Refused dental bridge on the NHS

MrHeisenberg

Hi all,

My NHS dentist has refused to provide me with a dental bridge on the NHS. She has been rather unclear as to the rationale and reasoning though, from what I understand, the main reasons are it would be a rather long bridge (UL1 to UR4) and it is around a "corner". She also expressed reluctance to "damage" the surrounding teeth but that would happen with any bridge.

I lost the teeth due to trauma at a young age.

Has anyone experienced something similar and if there are any dentists out there I would seriously value your input.

Sincere thanks.

brook2jack

NHS dentistry is there to secure dental health. It cannot always provide what a patient may prefer.

I presume that as you lost these teeth at a young age you have worn a denture up untill now , or perhaps a shorter span bridge that has now failed.

I personally dislike long span bridges and particularly ones that are anchored off a front tooth ,cross the midline and include the canine (eye tooth) . They are subject to enormous forces, particularly shearing forces that can break teeth at the root .In addition If the teeth the bridge is to come off are lightly or not at all filled you are then drilling down healthy teeth.

From the sounds of it you will be expecting two teeth , including a front tooth with a smaller root than back teeth , to support the strain of five teeth. This is obviously not biologically or mechanically a good idea.

Any tooth prepared for a bridge has a 20% chance of dying off. If it dies off it needs root filling , becomes more brittle and more likely to fail.

Even if the teeth don't die off the bridge will eventually fail. Then you are missing at least two more teeth.

The gold standard is to save up to have implants and an implant supported bridge. This will be a substantial spend and lengthy and substantial treatment.

The next ,less destructive , is a denture.

Very few ,if any, dentists ,private or NHS , would think your proposed bridge is a good idea and certainly no NHS dentist would provide it.

MrHeisenberg

Thanks.

Yes, I had a bridge in the past then the UR3 may have failed. I had a denture fitted a few years ago.

The problem I have is the denture is exasperating my facial pain problem which, on the face of it, appears to be trigeminal neuralgia. I understand that, even if I could afford implants, it could also make the problem worse after a bone graft is carried out and a titanium rod drilled into my jaw bone.

I was thinking maybe I should try get an implant into the UR3 area and then look to fit a bridge, possibly with the help of the NHS.

brook2jack

Unfortunately the NHS will not provide a bridge on an implant . Anyone preparing anything to fit on or over an implant becomes jointly liable for the implant. This and buying the pieces of kit to fix the superstructure of the implant which would make it financial suicide , means that the NHS cannot be used to provide any sort of treatment on an implant.

It is also not advised to fit bridges with a combination of implant and real teeth as both move in very different ways under load. The bridge will likely fail with loss of tooth/implant or both.

MrHeisenberg

Thanks.

I'm in a really difficult position then - I would need a bone graft and two implants which could fail and make the pain worse. A consultant quoted me around 5k for this type of work and I can't work because of the facial pain etc.

I feel really scuppered.

Dizzy_Ditzy

Do you have a dental hospital in your area? I had mine done at one by a very heavily supervised student. Didn't cost me anything.

brook2jack

Students do not provide implants and implants at dental hospitals are very strictly controlled. OP would not fit the criteria.

A bridge of the size op wants would not be provided by a dental hospital and many/most will no longer provide any bridge work at all e.g. http://www.guysandstthomas.nhs.uk/our-services/dental/patients/patients.aspx#na

MrHeisenberg

Dizzy_Ditzy wrote: »

Do you have a dental hospital in your area? I had mine done at one by a very heavily supervised student. Didn't cost me anything.

Did you have implants done or a bridge?

brook2jack

Implants will not be provided on the NHS unless you meet very specific criteria , and even then many areas still cannot provide them . You would not qualify http://www.ouh.nhs.uk/services/referrals/specialist-surgery/restorative-dentistry.aspx


Dental students do not place implants.

If you read the link on my previous post you will see that most dental teaching hospitals will not place bridges either except for patients who have had cancer etc . https://www.liverpool.ac.uk/dentistry/freedentaltreatment/

MrHeisenberg

brook2jack wrote: »

Implants will not be provided on the NHS unless you meet very specific criteria , and even then many areas still cannot provide them . You would not qualify

Looking at the criteria I may qualify (my denture is exasperating my trigeminal neuralgia).

ERICS_MUM

Perhaps the dentures are ill-fitting or too heavy ? Ask your dentist to check them.