Maryland Bridge Before an Implant Crown?
My daughter has a congenitally missing lateral incisor. We’ve finished orthodontics and plan to eventually get her a dental implant to replace it. She’s too young for one right now. Our dentist suggested that we get her a Maryland Bridge as a temporary tooth replacement until she is old enough. The problem is the Maryland Bridge just won’t stay on. She’s tried different cements but that didn’t work. We were using ceramic wings. The dentist thinks that may be the problem. So now she’s thinking about giving her metal wings. I’m a bit worried. It will be about five years before she can get a dental implant. I have some questions that have me worried. Will the metal wings adhere that long? Will they damage the adjacent teeth that they are being attached to? Will people be able to see the metal behind her teeth?
Carol
Dear Carol,
I’m glad you wrote. First, let me say that I am glad you picked a dental implant for her permanent tooth replacement. It is the best tooth replacement you can get her.
I am not sure why your dentist recommended a Maryland Bridge for your daughter. One of the reasons that your daughter’s Maryland Bridge is not staying on because cement isn’t enough for this type of tooth replacement. There actually needs to be a bit of a notch made into the tooth, like you see in the image above. Because of that, I would not consider it a temporary tooth replacement. Once she is old enough and your remove the Maryland Bridge, that notch will have to be filled in with dental bonding material. So, yes, it will damage the tooth.
I would not let her do the metal wings. They will not stay any better without the notch we talked about and they will stain her adjacent teeth.
Instead, I’m going to suggest that you get her a dental flipper. This will hold the space open, it is much less expensive than what your dentist is currently using, and it will not damage her tooth in any way. Then, once she is old enough for a dental implant, you can replace her tooth permanently.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
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Pain with Teeth Whitening
I’ve been whitening my teeth and I’ve started having some pain. It only lasts a few seconds, but it does hurt. It’s always around where I had a chipped tooth repaired. I’ve stopped whitening for now. Do you know if teeth whitening could weaken the bonding around the tooth repair. If so, how do I handle this?
Paula
Dear Paula,
There hasn’t been a case where teeth whitening damaged the bonding on a tooth repair. I’m assuming that you had dental bonding repairing the chip. Something that can damage bonding is alcohol, so you definitely do not want to allow alcohol to sit on your teeth. Also, be aware that if you use mouthwash, make sure you use one that is alcohol free. There are some out there.
In your case, it sounds more like something has damaged your tooth repair which left a little open spot. With that exposed, even a little bit, it would be easy for you to have that pain. My suggestion is that you continue to pause the teeth whitening until you see your dentist. Have him repair your tooth. Hopefully, you are having your teeth whitening done through a dentist. They can fix the spot that was damaged and then you’ll be able to continue with your whitening.
If you’re not doing this under the care of a dentist, then I think it is important you find one. Not only will your dentist be able to prevent a host of other problems that can pop up. Plus, your dentist can provide you with a lot stronger of a whitening gel which will allow you to whiten your teeth a whole lot faster than anything you can get over the counter.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel, a metal-free dentist.
Severe Metal Allergies and Dental Work
I have pretty severe dental allergies including copper and tin. Because of that it was hard for me to get dental work done. I’ve have worked hard to take care of my teeth, but cavities happen. Most of the time I had to wait until the decay progressed until there was an infection or the tooth was too decayed to be viable. Then, I would extract the tooth. I understand that things have changed and I’m looking for advice on how to procede. I think there are non-metal fillings now. Are there other ways for me to replace the teeth I have lost as well, knowing I have metal allergies? I know about dental implants, but understand they are metal.
Chris
Dear Chris,
I am concerned that you are not with the best dentist. We have had ways of treating people in your situation for years. Either your dentist does not keep up with his or her field or he or she does not care about saving teeth. I am sorry that you have not been getting the care you need and deserved.
First, lets talk about these cavities. There are composite fillings that are metal free. Even better, these are mercury-free fillings as well. You can get cavities taken care of in a way that will create no problems with your allergies. I would do that as soon as possible because you save so much more tooth structure, not to mention money, when a cavity is small.
There are also metal-free crowns as well for teeth that have more than 30% of the structure decayed. As for the teeth that cannot be saved, dental implants will be a good fit for you. None of the metal allergies you mentioned are in a traditional dental implants, which are made from titanium. This is very biocompatible and has been used for decades in prosthetics throughout the human body. However, if that worries you, there are also metal-free dental implants, made from zirconia.
What you need is a metal-free dentist. They don’t have to be holistic, but most holistic dentists are also metal-free.
I hope this helps.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Should I Give Up Holistic Care for Competence?
I am a bit frustrated. I feel like I am left to choose between getting the holistic care I want and competence in that care. We only have one holistic dentist in our town. I wanted to replace two things. First, a metal based crown for an all-porcelain one. Second, a mercury-filled filling for a composite one. My previous dentist didn’t believe that they needed exchanging. So, I found the holistic one and she was willing. Unfortunately, she used this new machine called a CEREC to make my crown while I waited. The crown I had before, though metal based, was comfortable and fit well. The one she made hurt and was too big for the area. I went back and she sanded it down to try to get it to fit the area. This changed the rest of my bite somehow and everything is off. She’s now telling me my problem is I need rothodontics. That would cost $6000…all for a crown not placed properly. I don’t know what to do.
Daria
Dear Daria,
I’m sorry this happened to you. First, let’s talk about your options. Holistic dentistry isn’t a specialty. It is a philosophy of care, which entails considering your whole body during treatment and not just your teeth. They are more likely to work around metal sensitivities that you have and will know how to do a sanitary amalgam removal. There are plenty of dentists who will adhere to this type of treatment without offically calling themselves a holistic dentist. If you do an internet serach for a mercury-free dentist or a metal-free dentist, you can probably find someone with that same philosophy. You are not stuck with the one declared holistic dentist in your area.
As for your dental crown, it sounds to me like your dentist didn’t not know how to use the CEREC machine. When the right information is input into the program, you actually end up with better fitting crowns because they are precicely milled by a computer. It sounds to me like what you were dealing with is a dental competence issue more than a CEREC issue.
If your bite wasn’t off before the dental crown but is after, that means she did something wrong. I would ask for x-rays from before your procedure and after, then take them to another dentist to look over. At the very least, you should get a refund for the crown. However, if she’s thrown off your bite than the repairs could be expensive. In that case, she bears some of the responsibility in covering that expense.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.