Implant or bridge?

silvercar

I've just had a tooth removed - upper left 5 - and my dentist has given me a few options to consider.

I appreciate everyone's mouth is unique, but my dentist was advising and said there are positives and negatives for each.

To first explain the state of my teeth. my dental care is now good, but suffered as a sweet eating teenager combined with a drill & fill attitude dentist of the time, has left me with a lot of fillings.

1. option 1 is do nothing, the gap is only visible from the side when I am smiling. At the moment my tongue finds the gap awkward but this may settle down.
2. Implant, I already have one on the other side, so am used to the care that is required.
3. a bridge. The teeth on either side are currently stable, one had a large amalgam filling and the other a medium sized white filling. Both would need crowning to attach the bridge. Neither are root filled. The downside is that if either needed attention, the whole bridge would have to be replaced.

I know that a bridge would be less costly than an implant and less invasive, but am worried about the long term risks to the 2 anchor teeth.

Grateful for any opinions.

kayeb

I'm in a similar position to you, and about to have my first extraction on an upper pre molar that my dentist tried & failed to root canal, due to calcified canals.

I've also been given the option of braces as another option to close the gap.

I opted for an implant because I felt a bridge would compromise the 2 teeth either side of the gap. I thought grinding down 2 teeth would put more teeth at risk, leading to even more gaps/implants. I also get the impression that bridges have a limited lifespan, I know 2 people who have had teeth crumble under bridges, although it sounds like this may be down to a lack of hygiene & improvement in diet. I was very unsure what to do though, having had a few sleepless nights! (Pathetic I know).

I would add my next door neighbour also had the same dilemma as you, but opted for a bridge. He is in his 70s so he probably thought a bridge should see him out!

3 of my friends & relatives have had implants & said they don't regret them & would have more if necessary. They've all had them done in the UK.

Good luck with your decision, let us know what you decide.

maryannlee

Implant, but it will be very expensive, for sure

silvercar

I've been told that work on an implant can't start until a few months after the extraction, so I have time to decide.

I know it will be expensive, but 2 crowns with the bridge won't be that cheap. If an implant lasts longer than the bridge, it may be a long term saving, but may not. I am trying to not think about the costs and get a feel of what is dentally better for me.

kayeb

Yes I'm going to have to go with the pirate look for 3 months as there was an abscess & he said he'd got to give it a good long time to heal. I actually find this comforting as it shows it's being done right & not rushed. Implants are certainly not an easy overnight fix! And to those contemplating going abroad, I don't see how it could be done quickly.

Sea_Shell

Similar here.

I've got a lower molar that's filled, but starting to give me problems, pain on biting down.

Dentist says it's stable, but if it worsens he'd recommend bridge or crown (NHS), but can't guarantee it'll 100% fix it!!

Considering extraction, with subsequent implant... we'll see. Do they take a lot of special looking after, over normal teeth?

kayeb

I understand they do. My dentist told me her boyfriend had 3 implants done in Spain (he's Spanish), & he was given no aftercare advice. She put him right & told him he had to floss daily & be using the interdental brushes else you can get serious infections.

silvercar

You have to be careful about cleaning around an implant. In non-technical terms, there is a pin that secures the "tooth" into the bone through the gum. So the area where the "tooth" sits on the gum is only attached at one point, so debris can get between the gum and the tooth and you need to keep this area very clean to stop any infection taking hold.

With a crowned tooth, the whole of the tooth goes into the gum, so it's only the area between the teeth that has to be cleaned.

A dentist could probably explain it better.

Toothsmith

silvercar wrote: »

A dentist could probably explain it better.

Indeed

And yours seems to have explained things pretty well to you.

One thing from your first post you've not quite got right is that the bridge will be more invasive than the implant, not less. Although the implant will be put into your bone, as you've experienced on the other side - a bridge chops down the teeth either side - damaging them more. This is more likely to cause future problems than having an implant, which would then leave them untouched.

You have to balance up the risk vs the cost, really. The bridge is cheaper but more risky, the implant is expensive, but won't damage the other teeth any more, doing nothing is the cheapest, it also won't damage teeth further, but it is the least aesthetic.

No one can give you a proper 'Mystic Meg' look into the future and tell you exactly what the consequences of your decision will be in 10 yrs time. Your own dentist is best placed to make a guess, as he knows the teeth best.

In the end though, it's what outcome do you want (tooth or no tooth)? How much do you want to spend? What do you feel about the risk of causing problems to the teeth either side?

The final decision has to be yours.

Mands

silvercar wrote: »

You have to be careful about cleaning around an implant. In non-technical terms, there is a pin that secures the "tooth" into the bone through the gum. So the area where the "tooth" sits on the gum is only attached at one point, so debris can get between the gum and the tooth and you need to keep this area very clean to stop any infection taking hold.

So how do you go about keeping it clean?

I had a lower molar removed late summer and I'm meant to be going back to see the dentist for the bridge vs implant conversation. I made a passing reference to doing nothing and he looked horrified, but then this is his business.

Mands

silvercar

Mands wrote: »

So how do you go about keeping it clean?

I had a lower molar removed late summer and I'm meant to be going back to see the dentist for the bridge vs implant conversation. I made a passing reference to doing nothing and he looked horrified, but then this is his business.

Mands

Tepe brushes, making sure they go as far under the (implant) tooth as they can.