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Front 4 tooth bridge
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Front 4 tooth bridge

I have had a 3 tooth bridge (front teeth) for years.  Bridge came loose after years and in removing it, one anchor tooth broke and was advised to have it removed.  Did this.  Now the next tooth to be used to hold up the now 4 tooth bridge has been a problem for 4 years.  It was tramatized (a canine natural tooth)in removing a tooth next to it.
It has had minor pain for the 4 years but a root canal doctor said leave it alone.

Now that the one anchor tooth of my front bridge was removed due to breaking it as stated above in removing the bridge, I am faced with the tramatized canine being ground down to hold the bridge.  I am now in temporary bridge (4 teeth front).  Yesterday they removed temporary bridge which has been in place for 6 weeks because I had to have a surgeon remove the broken tooth and it was healing while I wore the temporary bridge.

Now very concerned after yesterday's prepping and taking new molds for new bridge that has "kicked" up the canine more.  There is no decay involved, just hurts if I press on it upward.  Before they ground it down to hold the bridge, it did not hurt when I pushed upward but it did not feel normal and did not bother me unless I pushed on the long root it has with my finger.

Problem now is:  they are ready to order new bridge and leave it up to me whether to see root canal doctor.
I just saw him last year about the canine and he said to leave it alone BUT now it will be holding up (four tooth bridge along with another tooth on the other side).  To clarify:  It will be a 4 tooth bridge (end teeth plus two missing teeth).  All of them are front teeth.

I imagine the canine will calm down to the way it was before.  (remember, yesterday they did molds, pressed cord into my gums to make better fit for permanent bridge AND now the canine and the other anchor tooth both hurt from all the procedures yesterday.

I don't know whether to go ahead and have permanent bridge made using this canine or will the extra workload it will have cause further problems with the canine?

How serious will it be if I go ahead with the permanent bridge and the canine becomes a real problem?

I need an answer quickly as they want me to go to the lab tomorrow to pick out color match.

And I have been in temporary 6 weeks already. THanks.
12 Comments Post a Comment
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3149845_tn?1415046551
Hi and welcome. What about having an implant, they cost about $3000 each but really work well.
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Avatar_f_tn
The concern is (as I'm sure your well aware), you don't want to put a bridge on a tooth that has lasting sensitivity, otherwise you could end up doing a root canal and having to drill through the brand new bridge... which is  not a huge deal, but who wants that nice, pretty porcelain altered right away? Also, if there are other significant problems with the canine found (like a root fracture) the tooth could require an extraction. Always best to find that our before a bridge is placed.

In our office if a tooth is sensitive, we give it at least 1-2 weeks to calm down. If it doesn't get better or if it worsens within that time frame, a consult with the root canal specialist is indicated.

A canine is a strong tooth, but it will take a lot of force while supporting a 4 unit bridge. This could allow the tooth to remain extra sensitive.

I would have it double checked by the endodontist (root canal specialist) before they insert the new bridge just to be on the safe side. You can still get the shade matched at the lab tomorrow, but notify your dentist that you are seeing the endodontist so insertion of the bridge may be postponed.

Better to be safe... And at least you have the comfort in knowing everything is ok before you chose to insert the bridge :-).
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Avatar_f_tn
I have been in temporary  bridge for about 4 weeks. How risky is it to wait another two weeks to see if this situation settles down?

Also, all the "pushing up of a cord" to the gum line and then the girl pushed upward on the teeth was for what purpose.  I don't remember this procedure on the two previous bridges I had made at this location.

That procedure is what really caused this canine to act up..the pushing up on it always did causes discomfort if I did it.  (I never made it a practice to chew anything on this bridge area since it was originally made many years ago).

Thanks for an immediate reply as I really need one.
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Avatar_f_tn
There really is no significant risk staying in the bridge for an additional two weeks as long as you keep the area clean. If the temp breaks, the dentist will have your impression to make you a new temp if needed.

The cord is referred to as "gingival retraction cord" and it does just that. It lifts your gum line up just enough for the dentist to shape the enamel and make a good resting edge for the margin (or border) of the bridge to be bonded to.

Teeth that are already having occasional dentist it's, especially when chewing can be made to "flair up" when aggravated. Since this tooth has bothers you in the past with chewing, it's best to have it checked out. I wouldn't want to hear you had the bridge placed and then have to go through a root canal. Again, if needed this can be done.. But most people like to avoid it.

Even if the tooth calms back to its occasional chewing sensitivity in two weeks, due to the history of the sensitivity, I would have it checked.

And sorry if I didn't see this soon enough! I only get online about once a day and that's usually later into the evening.
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Avatar_f_tn
* occasional sensitivity especially when chewing
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Avatar_f_tn
Thanks for following my problem.  I have set an appointment with the root canal doctor for Tuesday.

This is a memo of what happened.

Old 3-tooth bridge came loose and in removing they broke the one anchor.
The next natural tooth in line to take its place as anchor is the canine.
This canine was traumatized 4 years ago in removing the tooth behind it for root canal prep.
It hurt so much I could not use floss or brush it (canine).
Four months later when I went back for root canal checkup, it had calmed down except if I pushed slightly on my face where the long root went along my nose.  I could brush it at that time with no problem.

Now back to the present:
About 4 to 5 weeks ago, when they had to grind down the natural canine, it did flare up somewhat when the temporary bridge was in place but I could floss and brush carefully.
Two days ago, they took models of my mouth(upper and lower) and then did the gingival cord, this canine is back to the state it was four years ago.  I cannot floss even gently and brushing hurts.  The girl "pushed" over and over inserting this cord and then pushed upward on the teeth involved.
It was rather uncomfortable with all this pushing even though I can take having much dental work done.

I went to the same root canal dentist last spring or summer just to check out the natural canine because I was going on a cruise and wanted no trouble away from home.  

He xrayed and tapped and put cold ice, etc. and said to leave it alone.

I see him on Tuesday and this tooth will not have time to recover from all the pushing and cording because, as I said above, at the time of the original damage to it, it did recover about 90% so I could live with it for the last four years.

Thanks for reading this.

Question:  I read online that a root canal holding a bridge should have a post inserted because the tooth will become brittle and could break.
The article talked about the root canal specialist doing this post into the root canal.  Is he the one who does this?  The girl in my dental office says they do it and not the r.c. dentist.
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Avatar_f_tn
Post Script:  To clarify.........

  All that cording and then having each tooth pushed upward has caused this pain I am having.  
The original placing of the temporary bridge four weeks ago did not cause all this pain in the canine and the gums involved.

Was all the upward pushing (not the cording procedure into the gums) but pushing on the tooth stumps upward necessary?
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Avatar_f_tn
The girl informed you correctly, your dentist would be the one to place the post at the time the bridge is inserted. This adds strength to the tooth to help hold on to the bridge, since root canal treated teeth can become very brittle with time.

I'm not entirely sure why they would have to push on the teeth if it wasn't for placing the gingival cord. You could always ask your dentist who did the prep work why they were pushing at that time? Each dentist does the same procedure in different manners.. what tends to work best for them.

It definitely wasn't the pushing that caused the sensitivity as you know.. it was just the trigger for sensitivity from a pre-existing problem.

I'm almost curious if there is a internal fracture within the tooth, since it is mostly sensitive to chewing? This could have been something that happened years ago but is just flaring now.  It could also be that your nerve in that tooth is just very upset and needs to possibly be treated (ie/ root canal).

I'm interested in hearing what the endodontist says! Definitely keep me posted! Good Luck!
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Avatar_f_tn
Regarding the "pushing upward" of the teeth involved in the temporary bridge"................that was done immediately after or during the "cording" process and I cannot imagine why the pushing upward was done.  I will ask next time I see her.

  The canine, which is the problem tooth, did not hurt unless I would "test" it prior  to its being ground and making it an anchor tooth.

As I mentioned, the canine was seen by my root canal doctor last spring or summer and he said to "leave it alone" at that time.  It was sensitive because of the tooth behind it being removed and never fully was normal again...always sensitive I I pushed upward on it (since I never have used this front bridge for biting ANYTHING since it was put on years ago, I was able to live with the "touchy" canine.

Thanks for your interest.

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Avatar_f_tn
Endodentist said to leave it alone without doing a root canal.  If necessary at sometime in the future that problems develop with the canine, he has done root canals successfully through bridges without breaking them.
Thanks for all your interest.
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Avatar_f_tn
That's great to hear. Thankfully you now have the peace of mind to go ahead with the bridge. I hope it looks fantastic! Best of luck!
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Avatar_f_tn
I have had a 3 tooth bridge (front teeth) for years.  Bridge came loose after years and in removing it, one anchor tooth broke and was advised to have it removed.  Did this.  Now the next tooth to be used to hold up the now 4 tooth bridge has been a problem for 4 years.  It was tramatized (a canine natural tooth)in removing a tooth next to it.
It has had minor pain for the 4 years but a root canal doctor said leave it alone.
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taipei, Taiwan