 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Dentistry / December 2006Need Advice on Dental Work
My Mom is 79 years old. She needs work on her upper teeth. On the right side, she has the #2 tooth and then some missing teeth till the front teeth, so she needs a partial for that gap. And on the left side, after the front teeth she has a 3-tooth bridge, underneath are teeth #11 and #13, with #12 missing. Tooth #14 is OK. Tooth #11 had a root canal and then the pre-existing bridge was recemented. Now, the bridge is not fitting well enough on the teeth to hold long-term (it has gotten loose recently and had to be recemeted). So something has to be done about this area - either redo some aspect of the bridge and/or the teeth, or make the partial cover the left side as well, and with new crowns done on #11 and #13, I believe. Does anyone know: - The benefits, in this situation, of saving teeth #11 and #13 vs. extractions? - Should we consider saving #11 but extracting #13? - If the bridge is recemented, whether crowns are needed underneath, and what the criteria are in this decision? - How do we pick between using the pre-existing bridge or making the partial to cover the left side? We would like to understand the options and the rationale before proceeding. I have talked to the financial advisor at the dentists' office, but since I am not the patient, it is awkward to actually talk to the dentist, which would be better. Any comments on what I have described would be appreciated. > My Mom is 79 years old. She needs work on her upper teeth. On the right > side, she has the #2 tooth and then some missing teeth till the front [quoted text clipped - 22 lines] > to the dentist, which would be better. Any comments on what I have > described would be appreciated. It is difficult to give specific recommendations based on your post. If I understand you correctly, root canal was done on #11 after the bridge, and this compromised the fit of the bridge. The dentist certainly should be willing to discuss this with you and/or your mother, and I see no reason for embarassment. The best treatment will depend not only on expense, but the condition of the remaining upper teeth (why are you considering having #13 extracted?) and your mother's general health and ability to maintain significant restorative treatment. Generally upper canine teeth such as #11 have long roots and thus are excellent holding teeth for either fixed bridge or partial denture. Also, if a partial denture is made, it usually will be more stable if there are teeth being replaced on BOTH sides. One consideration might be removing the false tooth from the bridge, and if the crown on #13 is still in good shape re-cementing that; then making a new crown on #11--and then making a partial denture that will replace the missing teeth on the right side and tooth #12 on the left. There are a number of possible scenarios--the dentist should be willing to kick them around with you and your mother--this is normal, everyday dental-type stuff. Good luck, Steve Bornfeld, DDS > > My Mom is 79 years old. She needs work on her upper teeth. On the right > > side, she has the #2 tooth and then some missing teeth till the front [quoted text clipped - 46 lines] > Good luck, > Steve Bornfeld, DDS Thanks for the reply to this, Steve. The extraction of a tooth has been considered because the crown to keep it costs almost $1,000. I think that's a good motivation for at least thinking about all the options. Also, that tooth extracted would mean a denture would fill two spaces on that side instead of only one, but of course that is not as important as whether the tooth should be saved. I'm sure there are other reasons to not extract the tooth, which you could fill me in on if you like. It sounds like you like the idea of the partial going to the other side for stability. I believe it would have only one tooth if the two teeth are saved. Thanks for the advice and feel free to add something about partial vs. bridge if you like. We will also talk more to the dentist. John > Thanks for the reply to this, Steve. The extraction of a tooth has been > considered because the crown to keep it costs almost $1,000. I think [quoted text clipped - 11 lines] > > John One consideration in deciding to keep tooth #11 is that it is both generally much stronger than #10 (upper left lateral incisor) if a clasp is needed to stabilize the partial in this area, and it may be more difficult to clasp the lateral incisor in an inconspicuous place. Steve > > Thanks for the reply to this, Steve. The extraction of a tooth has been > > considered because the crown to keep it costs almost $1,000. I think [quoted text clipped - 18 lines] > > Steve Thanks, Steve. We were thinking to keep #11 for sure. What about #13, can you sell me on keeping that one? (Not that you're under any obligation to, of course!) And are there any other considerations on partial vs. bridge for the left side, aside from what you already said about stability of the partial? > Thanks, Steve. We were thinking to keep #11 for sure. What about #13, > can you sell me on keeping that one? (Not that you're under any > obligation to, of course!) And are there any other considerations on > partial vs. bridge for the left side, aside from what you already said > about stability of the partial? #13 may well be worth saving if it's in good shape, particularly if the molars (#14 and 15) aren't so hot. Whether to go for the bridge generally should look at the entire arch. I don't see any reason to do a fixed bridge to replace #12 and then do a unilateral partial denture to replace the missing teeth on the right side. If you and your mom have the money and inclination, you might wish to see if the missing teeth on the right side could be replaced with implants. That's really the only scenario I see that replacing the fixed bridge on the left side makes sense. If you don't replace the teeth on the right side you encourage chewing on the left side. (I say this without knowing the situation on the lower jaw, which we haven't discussed. The ideal is to get optimal function on both sides. We can't always get it, but it's what we aim for). Steve > > Thanks, Steve. We were thinking to keep #11 for sure. What about #13, > > can you sell me on keeping that one? (Not that you're under any [quoted text clipped - 17 lines] > > Steve I noticed in my first post that I was asking about extraction of teeth #11 and #13, but then later in another post I said we were thinking of keeping #11 for sure. Sorry about the confusion. We will probably keep both of them if possible. We could get a bridge on both sides of the top (2 bridges total), but I believe this is more expensive. We weren't quoted on that. She would not have to move around an upper partial all the time then. Since you asked about the lower jaw, I'll tell you that she has a partial on the bottom that covers gaps on both sides. Is a top partial more uncomfortable because it has the plate across the roof of the mouth? I guess that's something we should know. John >>>Thanks, Steve. We were thinking to keep #11 for sure. What about #13, >>>can you sell me on keeping that one? (Not that you're under any [quoted text clipped - 32 lines] > > John Generally a partial on the top is (if anything) LESS of a problem, unless it requires a full palate and the patient is a gagger. Since there are apparently molars on both sides this seems unlikely to require a full palate. This is a separate issue from retaining individual teeth. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Thanks for the reply to this, Steve. The extraction of a tooth has been >> considered because the crown to keep it costs almost $1,000. I think [quoted text clipped - 18 lines] > >Steve True but, one word: equipoise >> > My Mom is 79 years old. She needs work on her upper teeth. On the right >> > side, she has the #2 tooth and then some missing teeth till the front [quoted text clipped - 62 lines] > >John If you could post some x-rays we would be better able to advise you. In the geriatric patient keeping treatment simple is the order of the day IMO. >>>>My Mom is 79 years old. She needs work on her upper teeth. On the right >>>>side, she has the #2 tooth and then some missing teeth till the front [quoted text clipped - 65 lines] > If you could post some x-rays we would be better able to advise you. > In the geriatric patient keeping treatment simple is the order of the day IMO. Agreed. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > >> > My Mom is 79 years old. She needs work on her upper teeth. On the right > >> > side, she has the #2 tooth and then some missing teeth till the front [quoted text clipped - 65 lines] > If you could post some x-rays we would be better able to advise you. > In the geriatric patient keeping treatment simple is the order of the day IMO. I don't have any x-rays to post. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.