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Dentistry/implant vs fixed bridge


I am in a bit of a quandary of what to do in my current dental state. I have a mouthful of fairly messed up teeth due to accidents, braces, extractions, root canals, and periodontal surgeries. The initial trauma to my front teeth happened at age two after a fall down a flight of stairs and the right central incisor was knocked out. The adult tooth came in deformed and misshaped. At age 13, many molars were extracted to allow orthodontic treatment. At age 16 both upper central incisors required root canal therapy. At age 19, the gums were removed over my top four front teeth due to periodontal pockets. At age 43, I had the four top front teeth crowned. Now at age 52, the right upper central incisor is loose and has dropped noticeably. According to my dentist, I have significant bone loss in that area; although, in my last pan X-ray he said my bone looked as if it were repairing?? Now, I'm not sure if the bone can repair itself or not, but I am a little confused as my dentist has said I am not a candidate for an implant because of the bone loss. Is my loss of gum tissue from the surgery also contradictory to implants? The surrounding teeth are stable and I'm concerned a fixed bridge will harm those teeth and I will need to have them removed as well. In your experience, how long can a tooth remain loose and falling in a person my age; does it just fall out quickly or do  I still have time to make an educated decision? Can you offer any alternative solutions? Thank you so much for your time! Libby

Dear Libby,

I can't answer your "How long" question with any accuracy.  I have seen loose teeth last a long time for some patients, and quickly come out for others.  And for still others, they become painful and cause sinus and facial infections before being removed.  Your loose tooth or teeth need attention as soon as possible.

Without seeing your xrays, your teeth and gums, and speaking to you for a while, I cannot recommend any one treatment for you.  I can tell you that bone can go through alternating periods of destruction and repair.  I can tell you that it is likely that you can get implants in the area where there is bone loss.  We now have available to us several types of bone replacement materials and methods.  Once your bone is regrown and stable, implants can be placed.

If what your dentist is telling you seems odd, or difficult to understand, you may want to meet another dentist or two and get their opinions.  Yours sounds like a fairly complex case that might also require some specialist evaluation.  If you are going to make a large investment of your time, money and emotions, you should make sure your dentist is looking out for your welfare, and has the skill and interest to provide you with the best we have to offer.

Let me know what you find out.


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Howard Finnk, D.D.S., P.A., CEO


I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.


Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center ( On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (, I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

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Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

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