Please reassure me about dental bridges!
February 12, 2009 8:34 AM   Subscribe

My husband will be getting a couple of dental bridges and I am looking for reassurance and advice.

My husband recently began going to the dentist again after 15 or so years of neglect, and had to have a couple of non-wisdom teeth pulled (in addition to lots of other work). He can have them replaced with either implants or bridges. The implants would be a huge problem financially, as they are $1000 each and not covered by insurance. We would have to get some sort of new line of credit to pay for them. The cheap alternative involves fixed bridges. However, I am worried that they will not last or that they will involve too much damage to surrounding teeth. I am also concerned about function. Will he be able to chew with the bridge, or is it purely for aesthetics? So does anyone have any long-term (or short-term) experience with a bridge that they could share with me? If he gets bridges, could they be replaced with implants later in life when we are more financially comfortable? Are bridges a reasonable solution, or are we going to need to suck it up and go into debt for the implants?
posted by feathermeat to Health & Fitness (12 answers total) 2 users marked this as a favorite
I had a bridge done to replace two molars (cost: $2,800) and to fill a gap that would be permanent if not treated. When I first got the bridge I was very apprehensive about putting pressure on it and biting too hard. I was also worried about sensitivity. A year-and-a-half after the treatment I can say that it was a very good decision to get a bridge. An implant would have required me to get a bone chip placed in my gums where there was no bone density, wait five to seven months for that to heal in place, and then put the screw in and wait four months for the opportunity to put the tooth in. I am glad I didn't wait.
posted by parmanparman at 9:02 AM on February 12, 2009

One of my front top teeth is a bridge. . not only has it not been a problem, but it has made my mouth look better, in that the two teeth on either side are crowns now, resulting in more consistency.

One of the best things I have done, get this work done. He'll be taught to floss under it, but that is also not a huge deal.
posted by Danf at 9:30 AM on February 12, 2009

I went to a really bad dentist in the Dallas area and have had a terrible experience with my first and only dental implant. After a lot of drama and legal threats (something I never thought I would ever go through in my life- and certainly not at 25), I finally was able to get some of the money back from the original dentist. I've since gone to another dentist and he's redone the implant, which will hopefully heal correctly and I'll be able to get a crown in about 6 months.

I've done this all without insurance and the amount of money and pain I've gone through over the last two and a half years has been insane. I would never opt to do this again. I was told that this was the only option and was not presented with the option of a bridge until the original dentist finally admitted that the first implant had been improperly placed. Both dentists have told me a bridge should last around 15 years. If I could start over two years ago, before all of the botched surgeries, infections, weeks of liquid diet, depression, etc. I would have opted for a bridge. Do not believe any time estimate they give you regarding how long it will take an implant to heal. I was told this whole process would take 8 months at most.

I currently have a temporary "Maryland bridge" that the new dentist has put in and I can at least feel like a normal person now. I have chewed with it a little but I mostly eat soft foods and I have not chewed with it all since the new implant has been placed. This type of bridge is supposed to have a maximum lifespan of 2 years. Before, I had a "flipper" retainer with a fake tooth that I had to take out to eat. It was really unpleasant and destroyed my confidence while dating my now ex-girlfriend. I'm nervous about kissing anyone with this temporary bridge in because I'm afraid it will fall out but a fixed bridge is much sturdier than what I have.

This is a front tooth and it's been a constant surgery site for two and a half years. I've had the tooth pulled, numerous bone and skin grafts, an implant, surgery to remove that implant (which, besides being improperly positioned, also got infected), and another to put a new implant back in after the spot healed. I have excellent oral hygiene, floss and brush everyday and use medicated mouthwash. The infection was caused by the way the implant was jutting into my gum.

Make sure whoever you go to is reputable and that you know someone who has gone there and has had a successful procedure-- especially if he decides to get an implant. I moved to this area for a job and didn't know anyone here before I went in for a routine cleaning. I went to this Dentist because they were open on Saturdays and I didn't want to miss work. I trusted the original dentist when he told me my tooth had to be pulled but now I believe that he was dishonest about how necessary the original procedure was.

I took out a line of credit to pay the original dentist. Do not do this through a program at the dentist office. Do it through your bank. I did it at the dental office and it was through Chase bank. Chase changed the terms and treated it as a credit card. I paid it on time but when I finally got the dentist to agree to refund my money, I signed a statement saying I would not sue if they refunded my money. They told me they could only refund my money to the original methods of payment. I stupidly accepted this and waited for them to refund the money. When it was not refunded within a few days I began calling them every day for a couple of weeks. The payment was a month late. Chase said there was nothing they could do to waive the late fees because the agreement was with me and Chase, not involving the dentist. I paid the fees, which at Chase's 855.58% APR (after one missed payment), turned out to be $1100 in bank fines alone.

Another thing I'm wondering about is that $1000 you've been quoted for the implant. I'd be really surprised if that covers the crown that hangs from the implant once the surgery is complete. I'm moving to Canada soon and I'm hoping to have the crowns done there since dentistry is cheaper there.

This story can be contrasted with my grandmother, whose 85 year old mouth is full of bridges that are ~25 years old and she never has problems with them. She had her dental work done in Spain where she lives.
posted by globotomy at 9:58 AM on February 12, 2009 [3 favorites]

I was born without an adult molar. I got a bridge when I was 18. At the time, I was advised not to get an implant because I was replacing a missing molar -- a tooth that gets a lot of impact. The worry was that it might not last as long, and when it came out it would require a bigger and bigger whole to set it into my bone.

So, the bridge. It's lasted 20 years and is going strong. My dentist (who put it in) thinks it will last my lifetime.

It looks and feels like all my other teeth. I don't have to chew differently, or be careful with it, or anything. It doesn't wiggle or protrude or look weird. In fact, it's only different than my other teeth when I floss.
posted by Houstonian at 10:22 AM on February 12, 2009

Wow, I think I can help answer this question for you. I was born missing two teeth- after two of my baby teeth fell out, they weren't replaced with adult teeth. So I have two bridges in my mouth, two different types. One is a Maryland bridge, an artificial tooth with two metal wings that attach to the back of the tooth on each side. (The other type I have cuts into the tooth more, kinda sucks... I'd really recommend the Maryland bridge)

Bridges last for at least a few years- probably more in your case. I'm not sure completely because for me, my teeth/jaw hadn't yet settled into their final adult shape until recently, so naturally my teeth shifted around a bit and I had to get extra dental work. For an adult though, this should be no problem, and will probably last years. It will fall out eventually, but you don't need to get another one, they are really easy to just clean up a bit and cement them back into place.

Implants, I dunno, but for me my dentist (who is great) didn't recommend them. In a lot of ways they're more permanent, more durable, but also involve some surgery, risk of infection etc etc. Oh yeah and they're more expensive.

I can reassure you about a few things though: you can chew with the bridge a bit, although I wouldn't use it directly to bite on things (also, no chewing on really hard or really sticky things with it- will make it pop out sooner. Just use the other side of your mouth). But if it's not near the front, it won't really matter too much, just be another thing to keep in mind when you eat.

Lastly, there's no reason you couldn't just stick with bridges, but if you ever change your mind about implants, my understanding is that you can replace the bridge with an implant.
posted by tachikoma_robot at 10:22 AM on February 12, 2009

Oh, and damage to surrounding teeth with a Maryland bridge is pretty nonexistent.. mostly they just rough up the surface of the back of the two surrounding teeth a little so it'll stick better.
posted by tachikoma_robot at 10:26 AM on February 12, 2009

I'd go against the trend here and recommend against a Maryland (aka resin bonded) bridge if you're concerned about durability.

Maryland bridges are just not as durable and won't last very long, unless you're lucky. I was 'lucky'. I had one last for 15 years and every dentist I saw was frankly stunned that it lasted that long. When it finally fell off there was so much decay behind the tabs (because you can't get into the area to floss or brush properly) that I had to get the teeth filled and a "proper" bridge fitted. In fact all the dentists I talked to wouldn't even put in a Maryland bridge, they said they were a fad a while ago but were not durable, 5-10 years at most. Actually my first one came off within a year of getting it. Super cheap though, but your husband has already paid the price for cheaping out on his teeth.

Depending on the teeth you might be able to get a cantilever bridge where they only attach it to one side. I really like the one I have because it lets me floss around and behind it without one of those floss threaders. (I found floss threaders a huge pain.) Mine is very stable and lasted for ever and I don't take any special precautions with it, I chew just like I always have. (Disclaimer: mines in the front, I don't know about bridges in the rear.)

I wouldn't go with an implant yet. 20+ years from now when you need to get the bridge replaced then you can get an implant when they've got them figured out properly.
posted by Ookseer at 11:11 AM on February 12, 2009

I have had Maryland bridge for one of my canines for the past 8-ish years (the bone where the tooth would be is too thin for an implant -- apparently I was born without this tooth altogether. Thanks, mom!).

It cracks and/or falls out about every six months to a year or so. If it just falls out, it can be cemented back on. If it cracks, they have to make an entirely new one -- they make a cast, fit me with a temporary bridge, and then I go back a week or so later to have the new bridge fitted. If I'm lucky, it's the right fit/color; if not, they have to cast a new one... and so on.

I recommend:

1) Chopping fresh fruits and vegetables, or anything hard and crunchy. When I first got my bridge I regularly ate whole apples and such without problems, but at this point I'd rather not risk it. I prefer breaking everything into bite sized pieces rather than biting into foods (or every kind of food, hard or not).

2) Your husband should keep some Polident on hand in case it breaks or fall out -- he can sort of glue it in place until he's are able to see the dentist.

3) Ask your dentist about his availability in emergencies. Mine gave me his home and cell numbers in case something dire happens -- luckily I've not needed it so far.

4) Find out whether there will be any impact to orthodontic work. The two teeth supporting my bridge have moved forward slightly, to accommodate the bridge wings that I'm now biting on. But the supporting teeth are not really damaged.

Sorry for such a long answer. I guess that all sounds kind of nightmarish, but I'm used to it. And the bridge is more sturdy than I thought it would be. So, good luck! I feel your dental hell pain.
posted by the littlest brussels sprout at 12:07 PM on February 12, 2009

Wow, sorry for all those typos. I am pretty hopped up on cold medicine right now. *snuffle*
posted by the littlest brussels sprout at 12:09 PM on February 12, 2009

Some of us are telling you about Maryland bridges, and others (including me, above) about fixed bridges. If you are confused about which is which, this site has a drawing. The Maryland bridge is the one on the top-left. A fixed bridge is on the top-right. Basically, a fixed bridge requires that the teeth to each side of the missing tooth has a crown, with the false tooth attached to crowns. A Maryland bridge does not require crowns on the surrounding teeth.
posted by Houstonian at 5:04 PM on February 12, 2009

I had an upper tooth pulled after it broke (the tooth had been root canaled and was empty anyway). The dentist first put in a bridge that was attached to the teeth on either side - it looked like what people are calling a Maryland bridge, though I don't think the tabs were metal.

One day, not long after I got it, I was eating raspberries and a seed got in my teeth somehow and pulled the bridge out. I went back to the dentist and she cut significant chunks out of the teeth on either side of the space and gave me a larger bridge that basically replaced the parts she removed. That bridge has been in place for over fifteen years, though I've been worried that it might fall out. At first I was afraid to chew on that side and was constantly afraid that the bridge would pop out and expose the roots of the teeth on either side (ack). When I began seeing my current dentist, I told her my fears and she said, "If you've had it for more than ten years it's not going anywhere!"

I was also worried that getting bridge was a solution inferior to implants, but in my experience it hasn't been a noticeable problem at all.
posted by bendy at 2:11 AM on February 13, 2009

Dentist here. For the past 40 or so years fixed bridges have been the standard of care for replacement of missing teeth. they are reliable and give nearly full function if done correctly. they last upwards of 20 years if properly cared for.
Implants have recently replaced fixed bridges as the standard for many circumstances, mostly because they conserve the teeth on either side of the space. there are other advantages of course, including the ability to place teeth in a situation where the adjacent teeth might not have enough bone to support a bridge. the biggest drawback to implants is cost.
maryland bridges are no longer considered up to standard.
You should not fret over fixed bridges if your husband is motivated to care for the investment you are going to make, but if the teeth adjacent to the spaces have not had any fillings and are intact, implants might be best.
posted by OHenryPacey at 6:05 PM on February 19, 2009 [2 favorites]

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