Will I be eligible for a dental bridge on the NHS?

crussell12

Here's the deal with my teeth:
I have hypodontia (several congenitally missing teeth). I currently have 25 teeth (22 adult teeth, 3 baby teeth still present).
Microdontia - very small teeth
My adult teeth are healthy (confirmed by a full mouth X-ray 2 months ago).
I still have 3 baby teeth (1 is an upper right molar which has been ground down badly from when I used to grind my teeth as a child, and has a filling, and the other is a bottom  incisor - it's very tiny - just 3mm long but is miraculously in good condition).
I'm 20 years old.

I recently had a bottom left molar taken out (my first ever extraction), and I was wondering if I would be eligible for a bridge? Has anyone got any experience with bridges on the NHS? What do you guys think is the most likely outcome for this?

I've got an appointment next week to discuss this with my dentist, but I'm worried that I'm going to be stuck with a denture. When I went in for the extraction my dentist told me that he believed there was an underdeveloped adult tooth underneath, so I'm not sure if that's going to present any problems.

Without going into a sob story, I'm in position to pay for a bridge privately and won't be for the foreseeable future. 

brook2jack2

For one missing molar it would be necessary to bring down at least two good teeth. At your age it is very unlikely that a dentist would do this. One missing molar does not need replacing to secure dental health. Also no one would place a bridge where there was a tooth ,even under developed, underneath. 

It is very unlikely they will suggest a denture just to replace one tooth , they are more likely to suggest leaving the gap as it is unlikely to affect your dental health..

For referral for specialist treatment with hypodontia you need to have more than 6 teeth missing , not including wisdom teeth, so you do not appear to meet this criteria. 

Baby teeth can last well into your 40s and beyond which is longer than a bridge would be expected to last and modern thinking is to retain the baby teeth as long as possible as they are far better than anything that a dentist could replace them with. 

crussell12

brook2jack2 said:

For one missing molar it would be necessary to bring down at least two good teeth. At your age it is very unlikely that a dentist would do this. One missing molar does not need replacing to secure dental health. Also no one would place a bridge where there was a tooth ,even under developed, underneath. 

It is very unlikely they will suggest a denture just to replace one tooth , they are more likely to suggest leaving the gap as it is unlikely to affect your dental health..

For referral for specialist treatment with hypodontia you need to have more than 6 teeth missing , not including wisdom teeth, so you do not appear to meet this criteria. 

Baby teeth can last well into your 40s and beyond which is longer than a bridge would be expected to last and modern thinking is to retain the baby teeth as long as possible as they are far better than anything that a dentist could replace them with. 

Thank you for your response. 
I'll be keeping the other baby teeth for as long as I can. 

As of current what my dentist is saying conflicts with what I was told at Kings College Hospital 8 years ago; they told me that there was nothing underneath that molar. So it's very strange that now I'm being told something different - I was very shocked! He said he was uncertain about it. But there was a possibility. 

What will happen if it's proven that there is an underdeveloped tooth lurking down there? Can it be removed? 

Say that I did have the money for private work - would I be able to have a dental implant given the circumstances? Would a bridge be possible then?

crussell12

And just to add onto this - I only have 1 wisdom tooth. Does this change whether I am eligible for specialist treatment or not? (probably not! But it's worth me asking)

brook2jack2

The wisdom tooth is immaterial , you would still not meet the criteria.
The problem with baby tooth replacement is the bone left behind is normally much smaller than normal so you would normally need bone augmentation ie bone added so there was enough for the implant. 

If there is an underdeveloped tooth down there , most would sit and wait and see if it comes through . Even if it is not a perfect shape it may be of some use. 

Eight years ago this tooth may not have started to develop so there may have been nothing to see at the time. 

crussell12

brook2jack2 said:

The wisdom tooth is immaterial , you would still not meet the criteria.
The problem with baby tooth replacement is the bone left behind is normally much smaller than normal so you would normally need bone augmentation ie bone added so there was enough for the implant. 

If there is an underdeveloped tooth down there , most would sit and wait and see if it comes through . Even if it is not a perfect shape it may be of some use. 

Eight years ago this tooth may not have started to develop so there may have been nothing to see at the time. 

That's very unusual. I didn't know it was possible for a tooth to develop (that wasn't a wisdom tooth) after birth. I hope it's just an anomaly on the X-ray, how is something like this confirmed for definite? 

How often do teeth like this actually come through? I get the feeling I'd have to be incredibly lucky for this to happen. 

brook2jack2

Most of your permanent teeth , other than your first molars and incisors , develop after birth . https://teachmeanatomy.info/the-basics/embryology/head-neck/teeth/

As for the likelihood of it coming through..... I've had patients in their 90s have previously impacted (stuck) teeth come through so you never know. 

crussell12

brook2jack2 said:

Most of your permanent teeth , other than your first molars and incisors , develop after birth 

As for the likelihood of it coming through..... I've had patients in their 90s have previously impacted (stuck) teeth come through so you never know. 

Thank you for your responses - they've been very helpful.

Is it known what triggers impacted teeth to erupt? Especially at such an old age... I wonder what's going on behind the scenes for the tooth to suddenly come through like that. Is it not possible to 'suction' the tooth out in some way?

I'm absolutely gutted that the chances of a replacement are so slim. I thought I'd at least have a denture as an option (which was actually my worst nightmare - but it looks like I'd be lucky if I even got that at this rate)! But I guess I'll have to see next week.

My dentist had already suggested a bridge before the extraction (but did express hesitance to filing down the other teeth), so he may be a bit more generous as far as NHS dentists go. 

brook2jack2

You can surgically expose a tooth , bond a chain to it and pull it through , but you do this for front teeth , typically canines , not molars (back teeth) . Mostly you just leave nature to its own devices. 

There are very many triggers to start a tooth erupting, and many factors that may stop it. 

Certainly if there is something down there you would not place a bridge, privately or NHS. 

The NHS is there to secure dental health and missing one molar will not affect your dental health . Very few dentists would suggest a denture with just one back tooth on it. 

Your own dentist is obliged to discuss all possible options with you both NHS and private. In most circumstances one missing molar would not be bridged on the NHS but a dentist could provide it privately. However there may be reasons , such as grinding down healthy teeth or a tooth underneath , why a dentist might not want to bridge such a small gap anyway. 

An implant costs around £2000 a tooth and most hypodontia patients are advised to start a savings fund to pay for implants when they lose their baby teeth because unless the hypodontia involves more than 6 teeth then the NHS will not get involved in replacing them other than with a denture.