Maryland bridge vs partial denture for missing canine teeth?

[neepsandtatties]

My baby canine teeth (both sides) have never fallen out. I had them veneered about 5 years ago to make them look good aesthetically, always realising this would be a temporary solution (as x-ray shows they are only holding on by a thread).

My (new) dentist now says that one of them has a cavity so this has accelerated the decision as to what to do about them long term.

Implants are not an option for a number of reasons (adult canines still in head but lying nearly 90 degrees to where they should be, and quite frankly, I can't face the faff of extraction, bone grafts etc).

So choice is Maryland bridges or partial denture and I don't know what to do! The gaps left would only be visable when I smile broadly (not when I talk), so aesthetically I could cope with a denture I had to remove at night (and forgot to put it back in for the school run!). But I understand they can also be uncomfortable and a pain to look after? I don't really know much about dentures - dentist said she would use a metal one?

I inherited my problem from my mum (though she has it only on one side), and she has a Maryland bridge but it has fallen out several times, which obviously is a nuisance, and costs money each time. She also has to make sure she uses the other side of her mouth when chewing, but I couldn't do that as both sides are affected! My dentist also said that missing canines aren't the best teeth to bridge?

My dentist is also keen to do the work pre-emptively (i.e. remove the baby teeth now, rather than wait til they fall out naturally in x months/years). My DH thinks she's on the make, keen to get the work. Her justification was both the cavity and that it would be better to do it all in a planned way, rather than have to try and schedule it in at short notice when they fall out. But I'm not convinced on this explanation. Does it really matter if the baby tooth has a cavity if it has no roots and is going to fall out at some point anyway?

If anyone has any experience or thoughts, I would love to hear them. Also, I've read that you need to leave the gums time to heal after losing a tooth before starting any bridge work etc - am I right in thinking that since my baby teeth have no roots to speak of, that wouldn't be an issue here?

I have a Maryland Bridge to replace an upper incisor which I lost in a bicycling accident aged 13.
I've now had it for 25 years without problems apart from that one 'wing' became loose a couple of years ago. It's still loose as I am unsure what to do about it.

My dentist said as well they would only fix it on one side nowadays, exactly to avoid my problem: if it came loose, it would just fall out, whereas mine is still hanging on on the other side. There is a risk that I'll develop cavities under the loosened wing.

I've looked at an implant too but it would be ££££ because I'd need some upper jaw bone replacing as well and I cannot quite stomach the idea of the pain and disruption...

Ah, that's interesting about the reason of one side only. Makes sense, and is what the dentist said she would do. I only thought it strange because my Mum's bridge is stuck on both sides.

I had a bridge (second tooth in from top incisor) for about 15 years (bad dental history- dentist was struck off). It was attached to the tooth in front of it. It was great, but fell off a couple of times in the last year as my teeth were moving forwards so the gap it sat in became too small for it.

In the end I didn't get it replaced as the gap had become so small, my dentist and I agreed that it'd look weird because the false tooth would have to be teeny to fit in the gap hopes dentist isn't an mner as this post would out me

I'd guess your dentist is suggesting it now as a preemptive thing, as other pp have said.

I hated and could not get used to a partial denture. Waste of money for me. I'd go with a bridge. Not sure what a maryland one is. I have a bridge and am happy with it.

I have a (very big) Maryland bridge as my 2nd incisors never grew (not there on any x-rays either). Mine was attached to my front incisors and my canines, so basically six teeth joined together.

It did come unattached from one canine, so he just filed the wing off, so that's just a normal tooth now. Couldn't your dentist do that Pacific?

pacific your dentist should cut the extra wing off. Makes it to clean etc.

OP, please pm me. You shouldn't be paying so much.

MrsMOrton, yes, I know. He's offered and advised to do it. The problem is that my remaining fixed win is attached to another dodgy incisor (same accident) and there is a risk interfering with anything will cause more trouble IYSWIM.

I know I am procrastinating btw...

Oh, just saw your comment too, Scatter - I fear something will have to be done sooner rather than later about it

Nah, get it cut off. There's a reason it debonded (it shouldn't have been bonded in the first place!)

I have an appointment - may just brave it after this thread. Ack.

I saw someone a few months back with this, there was so much decay under the loose wing that we had to do a root canal treatment on the tooth and I'm not sure it will last the next five years.

I have the same thing with my teeth but the first molar on each side at the bottom rather than the canines. If the baby tooth is healthy I would leave it. Mine lasted longer than predicted. It does sound like the one with the cavity would best be removed. My first one became wobbly in pregnancy 7 years ago and I got a maryland bridge, attached to the tooth behind. It has been fine but I tend to chew harder things towards tge back to avoid it a bit. I don't likevthe aesthetic of the metal but noone else can really see it. The second one became wobbly earlierthis year (pg agsin, cooincidence?!). I had it pulled out as it was such a pain. It wasn't long for the gum to heal but the dentist said to wait a couple of weeks. I was booked for another maryland but later decided to leave a gap as it it is not noticeable whereas I thought the metal might be as its a bit closer to the front iyswim. The dentist said a gap could cause problems long term but there was no need to rush.

Do yoy normally have nhs dental treatment? My bridge was done under maternity excemption so free but would have been around 200. A white one was more like 700 but not recommended as the bond would not be as good? If I had several grand spare i would have implants but bi cannot imagine having so much money and not needing it for something more urgent!

Mrsmorton, will PM you, thanks!

Fruitpastille - my mum's baby tooth fell out during pregnancy - apparently the gums get a bit goo-ey (not a technical term!) during pregnancy and I was fully expecting mine to fall out then too, but that was 6 years ago and they are still here.

My adult canine teeth aren't present and I had the milk teeth extracted when they had cavities - not both at the same time. Because the gaps were small, one missing wasn't noticeable (removed about 17 years ago), but I had a bridge fitted after the other was removed.

My dentist waited a few months after extraction before fitting the bridge. The bridge was stuck at both sides (it's like a metal wing at the back that is stuck to the tooth next to the gap, it feels very smooth). Unfortunately it did come out whilst on holiday - biting down on a very crunchy bit of bread - after only about 2 years. As I hate going to the dentist (anxiety issues, tendency to hyperventilate), I did nothing about it. Eventually went back to dentist a couple of months ago and have just had a new bridge fitted. This is only fixed to one tooth. It looks great and has made me feel much more confident - I was very conscious of the gap whilst talking and smiling.

I do have another gap one tooth further back at the other side where the dentist also wants to fit a bridge, but I'm worried I won't be able to chew then, so I think I will cancel that appointment and leave it for now.

I decided against a denture, as I read so much about people having problems with pain and rubbing.

So, I guess my advice would be I'd have the tooth with the cavity removed and a bridge fitted, but can't see why the other one needs to be done at the same time tbh and would leave it to fall out naturally or until it has a cavity.

Hey, someone else with the same imperfection! One-wing-only seems to be the way to go. The dentist explained to me that the different directions of the shear forces when a bridge was stuck to two teeth can make them more likely to fall off, so that all concurs.

Can I ask, were your bridges done on NHS or privately?

Neeps, mine were done on the NHS and dh is unemployed at present so cost me nothing I was told it would otherwise be the highest bracket of NHS payment, not sure how much that would be. No mention of having to pay privately though.

Thanks everyone for your help, including those by PM.

I think I am going to go down the road of a maryland bridge, but I will question my dentist on why she told me it had to be done privately, rather than on the NHS and take it from there, if necessary changing dentist...

I hope it works out well OP, I just wanted to reassure you that implants are not as bad as you fear. I had canine and next in teeth done this year - one had been support tooth on an earlier bridge and one was the replaced tooth on that bridge. They always warn you about bone grafting in case necessary but I didn't need it and am really pleased with the result - £2k for 2 teeth.

KEEP YOUR TEETH FOR AS LONG AS YOU CAN! Please do not listen to a dentist who suggests otherwise. I am American and I know this is a UK site, however I saw the posts and felt the need to jump in.

My grandfather was a dentist. Thanks to his forethought, I had major surgery on a canine tooth that was lying 90 degrees in the roof of my mouth when I was 14 years old. The surgery and aftermath was nightmare, but I have managed to keep a difficult tooth in my head for another 40 years.

I was told by a respected oral surgeon that I would not have the tooth past the age of 45. She was wrong. I am now 54 and the tooth is finally bothering me enough that I am going to have it extracted. I ignored them when they suggested extraction and just kept it very clean with a strict oral cleaning regimen.

I will probably opt for a permanent bridge because I cannot handle any more surgery in that area. I am not willing to risk implant surgery.

A good dentist will answer every question to your satisfaction. A good dentist should be able to explain themselves. I got a good run from this tooth. I cannot complain that I will now lose it.

You are a young person, keep your natural teeth for as long as is medically viable. No one can accurately predict when it will fall out, not even the most talented and experienced dentist.

If she can't work with you - find a new one, and hang on to those teeth for as long as you can.

I have the same problem as the OP on one canine.

My dentist offered to do a Maryland bridge bond to one tooth, and quote me £1,400.

My baby tooth already fell off few years ago. So no extraction required, only a bridge.

For a Maryland bridge, does the healthy tooth/teeth need to be trimmed?

I would like to preserve my healthy teeth, so not choosing a fixed bridge.