“I’m Looking for a Second Opinion on my Bridge“
Those words are roughly how my conversation began this week with a new patient. He came to me with questions regarding a twenty-year-old bridge in the front of his mouth
Another dentist told him that it was time for a dental bridge replacement, and he wanted my input.
I examined the bridge and saw that it did not cover his tooth entirely. I found this discrepancy on the inside aspect of the bridge towards the roof of his mouth. The lack of coverage was not new. The exposed tooth has been there since the placement of the bridge. It took over two decades for a problem to occur. I looked carefully and found decay present and working its way under the bridge.
Color Discrepancies And a Chip
I told him that I agreed with the treatment involving updating the bridge. Besides the fact that decay is present, the bridge maintained its color for all the years in the mouth. The color of the bridge matched his teeth years ago. At the age of 71, the color was different from the teeth adjacent to it.
The color discrepancy may not have been an issue in any other spot of the mouth. However, the difference was pronounced in the front of the mouth. His other front teeth were darker and appeared missing when he smiled.
The brighter color of the bridge hijacks the eyes, if you will, and draws attention to the bridge. In doing this, it appears as if there are missing teeth next to that bridge. When I brought this to his attention and took a photo to show him what the world sees when looking at him opened the way to a broader discussion. We needed to decide what to do with all of his front teeth.
One last observation is important. The front tooth next to the bridge showed a chip from severe wear. The cosmetics of this tooth was also a concern
Options For The Dental Bridge Replacement
Let’s talk about our options. The one constant that we have is remaking the old bridge. If we don’t address the decay on one of the anchor teeth of the bridge, that tooth will disintegrate, leading to an infection or a fracture of the tooth. We have to decide if we touch the other front teeth in addition to the bridge.
Option 1. Ignore the Chip & Match the Darker Colors of The Other Teeth
If I forget the chipped tooth, then when I remake the bridge, I need to choose a dark color to match the other front teeth.
From a simplistic standpoint, this approach is excellent, but I am not dealing with the chip on the other central front tooth. Fixing the chip and matching the dark color would be our next level of care. I cut down on treatment by matching all the dark colors, but I shortchange his smile.
The dark color on all the front teeth gives him the appearance of having no front teeth.
This dilemma led me to the next level of treatment
Option 2. Brighten the Other Teeth to Match The Replacement Dental Bridge
I suggested that the way to give him the best cosmetic result would involve incorporating more teeth into treatment. Treatment involving more teeth would match the lighter color on his older bridge and maintain a youthful appearance. We say that “youth is wasted on the young,” but we all yearn for our look not to change when it comes to appearance. One way to maintain a vibrant appearance is through our teeth. In particular, we all know that our front teeth are critical to this.
Here to Help Whatever The Decision
I want him to think carefully about which direction he would like to head.
He went home to discuss his options with his wife and choose the most appropriate option. He must think about all of his choices from a health standpoint and a cosmetic standpoint.
The good news is that whatever direction he would like to head, the work involves only two appointments; the fix for him is not overly complicated. If you would like to see a smile that was once there, please call Nikki at 440.951.7856 and arrange for us to meet. Have a great week!
Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.