Tooth #13 cracked and wasn't salvageable. Should I replace it with a bridge or an implant? Anyone have experience with both who can do a comparison? Implant is more expensive but it doesn't rely on adjacent teeth.

__________________
1977 300d 70k--sold 08
1985 300TD 185k+
1984 307d 126k--sold 8/03
1985 409d 65k--sold 06
1984 300SD 315k--daughter's car
1979 300SD 122k--sold 2/11
1999 Fuso FG Expedition Camper
1993 GMC Sierra 6.5 TD 4x4
1982 Bluebird Wanderlodge CAT 3208--Sold 2/13

Unless you are in danger of losing adjacent teeth in the near future, just go with a bridge. Implants are sturdier, but they will hurt in the interim during install.

My lackluster dental care over the years cost me several teeth (should have played hockey or something), so a bridge is not an option. Even with insurance, the caps for the salvageable teeth coupled with the implants set me back about $7K...and of course, this was performed on the same year that me daughter required braces!!!

__________________
2009 ML350 (106K) - Family vehicle
2001 CLK430 Cabriolet (80K) - Wife's car
2005 BMW 645CI (138K) - My daily driver
2016 Mustang (32K) - Daughter's car

I can only comment on the bridges, of which I have two. Both are functioning perfectly fine and the first one is over 10 years of age.

The downside of the bridge is the fact that they must remove all of the enamel on the adjacent teeth, leaving them exposed and sensitive. Sometimes the new bridge covers and properly protects them...........sometimes they remain sensitive. If the latter situation develops, you're looking at a root canal.........another $1K on top of the expense of the bridge (close to $3K).

If permanent cement was utilized on the bridge, the root canal must be done by drilling through the bridge..........far less desirable and more difficult.

The skill and patience of the dentist is paramount with a bridge. The very best work will allow the bridge to sit in place without any cement (during the trial fit) with perfect margins where the tooth meets the gumline. It takes a dedicated professional to achieve this level of performance, and most dentists do not fit the bill in this regard.

For a difficult situation with #15, I went to a prosthodontist who specializes in crown and bridge, and, therefore, is quite a bit more skilled than a dentist. Of course, you pay for this level of skill...........the crown was $1.5K..........but was worth every penny. This difficult situation developed due to the lack of skill by the dentist in installing a crown on #15 originally.........and said crown had to be removed and discarded due to the improper work.

I do understand that the implants have come a long way over the past 10 years. I might opt for such a solution if I needed it. The cost is about $3.5K but there is no risk of harm to the adjacent teeth and no risk of screwing up the margins on the adjacent teeth.

Good luck..........you'll need it.

From hard experience, I'm in favor of implants.

I had bridges on both sides, lower jaw. Both cases the next to last molar had been pulled. The first one was put in late 70s, and it lasted 13 years longer than the second, which was installed in '87. The second one developed a small hole above the back molar which let in bacteria and slowly ruined the stump. I was getting some small pain but I was traveling and not high on funds and I didn't get it checked out. DOHHH!!!

It eventually came loose from the back stump and during chewing action, the leverage snapped the front stump leaving both teeth unusable. Both had to be pulled, some $300 apiece for that alone.

With that type of bridge, both adjacent teeth need to be ground down quite a bit to accomodate the bridge. So you go from one missing tooth to one missing tooth and two largely destroyed teeth. Bacteria will eventually get under the bridge and it will fail. Usually just a matter of when.

The first bridge to fail (the second installed) failed in '91. I didn't realize that you have a limited window to get implants. The body reclaims what looks like unused calcium and the bone resorbs, eventually making it too small to receive or support an implant. In the lower jaw this is more critical, as a large nerve is closer to the top of the bone -- if that nerve is damaged badly enough, you have permanent novocaine mouth for part of your face.

So when my second bridge failed in '05, I didn't waste any time. Fortunately for me, the back stump on that one was still in great shape. So I had two implants and the bridge rests on those two as well as the back stump. Total cost for everything -- about $15 K. It was either that or hasten my way to removable false teeth.

I'd recommend a thorough search for a really good surgeon. I gather that high quality work can be had in Hungary for about half of US prices. If I had a large amount to be done, and I may one day, I might look into that.

What's more, I hear that there are experiments going on for ways to regrow bone on resorbed areas so as to receive implants. One method my dentist (the bridgemaker for the implant side) told me about involves breaking that part of the bone lengthwise and adding a device that can apply pressure on the upper part of the bone, pulling it away from the main part as new calcium is brought in. By keeping the pressure on, it's said that first qualtiy bone can be regrown, bone that it is supposed to be even better than original bone for implant use.

Now all I need is a spare $100K (I'm guessing).

__________________
1986 300SDL, 362K
1984 300D, 138K

Like most things in dentistry or automobiles, maintenance is the key here.

The bridge must be properly moulded to fit the two ground teeth very well. Then, the cement utilized to secure the bridge must be a high quality permanent cement that won't break down over time. Finally, the owner must floss beneath the "bridged" tooth as bacteria love to live in the hidden margins.

The typical life of the bridge is stated to be 10-15 years, but I'm not clear as to their failure mode. The dentist was a bit evasive as to the actual reason that they don't survive, but, I'm inclined to believe that operator error is a significant part of it.

About 8 years ago, before I was gainfully employed again and on dental insurance, I went to the teaching dental clinic in Oakland. Those are sorta cool as you get dentists who have just learned the new state of the art. The older student overseeing the procedure told me that more and more new dentists are just skipping the root canal option and going straight to implant. Root canal teeth are more brittle and usually don't last all that long. Both of my molars that failed, leading to both bridges, had been root canal-ed.

So there was the cost of the root canal and the cost of a crown in both cases. The reasoning is why not just use those funds for the more reliable implant and be done with it?

I might add that when my first bridge failed in '91, implants were not nearly as refined as at present.

__________________
1986 300SDL, 362K
1984 300D, 138K

Additional info:
#12 already has a root canal and a crown, so grinding away on a healthy tooth is not an issue on that one. On the other hand, the crown has been on there for a long time and is in good shape.
#14 has a very large filling in it. If it follows the path of my other molars with large fillings, it will eventually crack and need a crown itself so putting a crown on it for a bridge could be a preventative move.

I have double dental coverage (I'm required to buy a bad plan and my wife's plan is much better) so some of the cost will be covered, more on the bridge than the implant.

__________________
1977 300d 70k--sold 08
1985 300TD 185k+
1984 307d 126k--sold 8/03
1985 409d 65k--sold 06
1984 300SD 315k--daughter's car
1979 300SD 122k--sold 2/11
1999 Fuso FG Expedition Camper
1993 GMC Sierra 6.5 TD 4x4
1982 Bluebird Wanderlodge CAT 3208--Sold 2/13

Guilty as charged. I flossed regularly but I didn't use the floss needles to get under the bridge. I thought just using the brush to agitate the area would be good enough. I gather that water picks are good for that, but I didn't know that at the time.

__________________
1986 300SDL, 362K
1984 300D, 138K

Kerry- You have to do your homework on this one to decide which option is best for you. My entire lower jaw with the exception of 4 permanent teeth is bridgework due to having braces way back in the 70's....implants are very good for certain teeth but the main thing and most importantly is where the main nerve is and how far down they have to drill into the jaw bone for the implant. Some oral surgeons won't touch it unless there is sufficient bone and they aren't anywhere near that nerve that runs the length of the jawbone. This can be done with a Pan-X xray of your jaw. I know people who have had implants and love them, I didn't have an option because of too much bone loss and they would have had to drill down to close to the nerve! Good luck.

__________________
"It's normal for these things to empty your wallet and break your heart in the process."
2012 SLK 350
1987 420 SEL

That's interesting. #13 cracked and had to be removed and my second bridge spans 12-14. It's been excellent, other than the need to go and do a root canal on 14..........it became infected for unknown reasons.

You've got all the makings of a proper three tooth bridge. IMHO, it tends to tilt the preference toward the bridge.

I had the unfortunate displeasure of having #15 fracture after the second crown was installed by the prosthodontist. It fit perfectly, but I only used temporary cement at first to be sure of the fit. Naturally, I neglected to go back in a timely fashion because it fit so well. But, then the temporary cement let go and I went to a drug store and got some cement and replaced it as a temporary measure. Wrong move...........it didn't fit perfectly and a bit of side pressure fractured it so badly that it's not restorable. So, now it sits.........fractured below the gumline..........after spending $3K on it. I'm so annoyed that I just haven't proceeded...........

I have an implant on my rearmost lower left molar. It was more expensive than the bridge option, but when I weighed the pros and cons over time I decided to go with the implant. I've had it for 10 years now and it has been no problem at all. It is a more time consuming process, especially for a molar, because after the offending tooth is pulled you have to give the jawbone time to heal and fill the gap left behind by the tooth so the implant can go into the jaw snuggly. That will be from 4 to 8 weeks, depending on how quickly you heal and how big a hole there is to fill. Then you have to wait another 4-8 weeks before the implant has fused to the jawbone and is strong enough to have the crown installed.

__________________
Jonathan

2011 Mazda2
2000 E320 4Matic Wagon
1994 C280 (retired)

I broke two lower teeth and went implants. The oral surgeon got 1,200 each for installing the screws. My dentist did the surface work. A good guy. Took a long time getting the surface work with periodic visits to make sure the "teeth" were shaping properly. I think between the molds and the final surface, there were about 4 trips back & forth to the lab...in Philadelphia. But, I'm pleasedwith the results. Figure the dentist and the surface work matched the price of the implants. 2,500 per tooth, all in all.

I declined the gas/sleep option for $750. Interesting feeling having the titanium screws ratcheted into your jaw. It was actually a little ratchet..click..click..click.

Will #13 missing be visible when you smile? Once the implant heals & the bone knits around the screw, it's pretty simple to get a temporary tooth atop the implant, while you want for the permanent crown to be made.

If I were in your shoes, I'd go with the implant. I don't think the pain will be too great and if you are careful and keep it clean, it should heal in normal time...about 6 weeks iirc. Then get a quick cap and wait for the final top to arrive.
If the bookends 12&14 already have issues, bridging with them may cause long term problems.

I've had my implants about 5 years or so. No problems.

If you have limited or no dental insurance, maybe your employer has a cafeteria plan which you could fund to get the benefit of paying your share with pre-tax dollars. Problem with that is you would need to have the funding amount already decided upon and the payroll deducitons already in place. At least I got the benefit of paying for mine with pre-tax dollars. (very small consolation)

Good luck..and, really, the pain wasn't too bad.

Hell, just move to Kentucky, Teeth aren't a requirement here. BTW I still have all my teeth I thank you.

__________________
For the Saved, this world is the worst it will ever get.
For the unSaved, this world is the best it will ever get.

Clk's Ebay Stuff BUY SOMETHING NOW!!!

I've met three people, all women, who have no fillings whatsoever. Oh mah God, what a glorious sight to gaze on all them perfect pearly whites.

Maybe in the next lifetime . . .

__________________
1986 300SDL, 362K
1984 300D, 138K

12 yr olds??

__________________
1977 300d 70k--sold 08
1985 300TD 185k+
1984 307d 126k--sold 8/03
1985 409d 65k--sold 06
1984 300SD 315k--daughter's car
1979 300SD 122k--sold 2/11
1999 Fuso FG Expedition Camper
1993 GMC Sierra 6.5 TD 4x4
1982 Bluebird Wanderlodge CAT 3208--Sold 2/13