Making quick decisions about our teeth has to be the worst feeling in the world. You go in to see the dentist because you have a slight tooth ache, and the next thing you know, you are being bombarded with information, options, and fees. You know you have to do something, but you’re not quite sure what or how soon. On top of that, you are hit with the bad news that your tooth has to be extracted. YIKES!!!!!!!
My recommendation is to NOT make a snap decision, especially if you don’t have a long standing relationship with the dentist and the office. Instead ask the dentist to help you buy some time, perhaps prescribe some antibiotics and pain medication to make sure things don’t worsen. Gather all the facts, define your options, and ask for your records (including x-rays, treatment plans, and estimates).
Now that you have a clear mind and you are not in immediate pain or discomfort, take a look at all of your options. If your 2nd and 3rd opinions have recommended the same treatment, narrow down the dentist you want to be treated by. Your realistic options after an extraction are to have a bridge put in or to have an implant placed followed up with a crown. So let’s break down both options.
First, let’s go over what a bridge is and the pros and cons of that option. A bridge is used to cover the space from a missing tooth. It requires at least two teeth on either side of the missing tooth to anchor the bridge. Structurally, it’s the same as most crowns, with metal substructure covered by porcelain, except there are at least three units fused together. The most common materials used for this procedure is metal with porcelain over it. The pros: The aesthetics, if done well are very acceptable and well constructed bridges look very natural. The part that covers the area where the tooth is missing is called the pontic and the anchors that are attached to the adjacent teeth are called the abuptments. This procedure on average takes 2-3 weeks to complete and the dentist will place a provisional bridge while you wait so you will never really be without a tooth in place. These restorations can last for many years with good oral hygiene and regular check-ups. Here is the down side to this option. To place a bridge, you have to use and cut on two other healthy teeth to anchor the bridge. Since the bridge is fused together, you will not be able to floss easily in that area, causing concern for decay under the bridge to develop. If anything happens to either anchor, like decay or a fracture, the whole bridge will fail and need to be replaced. The anchor teeth are usually weakened due to the amount of extra force they endure. The cost of this option is what ever the dentist fee is for a crown times three, this is not including other possible procedures the abuptment teeth might need (like root canals or core build up)
Now let’s look at the implant option. This is the more conservative option because it does not involve other teeth. Each tooth has two main parts to it: the crown and the root. The crown of the tooth is the part that is above the gum line, the root is the part that is below the gum line and is not visible (unless with a scan or x-ray). The implant takes the place of the root and the shape is based on the design of your natural roots. It’s basically an artificial root placed inside the gum, with an attachment that connects the implant to the crown. The implant is made out of titanium, which our body normally accepts. The process usually takes at least two visits, although it can be completed in one visit if the conditions are favorable. The cost per implant is comparable to the cost of a bridge. A well placed and restored implant looks and functions just like your natural teeth. The implant will not decay and they rarely need to be replaced (they have a success rate of 90-95% rate). The main concern with implants is that not everyone is a perfect candidate for implants (due to health conditions or lack of bone support). Cost and time it takes from when the implant is placed to when it is completely restored.
Now that we’ve discussed all the facts, pros and cons of both options, I would highly recommend going with the implant option. The main reason is that each implant stands alone and does not require the support of other teeth. With new technology and research, dental implants are more common than ever.