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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.