I have a daughter who has a congenitally missing tooth. We’ve already gone through a round of orthodontics in order to get space open and ready for a new tooth. Our dentist suggested we get a Maryland Bridge until she is old enough for a dental implant. Here’s the problem we are having. Our dentist gave her a zirconia bridge, which we liked. However, it fell off two days later. He decided to try a different cement and we got that one done, but it fell off as well. Now he’s talking about a metal-backed one. Before we go through this again, I want to get a second opinion and some questions answered.
First and foremost, will the metal bond any better? Second, will the metal show through? These are visible teeth which is why we want to get her a dental implant when she is old enough. Third, will the metal damage her teeth?
Loraine
Dear Loraine,
I’m going to steer you in a completely different direction and then answer your questions. What I would get for your daughter is called a partial dental flipper (pictured left). Not only will this last the length of time she needs, but it is also significantly less expensive, and requires no structural changes.
What Not a Maryland Bridge?
I’ll answer your questions one by one. The metal will be much harder to bond than the zirconia was. In fact, this is why most dentists are switching to zirconia. It makes it much easier to bond. Your dentist seems to be in over his head. He may be a great general dentist and he obviously is trying to find a solution, but he doesn’t understand this procedure.
In order for a Maryland Bridge to stay on properly, there needs to be some tooth preparation, like you see in the picture to the left. No matter what cement he tries or what backing, without that groove, the bridge will not stay.
Secondly, the metal will darken the appearance of her tooth. There is no way around that. Finally, It’s not as much that the metal will damage her teeth as the proper preparation of the tooth requires permanent structural change. Of course, if you decide to go that route, you could fill the space with composite resin. But one of the reasons to get a dental implant, to begin with, is so you don’t have to do anything to the healthy teeth.
As I mentioned earlier, I highly suggest the dental flipper. It will look fine, cost less, and protect her adjacent teeth. Then, when her jaw is developed enough, you can get the dental implant, which is a fantastic tooth replacement.
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