for some heavy cleaning. The deeper it goes, the harder it is to reach to clean and there begins the cycle. If you left this it would continue to work its way down the root of the tooth until it reaches bone and the infection starts to eat the bone away. You'll notice lose or leaning teeth and eventually if left untreated you will have nothing holding your teeth in and they could virtually fall out. So as you can see, someone would have to really neglect their teeth to lose an implant to gum disease caused by smoking, etc...You can smoke all you want, if you take good care of your teeth and have regular visits you will never have worry. Unless of course you have gum disease to begin with and in that case no good dentist would suggest an implant. I hope I have helped. Also , yes you could have a maryland bridge to replace a lower first molar, as a matter of fact that is where mine is on the left side. I have been very satisfied, but because they rely completely on the strength of the cement, don't be suprised if is gets lose and has to be recemented in a few years, usually at no charge if you visit the dentist who did it. But it may never come lose. I have had to have my lower one recemented but never the top. I believe it is because of the forces put on lower teeth by the tongue.

[This message has been edited by lola32 (edited 08-28-2002).]

[This message has been edited by lola32 (edited 08-28-2002).]

 
Old 08-28-2002, 08:37 PM   #8
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lola32, So are you saying a Maryland Bridge is cemented to your teeth? I thought they were removeable like a retainer. Snap in and take out to clean. I just had my first tooth pulled yesterday and I am undecided about how to replace it. It is #29 tooth. It had already had 3 root canals done on it in the last 21 months and was still achy feeling so I finally got the courage to go in and have it extracted. It always looked ok on xray and after it was removed Dentist said he saw nothing wrong with it. So now I am just waiting for the extraction pain to go away to see if all the pain is gone I had before it was extracted. You are very imformative. I am glad I came across your post...

------------------

Sher
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Anterior Cervical Fusion w/donor bone & w/plating C5/6 Done March 6-2003

 
Old 08-29-2002, 01:41 PM   #9
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Subie HB User
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Lola.......WOW! This is such great information. I don't have gum disease, BUT I do have a few very sensitive areas due to brushing too hard some years ago. Actually had to have a gum graft about five years ago in one top area and I know I need to have it again in a lower area.

So far my dentist (a new one) and I have only talked about an implant and bridge, but they weren't in depth conversations because I have other dental work that needs to be done before I even cross that road of filling this gap. I wonder why he hasn't mentioned a Maryland bridge?? Is it cheaper? Maybe that's why.

I just wish I had taken better care of my teeth when I was younger. Now, I'm insane about it and floss two-three times a day and brush as well.

Question for you.... I always floss before I brush...is this the correct way to do it?

Thanks again for all your helpful information. I really appreciate it!
Subie

 
Old 08-29-2002, 01:43 PM   #10
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SherryElaine,

Which tooth is #29. Honestly, I should know this, but I've had soooooooo much work done I forget what's what!

Thanks
Subie

 
Old 08-29-2002, 06:05 PM   #11
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Subie,
You are very welcome, glad I could help. I am a certified dental assistant. Feel free to ask anything. Yes, Maryland bridges are cheaper. I can also answer your #29 question. That is your lower right second premolar. To always figure out which teeth are what, start with your wisdom tooth on the upper right. If you don't have them then imagine it there. Start with that tooth as #1, going from the right side of your head (your right) and count starting #1 and ending with #16 which would be the wisdom tooth on the upper left, drop down to the wisdom tooth on the lower left, start at #17 and count around until you get to # 32.
sherry Elaine, yes Maryland bridges are cemented in. I wish I could draw pictures on here, it would help tremendously!

 
Old 08-29-2002, 06:19 PM   #12
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lola32 HB User
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Subie,
I forgot to tell you, yes flossing BEFORE brushing is best. for years we were taught to floss last, but if you think about it, the **** would still be left in there, so if you floss, then brush, you will brush all of it away. Sorry about your sensitive areas, a lot of people think brushing hard was best. They finally quit making hard toothbrushed I think. Luckily there are products that can be painted over them, if they aren't to deep to lessen sensitivity, and if you aren't already using a sensative toothpaste, start now. Keep in mind that you wont see really good results until after about a month as the stuff in the toothpaste has to gradually build up on the tooth. I am sorry you have to go through so much but feel proud that you value what you have enough to improve the health of your mouth. And try not to let it overwhelm you, extensive dental work is like eating an elephant, you just got to relax and take it one bite at a time. In the end you will be so glad you did.

 
Old 08-31-2002, 08:42 AM   #13
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lola32, Thanks for all you have told us, my dentist also only told me about implant or bridge. I may consult another dentist about a maryland bridge or find a website and read about it. I am still waiting for extraction pain to go away before I do anything, I have been in pain for 21 months with this tooth with 3 previous root canals so I am in no hurry. Again thanks for so much information.....

Antoni... I was very scared to get this tooth removed and was told to do it 6 months ago and finally got courage to do it last Tuesday. I had to take a valiumn before I went it to calm my nerves and I was still tense and scared. It was first tooth I ever had to have pulled and I am 48 years old. Any way I was very worried that the hole would feel HUGE and was afraid to even look at it, but I have finally looked at it and it is NOT THAT BAD. Also the hole or gag is really not what I imagined either. I really can not notice the gag much at all. Sure I rather have my tooth back but it was not as scarry as I thought. I feel great relief that it is over, now to decide what to replace it with is new worry. I try to think of it this way, my friend had to have her leg amputated cause of an illness, mine was only a tooth. Thank God I still have my legs. Hope that helps....


------------------

Sher
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Sher
Anterior Cervical Fusion w/donor bone & w/plating C5/6 Done March 6-2003

 
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