A couple of years ago, I had to replace all of my upper incisors with a dental bridge. The dentist (I was going to Comfort Dental at the time), placed a dental bridge using the canine teeth as the supporting teeth. Now, those teeth are loose. I went back and they suggested I get a denture partial to replace the whole front. I did that but I am finding it horribly uncomfortable. I am certain I do not want to live like this. So I went back again. This time they are talking about doing mini dental implants on those teeth. Because everything they have suggested thus far has been wrong, I went elsewhere for a second opinion. This dentist’s recommendation was completely different and a lot more expensive. He wants to do an implant bridge with three full-sized dental implants, one on each side and one directly in the center of the arch. I’m hesitant to spend that much money, but I am not sure I can trust the other group. Do you have a recommendation?
Doug
Dear Doug,
I feel confident I can help you here. I want to start with talking about Comfort Dental. They are a corporate dental group. Their business model is about maximizing profits as opposed to a private dentist/owner who, though of course needing to make a profit, is more about building long-term relationships with their patients. It isn’t necessarily that Comfort Dental doesn’t want long term relationships; however, they tend to attract dentists just out of dental school looking for a safe place to gain some experience before opening their own business, especially if they were not able to get a place at an already established private practice. While cheaper, they may not always give you the best quality care, as you have personally experienced.
As to which procedure to go with, let’s look at it from an engineering perspective because you will want this to last as long as possible. First, let’s talk about mini-implants. These are not strong enough to support a dental crown and it sounds like that is what they were suggesting. They are mostly used as a cheap way to keep a denture from falling out. Given that they used your canine teeth as anchor teeth for your bridge, I’m not surprised they didn’t understand this.
Your canine teeth use twisting forces which does not make them good candidates as abutment (supporting) teeth. This is why they came loose and fell out. What the second dentist you went to is suggesting has sound engineering principles behind it. Looking at the diagram above you can see that there would be a lot of twisting on these abutment teeth whenever you bit down.
If he just put full-sized dental implants where the canine teeth are, you would end up in the same situation you were with the bridge you previously had with your abutment teeth coming loose. This is why the dentist is suggesting a third implant directly in the middle. Doing this will stabilize the forces enabling you to keep your implants for many, many years.
Though more expensive initially, I would go with this plan. It will save you money in the long run by lasting longer and you won’t have to worry about them coming loose as you did with your first bridge.
This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.
