My preteen has a congenitally missing tooth. She’s getting to the age where it really bothers her. We’ve finished orthodontics to move her teeth in a way that makes space for the missing tooth. Our long term plan is to get her a dental implant, but know she is too young for that now. Our dentist suggested that we get a Maryland Bridge as a temporary replacement so that her teeth do not shift while we wait on the dental implant. She used non-metal wings for them, which I was grateful for, but the next day the bridge fell out. Our dentist then ordered some new, stronger cement, but again, it fell out the day after she put them on. Now, our dentist is wanting to use metal wings. I do have some questions though, given recent experience. Please advice me on this.
1. Will the metal bond well enough to last the six years we need for her to get the dental implant?
2. Will the metal show through much? This is a visible tooth?
3. Will there be any cosmetic damage to the tooth when we remove the bridge?
Martha
Dear Martha,
First, I want to congratulate you on making such a great choice for your daughter’s tooth replacement. Dental implants are the best option and will not only give her a secure tooth, but will also preserve the bone in that area.
I can tell that your dentist means well and is trying her best. However, I believe she may be out of her depth here. It does not appear that she has technical knowledge and skill which she needs to do cosmetic bonding.
Even with metal wings, I do believe she will end up having the same struggles. Bonding on a Maryland Bridge is not simply a matter of cementing the wings onto the tooth. It requires some tooth preparation as well, such as the notch you see in the image directly above, to help secure it. This notch removes tooth structure and will have to be filled in with dental bonding after the Bridge is removed.
Anything that makes a permanent change to the tooth does not sound to me like a temporary tooth replacement. What you want is something easily removable that will not require any structural changes to the adjacent teeth. I recommend you get a dental flipper instead. These are inexpensive and are super simple to remove when she is ready for her dental implant. In fact, your daughter could pop it in or out herself if she wanted to.
I am a bit concerned that your dentist may not be qualified to do the dental implant, which is a much more advanced procedure than what she is struggling with now. In your place, I would recommend that you find a dentist with significant post-doctoral training in dental implants. Look at Dr. Marion’s bio to get an idea of what type of training your dentist will need.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.
