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QUESTION: My LL 2nd molar (#7) is too short to retain a dental crown which comes off all the time, whereas my LL 1st molar has sufficient height and is fitted with a dental crown. I am thinking, apart from using crown lengthening surgery on my LL 2nd molar, is it viable to remove the crown of my LL 1st molar and install a bridge on my LL 1st molar and  my LL 2nd molar ?  

But as I understand, the part of a tooth above gum line must have sufficient height in order to retain a dental crown, does the same apply to each abutment tooth of a bridge, in my case, namely my LL 1st molar and my LL 2nd molar ?   

Besides, will removing a crown break the crown and the tooth it covers ?

ANSWER: Hello, Dorothy,

Saw your question in the general dentist pool.  Maybe a lot of dentists weren't sure of what to do.

Your question is interesting.  Traditionally I have always thought of a bridge as two support teeth on either side of the middle one.  Why can't you do that?

If it were me, I would try to avoid "crown lengthening surgery."  I don't like the sound of that.  On the other hand, being fitted with a Bridge seems less invasive.

Have you tried taking this question to a prosthodontist?

Regards,
Jonathan
PatientPOV

---------- FOLLOW-UP ----------

QUESTION: Hello Jonathan,

Thank you for your comments.

I submitted my question to a few dentists in allexperts.com. One dentist told me to use crown lengthening surgery and keep the two teeth independent of each other. Another dentist said that there was no guarantee that the splint would be retained by my LL 2nd molar (short tooth). Another dentist said that the idea was sound and splinting the two crowns should allow both crowns to be retained but only my dentist could say for sure. Two other dentists could not answer. I also described my situation to a prosthodontist in allexperts.com without mentioning the idea of splinting the two crowns, and he suggested crown lengthening surgery.

Actually I am skeptical about splinting the two crowns together.  Will this work ? Will this cause me problems and worries ? My  LL 1st molar is fine and I don't want anything bad happen to it.  

I sent my question to a periodontist who had seen my short tooth before and had proposed crown lengthening surgery, and here is what he wrote back:
"It would be too plaque retentive and difficult to clean at the interdental area if you intend to make splinted crowns for 36-37 (not a bridge since there is no pontic (false tooth))"

Answer
Hi Dorothy,

I don't know what I can add other than my previous answer.  I can only provide a "Patient's Point of View."

You have done a good job of thinking this through and seeking the opinions of several dentists.

Which of these dentists has the most experience do the bridge work you require?   Although not always a reliable indicator of competency, check and see where they went to dental school.  What you're trying to do is get a general idea of whose opinion you trust and makes the most sense.  Conservative approaches are usually recommended, and you can work forward from there.

Sit in a quiet room for a while and turn the TV off.  Think about all you have learned from these different dentists and go with your gut. What do YOU think?

Best Regards,
Jonathan
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Dentistry

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Jonathan at PatientBabble

Expertise

My area of expertise from the patients point of view would be Dentistry/TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my TMJ/bite problem. I AM NOT A DOCTOR...but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their TMJ/bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. I will try and recall information or experiences that may be helpful to you.

Experience

About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. The majority of dentists believe they can treat TMJ, but only those whose primary focus is TMJ treatment, are really any good at it. Any dentist, can take an impression of your teeth, send that impression off to the lab and have them make a night guard. That is the easy part. The tricky part is what the dentist does with the night guard, once receiving it from the lab. The dentist has to do a "fitting" where they tailor the night guard to be evenly balanced and comfortable in your mouth. Sometimes it can take a few visits, because further adjustments need to be made to the night guard appliance, to get it just right. I have found that dentists, who have had the most practice, do a better job at fitting your appliance. It's almost like an art form.

Organizations
Jonathan's Blog is: https://patientbabble.squarespace.com/jonathans-blog

Education/Credentials
College Graduate with Bachelor of Arts Degree

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