My daughter has a congenitally missing tooth. Our plan is to replace it with a dental implant once her jaw is completely developed. In the meantime, we have done orthodontics and have the space opened up. Our dentist provided a Maryland Bridge for the temporary tooth replacement as we wait for her jaw to grow, The problem we are having is the bridge keeps falling out. She used the ceramic wings. At first, she thought she’d just need to try a different cement, but that didn’t help. Now she’s thinking that maybe metal wings will stay better. My only concern about that is the metal will look darker and affect the appearance of her teeth. Is there something we are overlooking?

Lacey

Dear Lacey,

I can tell you are a good mother and are doing everything in your power to give your daughter the best care possible. Your choice of a dental implant is a great one and will serve your daughter well.

One of the things you are running up against here is your dentist, though I am sure she has good intentions, does not understand how a Maryland Bridge works.

First, you should know these are not meant to be temporary tooth replacements. In order to get these to stay on your teeth properly, there actually needs some tooth preparation on the adjacent teeth, as seen in this image below.

A small notch needs to be added to the tooth to help keep the bridge in place. My guess is your dentist is just trying to keep these on with the bonding alone, which will not work.

Switching to metal wings, won’t be a great solution either. It is actually easier to bond porcelain to natural tooth structure than it is to bond metal. So by switching, she is actually making it more difficult for the Maryland Bridge to stay on.

What Makes a Good Temporary Tooth Replacement?

The reason I do not consider the Maryland Bridge a temporary tooth replacement is because of the necessary tooth preparation. The structures of the prepared teeth are not permanently damaged. Once you remove the bridge to place her dental implant, those notches will still be there and y ou will need to fill the are with some composite bonding.

Instead, I am going to recommend you get your daughter a dental flipper. Because these are much less expensive, not only will you save a lot of money over a Maryland Bridge, but they will do no damage to her teeth, so it is a safer option as well.

My suggestion is you ask for a refund on the Maryland Bridge and get a dental flipper instead.

When it is time for your daughter to get her dental implant, make certain you research the dentist carefully. This is an advanced procedure that requires post-doctoral training. There are many dental implant horror stories that would have been avoidable if the patient knew to check the dentist’s implant training.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.