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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.

 

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.