Should I get a bridge or an implant?

May 26, 2004 3:23 PM

I have a missing tooth. Should I get a bridge or an implant? [more inside]

I had a root canal, which was covered by a crown. The crown was destroyed by Gummi bears. (It was lots of fun to pull pieces of the tooth out of my head.)

This page outlines some pros and cons; I'm looking for advice from people with experience with one or the other. I'm leaning toward an implant because I don't like the idea of wrecking the two teeth on the sides of the missing one.

Also, would an implant set off metal detectors?

posted by kirkaracha to health & fitness (11 comments total)

Wait, can't they just give you another crown over the root canal? Or did the entire "stump" break when the crown broke, too?
posted by tristeza at 3:28 PM on May 26, 2004

I've had two Maryland bridges (moderately grody pictures here) for about 15 years. They work fine. At the time I got them, implant tech wasn't where it is today -- I remember the orthodontist telling me that if it were 20 years in the future, he'd recommend implants exclusively.

For me, the big thing would be, as you say, the damage to the teeth on either side. The Maryland bridges call for much less damage (or as the link above says, they offer the "absolute minimum of supragingival tooth modification"), but still involve a commitment: at this point, I don't think I could switch to implants without also getting the four teeth capped that are now acting as anchors. If at some point you decided to switch from an implant to a bridge, it'd be much more feasible (I think, not being a dental professional of any kind).

I'll actually be investigating that process myself soon, since the Maryland bridges have a life expectancy of something like 10-12 years. (Eeep! This page says 4-5!)

And I wouldn't worry about metal detectors -- I bet my two bridges contain as much metal as an implant, and it's never been a problem.
posted by gleuschk at 3:39 PM on May 26, 2004

Talk to your dentist, a bridge might not be an option, it depends on which tooth it is.

The implant is definitely the long term auction, I have one myself. It takes some time though, once they drill the bar into your jaw, it has to set and "form an intimate bond" with the bone. This could take up to 6 months. Then they'll pop on a plastic crown to make sure everything looks okay, and a few days later you can get a porcelain crown. Other complications might arise. The rod may not set properly in the bone. You may not have enough bone there to set the rod in, which happens if the missing tooth is congential. If this is the case they may have to take some bone from another part of the jaw and graft it on. Despite all the trouble and price, I think it was the best 3-4 grand I've ever spent.
posted by corpse at 3:42 PM on May 26, 2004

Also, you can get a lot of things done at the same time. I actually had all my wisdom teeth removed, and my implant placed in the same session.
posted by corpse at 3:43 PM on May 26, 2004

couldn't you have a gap?
posted by andrew cooke at 4:02 PM on May 26, 2004

The disadvantages of implants are that they are expensive and time-consuming

My implant cost me $600 out of pocket. Most of that $600 was because I had used up all of my dental coverage for the year. I also knowingly went to a well qualified dentist I knew to be my most expensive option. He had outstanding references and was everything the references claimed.

and the cost may not be covered by dental insurance.

Insurance will vary wildly.

You will likely have to deal with two dentists - the dentist who does the surgery to place the implant, and the dentist who puts the false tooth on top of the implant.

I had one dentist. Never knew it could be or is done by two.

There is also a delay in getting the false tooth or teeth - a healing interval of several months may be required before the artificial root can have a tooth placed on it.

Depends on how well you heal, but in the mean time you wear a cap. It's not traumatic in any way unless you swallow your cap. :-) My wait was not several months, though I did have to visit the dentist twice before he said I was ready.

There is also surgery involved with its attendant discomfort and healing period.

Surgery is a big scary word for sticking what look like needles in your mouth. If you can get over the fact that this is being done, it won't be much different than other visits. On the other hand, my dentists mentioned that those who have a fear of the dentist prefer something less invasive.

The discomfort was a hundredth of the pain I went in with. The healing was nothing compared to having teeth pulled, which resulted in bleeding for hours and getting sick from being unable to stop myself from swallowing too much blood.

Things they don't mention as disadvantages. You're dentist will sculpt you a tooth. Out of your mouth, it looks nothing like a tooth. It's hard to gauge when your dentist asks you if it looks okay to you. That ugly hunk of fake tooth is going where?

I had seven total visits, two of which involved sticking things deep into my gums. It wasn't remotely painful, but I was given enough to numb me that for the next 5 - 6 hours after the procedure. My entire right side of my mouth was paralyzed, as in, couldn't drink out of it, couldn't chew with it and nearly swallowed my damn tongue. I couldn't even smile.

Lastly, the implant feels weird at first and even two years later. It doesn't feel like a real tooth to the touch with a finger, tongue or cheek. It's odd. When food get's back there, you know it. However, I wouldn't trade my implant. When in the chair, drooling a bit, I asked the doctor if he could cut me a deal on a full mouth of them.
posted by sequential at 4:08 PM on May 26, 2004

did the entire "stump" break when the crown broke, too?

Yep.

couldn't you have a gap?

The tooth's in the back, so you can't see the gap, but I want to do something to prevent bacteria from getting into the root canals.

The "surgery" doesn't scare me. A root canal's made out to be this horrific thing--anything's better than a root canal!--but they gave me so much painkiller I didn't mind.
posted by kirkaracha at 4:24 PM on May 26, 2004

I'm not a dentist, but I'm not sure that a bridge would do anything to protect the gums from bacteria. If anything, it would likely make it worse sense it will be more difficult to get in there with floss. I'm not sure if an implant will help although it's supposed to be the most like having a tooth in there, so maybe. If bacteria is your concern, you should talk to your dentist to make sure the options you're considering will get you what you want.

I read about some scientist in Germany who was five years away from human trials with Stem-cell grown teeth. Not sure if you can wait or not, but that looks pretty cool to me.
posted by willnot at 4:47 PM on May 26, 2004

make that scientists in the UK and human trials in 2 years link
posted by willnot at 5:21 PM on May 26, 2004

Missing back teeth, so long as you have enough left to chew, are no problem at all. I have heard people say implants hurt long after the surgery is done. A talk show host I listen to went through implant surgery. He was miserable.

I hate getting dental work done.
posted by Goofyy at 9:58 PM on May 26, 2004

I had an implant about 3 years ago. It was relatively painless (besides the huge out-of-pocket costs), and seems to be doing fine. I disliked the idea of bridges, as they seemed to do trauma to the surrounding teeth just to support the bridge.

Think of it as an investment.
posted by jpburns at 5:10 AM on May 27, 2004