My dental bridge doesn’t look natural any more. Options?

I have a bridge on my top front teeth, (3 on bridge.) The bridge is over 20 years old but looks relatively good for that age. However, it has yellowed with age and coffee and where the veneer has started to wear, if you look closely, you can see a tiny bit of metal between the teeth. Also, where the natural teeth are missing, the gum area is sunken and not plump like the natural tooth area. Would implants plump the gum area and make the teeth look natural when all work is done?

I know a new bridge can “fix” the color and wear issue if I have my natural teeth whitened although I would also have to have a couple of other “crowns” replaced as they have discolored over the years also. Is there anything that can be done to “plump” the sunken area where the natural teeth are missing so that either an implant or a bridge would “butt” up against the gum line to look natural? I am very, very self conscious of the way this looks and although most people don’t really notice, I DO and that makes me uncomfortable. Thanks for your input. Teresa from Ohio

Let me help you with your options.

The yellowing of the bridge and the wear that is allowing the metal to show through, that won’t be able to be fixed except by replacing it. And you could replace it with another dental bridge or with a dental implant and then crowns on the abutment (anchor) teeth.

When you lose a tooth, the bone that used to be there to hold the tooth in begins to resorb, and I imagine that after twenty years it has shrunk quite a bit. Yes, it can be plumped up in preparation for either a new bridge or a dental implant. The dental implant itself won’t give any more bulk to the gum or the bony ridge – that is a separate procedure. It would be easier to do that plumping to prepare for a bridge, as it could be plumped up with a gum tissue graft. In preparation for an implant, it would require bone grafting. And, if an implant is placed, it will prevent any further resorption. So those are the factors that need to be weighed in your decision about which way to go with this.

With either option, I would strongly suggest getting an expert cosmetic dentist for this work. I see you are in a small town in Ohio, and I’m pretty confident that esthetic work that is this demanding is outside the scope of your family dentist. Find a dentist with a real passion for cosmetic dentistry, who proudly displays photographs of his or her work. Yes, their fees will probably be more than your home town dentist, but not a lot more.

This blog sponsored by Naperville dentist Dr. David Newkirk.

Tooth just filled and now abscessed. What do I do?

I had a broken molar (second one from the back on the lower left side). I went to the dentist and he filled it, but after about a month I went back because the filling was causing my teeth not to close properly (it never did close properly after he worked on it). He ground a little more off of the filling and told me that I now had an abscess. My teeth still do not close all the way because of the filling he put in my tooth. Sometimes there is some swelling on the side of the tooth that he filled. I don’t know what to do. I don’t want to go back to him because I don’t think he really cares about me.
– Rick from Missouri

I can’t tell, really, what is going on or what needs to be done without seeing you, but just from what you’re telling me, it doesn’t sound like you’re in a quality dental operation. I think your idea of switching dentists sounds like a good idea. And you need to trust your dentist, so feeling that he doesn’t care about you is also an indication that it may be good to switch.

It’s not unusual for a filling to get in the way of your bite and need adjustment afterward. That happens to every dentist. But then the dentist should be able to adjust it and get it to fit right without repeated trips back.

And for your tooth to be abscessed that soon after he filled it doesn’t sound right. Again, sometimes decay is deep and when the tooth is further irritated by getting a new filling, that can cause a tooth to become sensitive and eventually the tissue inside dies. And you didn’t mention anything about a toothache, but said that now the tooth is abscessed. Again, this isn’t in every case, but it sounds like the tooth was already infected when he worked on it. If you get out all the decay, you should be able to tell if a tooth is infected before filling it. There are cases where the pulp of the tooth dies without any toothache, but not usually under a fresh filling.

Furthermore, if your molar was broken, in most cases it would need a crown. So I’m not sure why your dentist did a filling. Maybe that was what it needed. But there are so many question marks here in what was done for you.

The tooth needs a root canal treatment and then probably a dental crown. It’s the second tooth from the back, so it’s probably a first molar, which is an important tooth. You definitely don’t want to lose this tooth if you can avoid it, and if you lose it, be sure to replace it right away, or your bite can collapse on that side.

This blog sponsored by Naperville dentist Dr. David Newkirk