Dental - Bridge & brace or Bone Block and Implants?

[Maeb]

I lost my front teeth in my teens when I crashed my bike and have had an NHS bridge since. My bridge needs replacing and I've also been told/ feel I would benefit greatly from orthodontic braces as I have 'a complicated bite'. My teeth as they are look okay but I think the bridge looks false.

So, I want better looking, more 'real' teeth and have had a consultation with an implant specialist and prosthodontist.

They said that the lack of bone in my upper jaw is significant (I've seen the scan and it is awful) and that my options are either:

A bone block & gum graft surgery followed (after many months) with implants for which they've given me a 80% chance of success. They have warned me that it is complicated by the lack of bone and that if it fails I will have a lot of scarring and that I may be worse off than before.

Or, orthodontic braces and a new more realistic bridge. But again, will it look like I'm wearing false teeth?

They obviously can't tell me which to go for and I just can't make up my mind. I don't mind the months of discomfort and horrible procedures if I end up with nice teeth but to go through all of that and be worse off.

Either way it's expensive, it's going to take months and months and involve feeling crappy and self-conscious :(

Does anyone have experience of bone block surgery? Or do you have a bridge replacing your front teeth that looks as good as the real thing?

I need lots of advice as I'm just spiralling into worry about it. Thanks pals!

Hi there, I feel for you having to make a difficult decision like this. Bone block is major bone grafting surgery, I recently had a consultation with implant clinic and another dentist re having bone block graft implant for a back tooth. I was told that failure rates of these types of grafts are a factor but a lot depends on the condition of your gums as well. Do you have good gums and no bone loss or periodontal disease anywhere else? That means no gum pockets bigger than 3mm or bleeding from gums. If your gums and general bone levels are good then there is more chance of it being successful and 80 percent sound like good odds. All the dentists I saw advised me to have a bridge on mine as the best option which would last average 10 years and by then better grafting materials would have come along, but I do have some slight periodontal issues so your prognosis may be a lot better. What are options to have the more realistic bridge? Is this going to be a lot more expensive?

Thanks CowardlyCustard2, my gums are all healthy but the bone loss from the accident and subsequent bone reabsorption mean there's quite a large chunk missing.

The bridge will be less expensive for sure, I just don't want to look like I'm wearing false teeth! They said they can try to minimise the white join between the teeth but that it will still be there.

A woman in the clinic showed me her bridge and was telling me how great it was and nobody noticed and all I could think was NOPE! It was a slightly different shade and didn't look right to me! I know I'm a bit too observant on details and probably most people wouldn't give it a second thought.

Have you got a handle on your periodontal issues? Or are they holding off till you get that sorted?

It might be worth seeing another dental implant surgeon to compare notes. I think they vary a bit in terms of price and what they may offer. Aftercare and number of visits are other considerations.

I've seen three. This one is highly regarded and experienced so I trust him and appreciate the realistic odds he's given. I just wish someone could tell me what to do...but they can't!

I would go for the implant. It is what you really want. If it doesn't work get the bridge.

It sounds like the implant is what you would be happier with. It's true that most people don't notice details about others. I had a colleague that wore a wig for 3 years and no one noticed! However if you are going to be constantly aware of bridge and it will make you miserable then I would go for implants xx

Hi, I have anot implant at the back. Excellent in every way but was expensive and I didn't need bone graft. I also have a single tooth bridge at the front and I don't think a good (ie expensive!) bridge will show at all. In your shoes I'd probably go for top quality bridge and orthodontics. I do agree with pp that other people don't notice. I notice everyone's teeth as I'm very self conscious about mine but absolutely everyone I know says that they only notice horrendous teeth and nothing else. Also I am always studying mine in mirror, photos etc but no one else does that. Hope it goes well for you either way.

No advice but following as in a similar situation, although my tooth is still hanging on (dead) at the moment...

for you. These decisions are tough.

Cowardlycustard2 - that is so funny about the wig! I'm terrible for noticing tiny details...I would have spotted wiggy straight away! I took what you said originally about how you'd been advised that bone graft techniques may improve in the future and have been mulling over that. Maybe a good bridge will be better and less invasive....

MrsEricBana - Did you get porcelain or zirconium bridge? I think my/your/ones eye is drawn to colour differences too. The woman who showed off her teeth to me at the clinic had white teeth but they looked different shades which draws your attention.

With the temporary bridge I have at the moment I can't talk properly either. I have a lisp and am stumbling on words as my tongue doesn't know where to go!

I really appreciate all your advice...it's so difficult.

Is there a dental hospital where you can be referred? As you lost your teeth due to an accident you may be able to get your treatment for free

YerAWizardHarry - I don't think I can. From what I gather Dental Hospitals, or at least the ones near me, are for children and/or people on benefits. If I went the NHS route I would only be allowed a palette.. ...and I'm too young to have false teeth in a jar by the bed!