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Tuesday, September 23, 2014
Crowns, Bridges, Dentures, Implants
Implants or Bridges
One of my upper canine teeth is resorbing. 1-Is it possible the resorption will spontaneously stop (various periodontists and prosthodontists have been pushing me to have it extracted and an implant put in but I do worry about the profit motive for unnecessary work).
2-If replacement is necessary and cost is not a factor which is the better option: an implant or a bridge? Some comments on the web, supposedly attributed to dentists, that have scared me: A dentist supposedly stating that if a bridge fails you can always go with an implant but not visa versa, upper implants giving rise to infections to the brain and abcesses, and one implant recipient stating that she was no longer able to bite into an apple without fear of damaging the implant. Help, I need an answer unmotivated by the profit factor! Thank you.
While resorption may stop in rare cases, there is about a 99% probability that it will not. Planning for that tooth's removal and it's replacement is the informed way to go, both from a scheduling and financial planning aspect.
The choice between an implant and a bridge depends on the teeth on either side of the tooth in question. If the adjacent teeth are in need of crowns already, a bridge would be a logical way to go. But if the adjacent teeth don't need to be crowned, it would be a sacrifice of good tooth structure to prepare them down for a bridge, an irreversible act. The average life expectancy of a bridge is about 15 years, whereas an implant can be for life.
The health risks for getting a dental implant are not much different than those for getting a tooth removed. In other words, if you are healthy enough to have a tooth extracted, you are likely well enough to have a dental implant placed without fear of infection.
It has been my personal experience that patients with implant crowns feel more secure than patients with bridges, and the implant crowns are easier to clean around as well.
Finally, if you choose the bridge option, know that the fates of the two adjacent teeth that anchor the bridge are now married. If one anchor tooth gets a cavity, the whole bridge may need to be replaced. The dental implant option divides and conquers that problem by not tying teeth together, each tooth is kept separate.
Hope that answers your questions, best wishes for a satisfactory outcome!
Julie A Holloway, DDS, MS, FACP
Associate Professor of Restorative and Prosthetic Dentistry
College of Dentistry
The Ohio State University