I had a dental bridge that went across the front of my mouth. My two canine teeth were the anchor teeth. Then, those became too loose to support the bridge and had to be extracted. At the time, I was going to Comfort Dental. They suggested I replace those teeth with a partial denture. I wasn’t thrilled but did it. I found the partial to be remarkably uncomfortable. Now they are talking about placing mini implants for those teeth, which they said should last me ten years, as well as using a flexible partial for four teeth I am losing on my lower arch. I sort of lost confidence in them so went to get a second opinion. This left me totally confused because this dentist’s plan is totally different. He wants to do three full-sized dental implants that support a bridge. One that is in the center and two on either side of the bridge. He also thinks the bottom teeth need to be dental implants as well. This second option is obviously much more expensive. I’m trying to decide which is better. I’d save money with Comfort Dental, but am not sure I trust them. Do you have a recommendation as you have no skin in the game?

Braden

Dear Braden,

While it is more expensive, I defintely suggest you go with the plan from the second dentist for reasons I’ll explain in a moment. First, I want to talk about why you lost those canine teeth. Using those to support your bridge was a bad idea on the part of Comfort Dental. The twisting forces would lead to those teeth being lost, which is exactly what happened.

Looking at Comfort Dental’s plan, I would not hold out much hope for mini implants to last you ten years. They’re not really designed to do what they’re suggesting. But, let’s say by some miracle that they do last that long. What will you do after that? You can’t just replace dental implants, even mini implants. You have to replace the bone that was lost when they are removed. That means an additional surgery of bone grafting. Only then will you be able to replace them.

Let’s look at the engineering principles for the second dentist’s plan. Here you would still have your canines as anchor teeth, so why is this any less dangerous? It is because he is suggesting a third implant placed in the center (where your front teeth would be). How does that help? Because it stablizes the bridge in a way that eliminates the twisting forces that would damage the canine implants. Done this way, your dental implant supported bridge could last you the rest of your life.

What About the Bottom Teeth?

While you can often get away with a removable denture on your top arch because they are held in with suction, your bottom arch depends on the bone ridge to support the denture. The problem with that is the minute your teeth are removed, your body immediately begins resorbing the jawbone to use elsewhere in your body. This has the unfortunate consequence of slowly shrinking your jawbone. In about ten or so years, you will no longer have enough bone left to support a denture. This is known as facial collapse.

Placing dental implants prevents that from happening by having prosthetic roots in your teeth. This signals to your brain that there are still teeth to support and will leave your jawbone intact.

I hope this helps. This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.