I have a dentist appointment at the end of the month to get a cracked tooth pulled. (The specific tooth is molar #14, upper left side.) The endodontist who did a root canal on the tooth last week said my dentist will likely suggest either a bridge or an implant to fill in the gap.
My understanding is that a bridge is a fake tooth attached to the teeth in front and behind by putting crowns on those teeth. An implant would require a screw to be inserted in the upper jaw and the replacement tooth would attach to that.
So, first of all, are those accurate descriptions? Second, are those the only two alternatives? Third, does anybody have any experience with either? Were you happy with the results or do you wish you’d had it done differently? And of course any other information (such as cost) that would help me make an informed decision when the time comes would be appreciated.
No, what happened was I had my dentist appointment back in Feb, and he saw a crack in the tooth. So he sent me to an endodontist to have it looked at further. The endodontist said it was going to need a root canal and crown, but during the root canal she discovered that the crack was deeper than she thought, and that a crown wouldn’t completely cover it. So she said “we can try to fix it now, but it will probably have to get pulled in about five years anyway, or you can just go ahead and have your dentist pull it now.” So that’s basically where I am now.
I had an upper bridge of 6-7 front teeth for almost 40 years. It was a bit odd at first, tongue always across the back, but quickly forgotten about. I now have full top and bottom dentures.
Not sure about implants, but when my dentist keep insisting I get snap on dentures, which requires metal posts, like a implant. Cost would be $10K+, but the main reason I declined was that I could eat only soft food for at least two months. A search gives $3-5K per single tooth [implant] and 3-6 months healing time.
Edit: As for missing a molar. I had one missing for years. Didn’t bother me at all once I stopped my tongue from going to the gap.
My late first wife had a single-tooth bridge. It was a mild extra PITA to keep the area under the bridge clean, but was otherwise trouble-free.
Installing a bridge means removing the bad tooth, letting the gum hole heal closed, then grinding a bunch off the two adjacent hopefully-good teeth to create smaller tooth-posts to glue the bridge to. If your teeth aren’t in that great a shape, or are naturally weak, the adjacent teeth might not take that grinding well.
My personal prejudice (not that I’ve faced this exact situation) is to do the thing that affects the fewest teeth the least. So by that logic, putting a single implant in place of the one irreparably cracked tooth is the path of least collateral damage and therefore the smart decision. Again I’m no expert, this is just how I look at the problem.
I had my lowers straightened and my uppers veneered a few years ago. In each case the techniques chosen were picked to minimize damaging what was still healthy / straight enough. It may not have been the cheapest approach, but it seemed to me to be the one with the least chance for a chronic bad outcome.
I went through an implant a couple years ago. I was not given the option of a bridge, maybe because of which tooth needed to be yanked.
The good news:
once it is all done, everything feels fine (no more pain, no real difference from the real tooth)
the actual tooth extraction was not bad at all. It might be that I was expecting worse, but I’ve had more discomfort from root canals
The bad news (there’s a lot):
It’s not cheap. Between the oral surgeon and my dentist, it was like buying a used car !
My dental insurance didn’t cover any of it. Not a penny. So it was all out of pocket. (Did I mention it was not cheap ?). Check your insurance to see if they might cover some. I learned a lot about my dental insurance.
It is a LONG process - like 10+ months. The oral surgeon did a wonderful job explaining the entire process, but he kind of glossed over the time periods of each step. Until they can put the post in, I had this temporary “spacer” thing that was kind of like a “retainer” to keep the surrounding teeth from encroaching. More $$ (which is then discarded once the implant is put in), and it was a pain to deal with.
In the long run, I suspect the implant is the better way to go. But just be prepared.
I can’t speak to the cost, because my dental insurance is covering a lot of it, but I’m going to get my implant for #14 tomorrow morning.
I chose an implant over the bridge because I don’t trust my teeth to be strong enough. I have more than enough dental problems without adding more stress to my natural teeth.
This tooth has been a “problem” for about 18 months. First getting a new root canal on this tooth that had a RC done about 25 years ago. Then it got a temporary filling and when my dentist went to finalize the deal, she said she couldn’t because there was an infection. I didn’t feel a thing, but it wasn’t safe to finish, then it was about 6 months of watching, waiting, treating with antibiotics until the endodontist said “Welp, we should just pull it”.
Got it pulled, a bone graft put in and waited 4 months to heal. Then after a scan the guy says “Welp, we have a bit of something still in there, I’ll dig that out for ya.” Another 4 months to heal and here we are, ready to get the implant put in.
I put problem in quotes because despite the infection, pulling, grafting and waiting, I’ve had very little pain to speak of, which I’m thankful for.
Is it a single tooth? If so, I had a Maryland bridge which does not require crowns - there are two “wings” which are bonded to the back of the adjacent teeth
First of all, our maker really shit the bed when it came to designing and engineering our teeth. We should be able to sprout replacement choppers when they fail. And also…why the hell do they fail so easily?
Anyway, I have had a bridge for a couple of years and have had zero problems with it. You do have to poke under it with a little plastic straw, but otherwise it feels as solid and as natural as my real teef.
I do have an implant in my future, though. I have a crown over a tooth that is just a little loose, and when it bails I will have just two options: an implant or a very noticeable gap. I don’t expect my Medicare dental coverage will cover any portion of the procedure, which is a damn shame.
I’ve had two implants but never had a bridge. Here’s my thread on the subject from last summer.
This depends on the dentist. I don’t remember my first implant all that well, but the dentist who did the one I had nine months ago pulled the tooth and put in the implant “screw” (don’t know the proper name for it) the same day. It was probably achy-- but not so much that I still remember. He gave me a prescription for the super-ibuprofen, but I only took them for a couple of days.
Then he put the “cap” (the new tooth) on top of the screw two months later. That’s this dentist’s protocol. I talked to his assistant about the timing and she said they used to do the 10-month thing, but found that the fast track worked just as well.
Make sure you get a GREAT dentist. This guy was The Bomb. In practice for 40 years and he has done hundreds of these. That makes a difference.
A bridge will cost less, but how much depends on any insurance you have. Bridges are fine. It can be tough to clean beneath the false tooth, depends on how it’s constructed and how your gums are underneath. A bridge spanning one tooth should be very strong.
There are a lot of things to consider, the location of the tooth, your age, the condition of your gums and the rest of your teeth. And of course how much money you have.
Yeah @ThelmaLou my guy is pretty good. He once fixed a filling for me with no Novocaine! He was like “I can fix that now if you have time, I won’t even need to numb you up!” I was nervous as hell, but he did a great job.
@Shoeless how old are you? I think that is one of the most important considerations. If you’re 70, an implant probably isn’t worth it. However the lifespan of a bridge can be as low as 5-7 years, and can compromise the integrity of the teeth it’s attached to.
I am in my late 30s and have chosen to go the implant route. 7 permanent teeth never formed when I was a kid, so I still have some baby teeth left. As they fall out, I’ll replace with them with implants. I had my first one done over 20 years ago and it’s been fantastic. It’s tooth #7 (between the front tooth and canine) so not only very visible but also used heavily for biting into food. The implant functions just as well as a regular tooth.
I’m wrapping up the process on my second implant (tooth #10). Just had the temporary crown placed this week and go back in 2 weeks to get the permanent crown. It’s expensive and a long process, but it will last me for the rest of my life.
My husband was given the option of an implant or just pulling the tooth. He wasn’t offered a bridge, for whatever reason. He went the pulling the tooth, in part because the implant would have been such a long procedure. He’s never mentioned any unhappiness about the outcome. I think he would have if it had caused any problems.
Follow-up: my dentist appointment was first thing this morning. We went over the visit with the endodontist, the (partial) root canal, why she sent me back to him to have the tooth pulled, all that. He said “It’s not bothering you now?” I said “I haven’t had any trouble with it since last fall.” He said “Well, I sure hate to pull it if it’s not a problem.”
So he drilled out the temporary filling that the endodontist put in, put in a more permanent filling, and sent me on my way. I was in and out of there in 15 minutes. He said to call if I started having any trouble with it, otherwise he’d look at it again in a year and probably crown it.
When I told him the endodontist thought the crack was too deep for a crown, he said “You know, I have a tooth like that, it’s got a crown, and it’s just fine.”
So, a huge sigh of relief! I didn’t know what to expect going in this morning, but it certainly wasn’t that!
Bravo! Excellent outcome! Wow. I love your very sensible dentist. He is a keeper, for sure.
Have a great lunch!
<ThelmaLou wipes tears from her eyes…> Oh, baby, baby…
Yeah, I guess 70 seems reeeelly reeeelly old to you, eh? Speak into my hearing aids, please.
I’m 74 and just had my second implant. First one was about five years ago. My mother lived to 93, so I could have 20 years left. That makes it “worth it” to me.
And yes, I’ve also worn hearing aids for almost 20 years. Super-expensive, super high-tech ones-- I’m on my third pair. And glasses since I was 11. I needed the glasses to keep track of the dinosaurs that chased me on the way to school.
I was nervous as hell, but he did a great job.