I've had a lot of work on my mouth, and to fully set up the scenario I need to describe two work areas in my mouth. Area 1: An upper incisor. Has had surgery to remove gum overgrowth twice, has been chipped and patched (patched twice), has had a root canal, two temporary crowns, and one permanent crown. One root canal was post-crown. In a car accident it was mildly chipped, but this is not an issue as it is barely noticeable and the chip does not extend to what's left of the tooth. I've been told it may, MAY possibly eventually need a third and final root canal. Area 2: Lower teeth directly under the incisor in question. The aforementioned car accident knocked out the tooth directly under the crown. At the time, I was not informed that a dental implant was a possibility and was given a bridge. I do not like the feeling of the bridge and have been told it may eventually need fillings where the root is slightly exposed at the front. The tooth that has had the crown I want to eventually pull and have an implant put in because it's had such extensive work that I really am frustrated with it and would like to get it over with. The bridged teeth I would like to pull as well; I don't want to go through the hassle of having two crowns, so I would like the entire device pulled and have a bridge implanted. I know that, as far as restorative procedures go, implants are the best option, and I know what the procedure, costs, and fail / success rates are. Knowing that insurance will likely cover very little or no cost of the procedure, I can afford to do one at a time (and, cosmetically, I would only want to do one at a time). I will be able to afford to get the second procedure, but in perhaps two or three years. My question is this: which do you recommend I replace first: the tooth that has had exhaustive work done but is more or less stable, or the teeth that have not had very much work done, but that my dentist called attention to in order to "watch and observe the progress of?"
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Ooh, that totally sucks for you and actually makes me kinda mad that they'd cut down two (presumably) healthy teeth to do a bridge like that! grr. I just re-did a case on a guy who, 15 years ago, lost upper central incisors playing footbal; was told if he did implants he couldn't play anymore which is B.S., but whatever. So they cut down the other two incisors AND both upper canines (eye teeth) to hold this bridge on. SOME margin of the four abutments is bound to fail and he had two leaking, so i have to replace the whole thing. $6000. I mean, the money is nice, i'm not gonna lie, but in principle it psses me off.... ok, on to your case. first of all, if you haven't already, get away from the guy/gal who did the bridge w/o discussing the implant. now you want to make really sure that you hate this bridge because you can do three thigns to replace it: 1 - cut the middle ("bridged") tooth out (this is called the "pontic" which you cna search for if you need a picture...). leave the abutments (the crowned teeth on either side of the missing tooth) alone and place a single implant w/a single crown in the space. you'd still have to worry a bit about decay/recession on the natural teeth and my impression is you're not inclined this way, but you WOULD be able to floss normally (ie, no threaders w/ fishline etc!) 2 - remove the bridge w/ both supporting teeth. place two implants and bridge them together w/ another bridge. this is the same as what you have now, but with implants instead of teeth holding it in. advantage - no root fillings to worry about; disadvantage - will still FEEL like a bridge, in the sense that you can maybe detect air (or catch food) under the pontic tooth. 3 - remove the bridge, both supporting teeth, place THREE implants and each one gets a crown. This treatment will look and feel MOST like your natural teeth. you can floss normally, you won't have a pontic, etc. disadvantage....one more implant probably tacks $2000 or so onto the total of your dental fee. My suggestion, to be honest, is to not worry about either procedure until you're done w/ medical school and you have some kind of stable income! I mean, you're saying, "I can't afford both at once..." I have fairly well-off patients who would have a tough time affording one at a time over five years! But maybe you have other income, financial resources etc. if you want to send me another email w/ your email, feel free and we can exchange info "normally."..... hope I'm helping!
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