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    gman2's Avatar
    gman2 Posts: 1, Reputation: 1
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    #1

    Mar 10, 2010, 07:33 AM
    Bridges need removal
    I'm an otherwise healthy 46 year old with dental issues.

    For lower teeth #22 through #27 are good, have never had dental work done and are cavity free. #31 has filling and is good. I currently have two lower bridges.

    Right bridge #28 and #30 abutment both with decay, #29 pontic:

    Dentist 1 proposed a treatment plan to replace the bridge and wasn't sure if root canal is required. Dentist 2 proposed a treatment plan to replace the bridge but added that root canal is likely needed, but could not be 100% sure and said bridge life expectancy is 10 years.

    Left bridge #18 through #21, #18 needs to be removed.

    Dentist 1 recommended sectioning the left bridge next to #18, leaving the remaining bridge abutment #20 with #19 pontic and #21 pontic both cantilevered, but did not suggest any other procedure for the left side. Dentist 2 recommended bridge removal, replacing the bridge abutment on #20 with a new crown and using a partial denture for #18, #19 and #21.

    Here are some options I have discussed with dentist 2 and dentist 3.

    An option which was discussed with dentist 2 includes removing #18, #28 and #30 and saving #20 and going with a partial denture for #18, #19, #21 on the left and #28, #29, #30 on the right. The denture would clip onto #20, #27 and #31.

    Another option was discussed with dentist 3 includes removal of #18, #20, #28 and #30 with partial dentures for #18, #19, #20, #21 on the left side and #28, #29, #30 on the right. The denture would clip onto #22, #27 and #31.

    With dentist 2, the partial is the same cost regardless of three teeth (#18, #19 and #21) or six teeth (#18, #19, #21, #28, #29 and #30).

    I'm considering a partial lower denture option with no bridge. I've read a lot of negative things about someone my age getting partial dentures for several teeth. What is the structural disadvantage of the partial with several teeth versus the bridge? Will the bridge provide that much of a structural advantage? Is the ten year life expectancy of the bridge reasonable? If the bridge needs to be replaced after ten years, can another bridge be placed on #28 and #30 if they are root canals? Is it possible to get work that does not require the bridge but allow structure, such as a crown on either #28 or #30 and a partial that covers the other two on th4e right side?

    Anything else I should know?

    Sorry for the long post. I'm simply trying to educate myself to make the correct decision.
    tickle's Avatar
    tickle Posts: 23,796, Reputation: 2674
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    #2

    Mar 10, 2010, 01:32 PM

    I can only say one thing. No dentist should be unsure about a root canal. The X rays tell it all. If you want to know for sure about the root canals which are very important before any bridge reconstruction is underway, get a referral to an endodontist who will read the X rays properly. Get your X-rays from your present dentist to take with you, this way you won't have to pay again for having them done.

    As for bridges, I have had mine in place for going on to 25 years with regular maintenance and check up on my entire mouth every six months. So, yes, bridges are good bet as long as the dentist knows what he is doing, and I know this isn't saying very much.

    I would go for bridge work over partial plate any day. At 67 I have all my own teeth because of good dentistry throughout the years because I am fussy about who touches my mouth and have had the same dentist for a good number of years.

    You have to make a decision on your own, but why are you talking about two dentists. This is confusing you.

    I can guarantee you are going to hear from Flossie, our resident expert who is always ready with good advice for people trying to make up their minds about their dental issues.

    tick
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #3

    Mar 10, 2010, 02:15 PM
    Thanks tick, you are too kind! :)

    Gman,

    Can you tell me what is on tooth #20? You said there is a bridge from tooth #18 through to #21. To me, that would mean that tooth #20 is also missing. What do you have for top teeth (your own or a complete upper denture)?

    The more a tooth is worked on, the higher risk it has of needing root canal. It may or may not happen.

    I would do whatever it takes to avoid having a partial denture. Most clients with lower partials end up leaving them in their dresser drawer more than wearing them. Food particles, especially seeds get under the partial and really irritate the gums until you can get them cleaned out. An upper denture is much easier to adjust to wearing.

    Was there any discussion about implants? If it was my mouth, I'd consider replacing the bridge on the lower right and replace teeth #18 and 19 with implants. Put a new crown on tooth #21 and if #20 is present, that tooth too.

    As tick said, you have to do what is right for you both dentally and financially. The more teeth you have in your mouth to support a partial the better if that is the route you go, try to save as many of your own teeth as possible.

    I hope this helps.

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