Category Archives: Dental Bridge

Will a Maryland bridge work for two teeth?

I have two teeth that will need to be treated. They are next to each outhr. I’ve been researching and have seen that a Maryland bridge is an option for a missing tooth. Will it work for two teeth, instead of just one?

-Jeff in Indiana

In some instances, a Maryland bridge will work for two teeth. But it will not work for more than that. That said, you still need to be careful in this case because of the extra stressed placed on the bridge. It would be most appropriate for two teeth on the bottom that are small in size.

When considering a dental bridge, the force and stress exerted to it is important to factor in. The vertical force doubles when there is more than one tooth on a bridge.

Additionally, there is another factor that should be taken into account, as well. The bridge will flex more when there is an additional false tooth it is supporting. The longer the span of the restoration, the more it will flex, which in turn stresses the abutments.

Typically, a Maryland bridge is bonded to the inside of a tooth. And even with only one tooth, some dentists feel that you’d be taking a chance with the Maryland bridge.

So, use this information when you consult with your dentist. Try not to feel pressured and be sure to explore all the acceptable options that may work for your specific situation and budgetary constraints. You may also be interested in evaluating the pros and cons of a dental implant vs a dental bridge. It may be in your best interest to meet with multiple dentists to best compare your options. Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

My mom is freaking out because she had another tooth fall out.

I don’t know what to do for my mother. She has always liked the way she looked and as she gets older, things have changed. Now, she’s having issues with her teeth, which is really freaking her out. She has had a partial denture for a couple missing teeth and another one fell out near that location. Then, in a completely different area of her mouth, another one just fell out last night. Obviously her oral health is slipping, so we aren’t sure if a bridge will cut it. Budget is also an issue. Any pointers or advice so I can help calm her down and put her mind at ease?

-Whitney in Indiana


Of course, it is difficult to give specific recommendations without having seen your mother in person. That said, when teeth begin to fall out, it is a symptom of advanced gum disease.

So, if that is indeed what is happening for your mother, a dental bridge will not be the ideal treatment plan because it isn’t likely that she really has any solid teeth left that would be able to support this type of treatment.

If budget weren’t an issue, dental implants would absolutely be the treatment recommendation. Dental implants are the standard of care to replace missing teeth because they function like natural teeth and are lifelike. They prevent bone loss around the implant site and are a permanent solution. But, a full mouth restoration with dental implants would cost tens of thousands of dollars.

At this point, keeping in mind that there are budgetary constraints, your mother may better candidate for complete dentures. This would entail extracting the remaining teeth. The major downside of this plan is that when the teeth are gone, bone loss will occur. If you’ve seen images of elderly with sunken in faces, that is what would end up happening to her as the years go by. The condition is known as facial collapse and if she’s concerned about her appearance, she will not like that. Although, depending on her age, it still may be the best option for her.

If she’s not ready to go to the extreme of having all of the remaining teeth extracted, there is another type of partial denture called a Cu-Sil partial. This type of appliance is similar to a complete denture, but it allows the natural teeth to poke through and they help secure it in place. It will provide more stability than a complete removable denture. But if she truly does have advanced gum disease, it may not be the right fit.  Although, as other teeth fall out, the Cu-Sil partial can accommodate the occurrence with an artificial tooth replacement onto the appliance.

Hopefully this information was helpful. It would be wise to meet with a couple different dentists to obtain multiple treatment plans. Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is the Encore bridge old fashioned?

Awhile back my dentist was telling me about an Encore bridge. We’ve moved and I can’t find anyone in the Atlanta area to tell me more about it. Is it outdated and not used anymore?

-Victoria in Georgia


The Encore dental bridge wasn’t widely used or accepted for individuals missing teeth. Not too many patients had successful outcomes because it is very difficult to get all the steps done correctly. It wasn’t as strong as other alternatives and it truly wasn’t the best option when compared to other treatments.

It is still available. But you should look into a the zirconia Maryland bridge. This is a very popular option and is much more aesthetically-pleasing. Zirconia is a very durable ceramic material that looks life-like. Patients have had many successful outcomes, when compared to the Encore.

What is the more important than the type or brand of restoration you choose, is selecting the right dentist. Make sure your implant dentist has placed other successful bridges that are similar to your case. You don’t want to walk into any dentist and tell them you want this type of bridge. Be confident that they have experience in both implant dentistry and cosmetic dentistry. Some dentists may make the assumption that this procedure doesn’t require tooth preparation. So, an expert cosmetic dentist would have a better all-encompassing understanding of the bonding materials and technologies to make this a success. Since it isn’t run of the mill, you may want to even ask upfront, if the restoration fails, could you be refunded. Best of luck and thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I have two implant crowns, will a Maryland bridge still work?

I am trying to find out if it’s possible to have a Maryland bridge placed between two crowns. The crowns are actually part of dental implants. The place where the bridge would be is a molar and I currently have a tooth there. But it needs to be extracted and replaced.

Does that make sense?

-Jim in Iowa


Yes, it is possible to place the Maryland bridge in a location between two dental implant crowns. The bigger issue at play is, how long will it last?

Maryland bridges have a short track record among many dentists. Although they seem easy to place, the force that will be endured with normal chewing and daily activities, presents some complications. Typically, to place a Maryland bridge, the adjacent teeth are ground down a bit and the framework is installed, then the bridge is bonded. But there needs to be small indentations or grooves implemented for success. Not every dentist will get this right. And the Maryland bridge may be at risk for popping out unexpectedly even if it is properly done.

Since you already have crowns on the adjacent teeth, that means that the bridge would not be bonded to natural tooth enamel. When bonding is done to porcelain, it simply isn’t as strong, even if it is well placed. Not too many dentists know how to bond directly to porcelain.

For an extremely skilled implant dentist, the possibility exists to bond the Maryland bridge to the metal framework. This alternative would be better than bonding to porcelain. But it’s a high risk treatment plan. So, although it is possible, it is definitely not ideal.

Hindsight is twenty-twenty. If the dentist would have originally anticipated the fact that the middle tooth would need to be replaced down the road, the implants could have been surgically implanted in such a way that the crowns could have been unscrewed and replaced with a bridge. But that’s neither here nor there.

At this point, the best permanent solution will be to have a third dental implant placed. As long as there is enough bone present at the implant site, this solution would give the the best outcome. The result would look, feel, and function, just like your natural teeth.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Of course I’m allergic to the Maryland bridge that was just put in…

I had to have one of my lower incisors extracted because my gums had deeply receded. The dentist placed a Maryland bridge to replace the tooth. Bad news. I’m allergic to it. I have been told that there is not enough room to place a dental implant. So, when I visited the periodontist, he was suggesting that the tooth next to the site be removed as well. Then, they will replace it with one tooth. I feel like this is an absurd solution. I’ll look ridiculous! Any other ideas?

-Cindy in Wisconsin


Sometimes dental professionals don’t think about aesthetics or what the patient really wants to live with. They are purely thinking about function. How about having one dental implant to support two teeth? This has been done before and works well under circumstances like yours. Discuss this option with your dentist. But if he or she doesn’t seem receptive, you may want to consult with another implant dentist that is more experienced.

Also, sorry to hear that you are allergic. The bonded porcelain tooth in a Maryland bridge is bonded to the metal framework. When the sides of the bridge are bonded to the surrounding teeth, there is metal in those portions. The metal must be etched for it to be successful. It is difficult to determine what you are allergic to within those metal components.

It is possible to create an etchable surface out of tin. The metal would be plated with tin. When that step is taken, a semi-precious alloy like palladium or silver can be used. Both of these materials are hypoallergenic. This could be a possibility for you.

Still another option for when you are missing one tooth would be to have a dental bridge made out of zirconia. This metal oxide is a compound of metal zirconium and oxygen. It is incredibly strong  and looks similar to porcelain. It can be bonded successfully and the best news is that it looks beautiful. When the restoration is complete, the bridge will blend in naturally and appear lifelike. No one will know you’re missing a tooth.

Hopefully this provides you with some possible treatment options beyond having the space filled with one large tooth. Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Looking for options for a dead tooth.

I have a dead tooth. It’s ugly and black and pretty much makes me feel like a hillbilly. I need to have it fixed. I can’t ever remember hurting or damaging it. The tooth has been like this for awhile. My dentist says it had to be due to a trauma of some sort. I don’t remember that instant, but it is quite discolored. I have grown up cracking jokes about my appearance. I acted like it was a choice. In reality, my parents couldn’t afford to have it fixed. Well, now that I’m graduating college and heading into the workforce, I want to be done making jokes. The dentist says it needs to be extracted and recommended a dental implant. Well, when I saw the price tag, I now understand why my parents couldn’t afford to fix it. Are there any other options to replace this dead tooth, aside from a dental implant?

-Karrie in Nevada


Well, it sounds like you have been making lemonade out of lemons for many years. Kudos to you on handling it through those tough teenage years. But now it is completely understandable why as an adult, you are ready to fix the aesthetics of your smile.

Your dentist is correct that you likely damaged the tooth. It could have happened when you were a kid and probably didn’t realize the extent of the problem. It also may have happened quite gradually after the incident. But that’s neither here nor there. From what you have described it sounds like the blood flow has stopped flowing to the tooth. The tissue is dead and there was probably an infection at one point. A root canal would have remedied the problem. But since it wasn’t done, the root may have been absorbed into your body over time. But since there is no longer any blood flow, it is really only a matter of time before you have problems and it may fall out. So it would be wise to have the tooth extracted.

A dental implant is a permanent solution to your missing tooth. It is the best option and looks, feels, and functions just like a normal tooth. But there’s no denying it, an implant is expensive. It is not your only option. A  dental bridge is a more affordable alternative. What happens in this regard is a porcelain crown is placed on each of the surrounding teeth and the false tooth is attached to those two surrounding crowns to fill the empty space. The big problem with this option, especially on a front tooth, is that if those other two teeth that require crowns are healthy, then it really doesn’t make sense to prepare them for crowns. This is because it is quite an invasive treatment that removes a large portion of those otherwise healthy teeth.

A partial denture or dental flipper is an economical option. This is a removable appliance that you wear that has a false tooth attached to it. This may end up being a shorter term solution until you can afford to replace the tooth with a dental implant. Hopefully this information was helpful.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is it possible to get my dental bridge repaired?

My dental bridge is an Encore. It is only a few years old and one of the teeth has already fallen off. Is it possible to get the false tooth re-attached? The other two teeth and gum are still in tact. It is serving as a front tooth replacement. Any help is appreciated.

-Becky in Louisiana


Not every dentist has experience placing an Encore dental bridge. So it may be difficult to locate a dentist that can successfully repair it. It’s as simple as redoing the dental bonding because the old bonding material will need to be removed and cleaned. The false tooth will need to have composite placed back on it. This step will require advanced knowledge with bonding materials, as well as with that particular type of dental bridge.

It isn’t an impossible task, but you need to make sure you seek out the right cosmetic or implant dentist that can properly clean, prepare (etch), and reapply the false tooth with the correct chemicals and bonding materials. Not just any dentist will be able to do this kind of repair.

You need to be aware that this is a temporary fix at best. The original framework and structure of the dental bridge has been compromised.

Have you considered a dental implant to replace your missing tooth? Dental implants look, feel, and function just like your natural tooth did. It is a permanent solution. Again, implant dentistry isn’t something that every dentist can do well. It takes extensive training and experience so be sure to do your research if you are considering this alternative.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Saving a tooth?

I have a very painful tooth that is bothering me day and night. When I was at a recent appointment to get it checked out, the dentist old that the cavity was down to bone level. He recommended bone lengthening surgery, a root canal, and then a crown in order to save the tooth. Truthfully, that recommendation freaked me out because I’m fearful of most dental treatments. Would it just be better to get it extracted and get a dental bridge? It sounds easier to me for some reason. Is it less expensive too?

– Larry in New Jersey


If a dentist states that the cavity is down to bone level, typically that means that the decay has reached beneath the gum tissue. What he has recommended is a procedure called crown lengthening. Your gum tissue will be reduced and the bone will be re-contoured. This is required in order to successfully remove the decay while at the same time having the appropriate space between the bone and the margin for the crown. If this important lengthening step is skipped, the crown will end up being placed too close to the gums and you will end up dealing with discomfort, irritation, and swelling. There is a good chance that your gums will be prone to bleeding as well, which will then increase the probability of bone loss around the tooth. Most dentists share in the  opinion to save a tooth if at all possible. Dental implants and bridges can be used to replace missing teeth, but you will never be as happy as you would be with your natural tooth.

So the decision is ultimately yours, of course. As far as the cost comparison, it will likely be similar. If for some reason the teeth that surround the decayed tooth have cracks or big fillings already, then a dental bridge may make sense. But if the surrounding teeth are in good shape, then ultimately you will be better off saving the tooth or considering a dental implant.

Meet with your dentist again and tell him or her about your concerns. Together, you will be able to come up with the right plan for your individualized needs.

Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Told I don’t have enough space for dental implants.

I used to work on a ranch out in Montana. I have the best memories of those long summer days. But one of the job hazards was the fact that I was kicked in the mouth by one of the horses. I lost a tooth that summer and it didn’t bother me too much because I was a kid. Also, you couldn’t even see it when I smiled. But, now I think it’s time to get it taken care of, mainly because I think the neighboring tooth also needs to be extracted. This may be due to the fact that I haven’t seen a dentist in years. Anyway, when I finally got my butt in to see a dentist, he told me there wasn’t enough space so dental implants weren’t an option. He was recommending a dental bridge. But from all the research I’ve done I’m seeing that implants are by far the best solution. Why wouldn’t there be enough room if there used to be teeth in those two spots? I’m feeling frustrated because I finally want to get this fixed and this feels like a road block.

– Donald in Texas


That is a good question which could be as simple as the dentist you saw may not be comfortable (or qualified) to place dental implants. This is a highly skilled area of dentistry and not just any old dentist makes an excellent implant dentist.

Also, you didn’t mention how many years had passed since your run in with the horse. Therefore, the teeth may have shifted over time into the space where the other tooth used to be.  That may be the reason he is stating that there isn’t enough room.

That said, it doesn’t mean that a dental bridge is your only choice. Most dentists prefer to keep as much of your healthy tooth structure in tact and since bridges require the drilling down of additional teeth that surround the missing ones – you should be able to find a dentist that will provide another alternative.

Mini implants may work for you. They are much smaller in diameter than standard dental implants. So if you are a mini implants candidate, this option may work for a smaller space. Although, mini implants aren’t as strong as conventional implants. It is also not unheard of for a dentist to move forward with a standard dental implant and then adhere two replacement teeth on the same post. The bottom line is that you should have options. So if your dentist isn’t willing or comfortable, it may be time for a second opinion.

Good luck to you and thanks for sharing your story.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Will a crown work if I’m missing a tooth?

I know what a crown is because I’ve had a crown on other teeth. I understand how it is filed down and than the crown is permanently bonded over it. But my question is about an area where I’m missing a tooth. This means there is nothing for the dentist to bond the crown to. I really do want an all-porcelain crown. Is this an option for me?

– Chase in Wisconsin


Based on your personal circumstance, the best solution for you would be a dental implant. You are correct in the fact that there is no tooth to prepare in that space for crown to be placed over it. So a dental implant can be used for the porcelain crown to be placed on. First, the titanium post is surgically implanted into the jawbone to serve you just like a natural tooth root. Then an abutment is attached and the porcelain crown can be placed directly onto that. This piece can be made to be either metal or porcelain. The benefit of the metal abutment is that it is typically stronger, but that being said there are now some very durable porcelain materials available. The porcelain may be a bit more expensive, but in order for it to be “all-porcelain” than that would be the way to go. Although, please be sure to discuss these specifics with your dentist. You never want to push a dentist out of his or her comfort zone, no matter what procedure is being done. Sometimes if there isn’t enough bone present at the implant site, than the oral surgeon may need to do some bone grafting prior to the placement of the dental implants.

The other option if you are missing a tooth would be a three-unit dental bridge. This treatment utilizes the two surrounding teeth which are prepared for crowns. These crowns are actually what supports the dental bridge. This treatment can also be done with all-porcelain.  But if this is a back tooth, than you may want to consider other materials since these teeth are very important for their strength during chewing. Dental bridges are less expensive than dental implants and there are many other benefits and disadvantages with bridges to consider. So be sure to discuss the pros and cons of an implant vs bridge.

This post is sponsored by Cleveland dentist Hylan Dental Care.