My teen daughter has a genetically missing tooth. We’ve had orthodontics done. Our plan when she is old enough is to place a dental implant. In the meantime, we need a temporary replacement. Our dentist suggested a Maryland Bridge. He prepared the teeth and placed the Maryland Bridge. We decided on ceramic wings so they would blend more naturally with her teeth. But, two days later it fell out. Now they are talking about using metal wings. Will this be any better? Will the metal show through? Also, does it damage her teeth to put it on and off later when she gets her dental implant?

Flo

Dear Flo,

First, let me say that choosing a dental implant for your daughter’s permanent replacement is a great idea. It will give her a stable replacement for the remainder of her life. I am less enthusiastic about the “temporary” replacement they chose. My first issue is anything that requires preparation for a tooth or changes the structure of the tooth should not be considered a temporary replacement.

Here are the problems your dentist is facing with the Maryland Bridge. The reason the one with ceramic wings fell out is because of inadequate preparation. If you look at the image on the left, you can see a grove in the tooth. In addition to the light preparation your dentist did, this groove would be necessary in order to keep the bridge more secure. That is a permanent structural change to her tooth.

As for whether the metal will be any better, it is actually a worse solution. Metal doesn’t bond to teeth as well as the ceramics. Plus, as you suspected, it will show through the color a bit. The bigger problem here is your dentist probably didn’t do adequate preparation. This is actually going to work in your favor because there hasn’t been too much damage done to her tooth yet.

My suggestion would be to forgo the Maryland Bridge and get a dental flipper. This should have been what they recommended to begin with. It’s much less expensive and will do no damage to your daughter’s tooth.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.