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Temporary Tooth While Waiting on Dental Implant Crown

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I am getting a dental implant. I’ve had the implant part done and we’ve been working on the temporary replacement tooth while I heal. My dentist suggested a Maryland bridge. We used the ceramic wings because we thought that would be more esthetic. However, it keeps falling off. One of the adjacent teeth is a natural tooth the other is a porcelain crown. My dentist tried a stronger cement and that did not work either. Now he is considering the metal connectors. Will that cause discoloration to the tooth?

Evan

Dear Evan,

Two illustrations. One of a Maryland bridge being placed and another of the notch that has to be placed into teeth to hold it in place.

Yes, metal will cause some discoloration. However, there are even bigger issues to consider here. I don’t think your dentist understands how a Maryland Bridge works. It cannot simply be bonded to the adjacent teeth. That is why it is failing. It does require bonding. However, there also needs to be a notch made into the tooth in order to help retain it. You have an additional complication where one of your adjacent teeth is a porcelain crown and not a natural tooth. Bonding holds better to natural teeth, so that other one will be at a greater risk of failure.

Whenever you have to make a change to the structure of the tooth, I would not call that a temporary tooth replacement. Because you’d have to drill that notch and the replace the missing structure with some dental bonding, I would say that is permanent damage. Most dentists would suggest you simply use a dental flipper until the crown for your dental implant is ready to be placed. Not only will this not require any structural changes, but it is also significantly cheaper than what your dentist is currently using.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Maryland Bridge Before a Dental Implant

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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,

illustration of a dental implant next to a tooth

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.

Images illustrating the placement and preparation for a Maryland BridgeEven 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.

 

Will a Dental Flipper Make My Teeth Look Straight?

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Some of my teeth are crooked and I’m looking for a way to make them look straight without getting a mouth full of braces. Someone told me that a dental flipper can snap over my teeth and make them look straight. Would that be a good solution for me?

Kevin

Dear Kevin,

Example of a dental flipperI think whoever told you about this has a dental flipper confused with snap-on smile. The image to the left is a dental flipper. It is used as a temporary tooth replacement while you are waiting on (or saving up for) a more permanent solution, such as a dental implant. They fit in empty spots. They will not fit over anything.

While snap-on smile will fit over your teeth to make them look straight, they are made of acrylic. They will not be as natural looking in close proximity and because they fit over your teeth can look a bit bulky. They’re mostly useful for things like a photoshoot and not as a permanent solution to crooked teeth that are making you uncomfortable to smile in front of others.

This doesn’t mean that you have to get traditional braces in order to get a beautiful, straight smile. You have other options. There have been many advancements to dentistry and orthodontics in recent decades. One of those is a way for adults to straighten their teeth without anyone even knowing.

Invisalign – Orthodontics for Professional Adults

Invisalign aligner

If you want to truly straighten your teeth without all those metal wires and brackets, then I suggest you get Invisalign or another quality brand of invisible braces. They use clear aligners to gently move your teeth into their correct position. Even at a conversational distance no one can tell that you are wearing them.

Additionally, the aligners can double as teeth whitening trays which allows you to straighten and whiten your teeth simultaneously. This gives you a mini smile makeover.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

16 year old Still Has Baby Canine Teeth

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I am 16 and still have my top two baby canine teeth. They look really stupid next to my big teeth. Is it possible to take the baby teeth out and replace them with dental implant teeth that are the right size?

Allie

Dear Allie,

metal and zirconia dental

My first question is to know whether or not you’ve been under the care of a dentist as you were growing up? If so, he or she was quite negligent in not taking care of this for you. Do you know whether or not you have adult canine teeth beneath the baby teeth? That would determine what solution is best. If you’re not sure, the first thing you will need is a good set of x-rays.

If you do have your adult teeth but they just haven’t erupted yet, then the most common reason for that is that they are impacted. You’ll need to have the baby teeth extracted and then have an orthodontist help you get them in the right position to erupt properly. Dental Implants will not work in that situation because you have teeth that are already there.

There are occasions where you’ll have congenitally missing teeth. In that case, dental implants will be a great permanent solution after your jaw has fully developed. What you can do in the meantime is have the baby teeth extracted and get your other teeth back into alignment in order to make room for the adult teeth. Then, when there is enough space for the adult teeth, you can get a temporary tooth replacement. Don’t spend a lot of money on that because you won’t need it for too long. I would get something like a dental flipper.

Once your jaw is fully developed, it will be time to get that permanent replacement. Make sure the dentist has significant post doctoral training in dental implants. Dental school is not enough for such an advanced procedure. Three great post-doctoral institutes for this will be the Dawson Academy, The Pankey Institute, or The Las Vegas Institute for Advanced Dental Studies.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Hockey Players and Dental Implants

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My son is a hockey player and recently had a tooth knocked out during a practice. I want to get him a dental implant but his teammates said it could get knocked out again and to not replace it with an implant. What do you recommend? Would a Maryland Bridge be okay?

Cathey

Dear Cathey,

Hockey player with missing tooth

I have a colleague that worked with the official team dentist for a hockey team in Minnesota. He also mentioned this problem. What happens is if the tooth gets knocked out with the implant it can rip the bone. I would listen to his teammates. Yes, a dental implant is the top of the line in tooth replacement options, but not while he is at high risk like this.

Here is my recommendation. First, you can go ahead and get the root form of the implant placed. Doing that will help preserve the bone structure for after his time with hockey is over. Just don’t place the dental crown yet. Instead, use a temporary tooth replacement.

I’m going to nix the Maryland Bridge idea as well. This attaches to two other teeth. If that gets knocked out, it has the potential to take two other teeth with it.

What he can get is a dental flipper. This will make a nice temporary replacement. It doesn’t cost that much money and won’t cause any harm to either his other teeth or any bone structure if it takes a hit with a hockey puck.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.