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Dentistry/Dental Bridge


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?


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

QUESTION: Hello Jonathan,

Thank you for your comments.

I submitted my question to a few dentists in 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 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))"

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,
Patient Point of View  


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Jonathan at PatientBabble


My area of expertise from the patients point of view would be 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 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 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 come from a family of dentists. My first house growing up was one of those residential/dentist combination homes and I was around the dental practice all the time. My teeth had always been perfect, and in many respects they still are. I have never had a cavity and my teeth are straight. About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." I have learned a lot over the years as I tried to figure out my problem from the Dentists, Speech Pathologists and assorted doctors that I have visited. I will try and recall information or experiences that may be helpful to you.


Twenty-Five years ago after my wisdom teeth were removed, my bite did not feel right and then had trouble speaking. 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. The years of searching for proper treatment has underscored the importance of understanding the relationship between dental and speech methodologies.///// To this end, and to further my research, I recently attended the American Speech-Language-Hearing Association Convention (ASHA) in Atlanta. At ASHA I learned about a specialty within Speech Pathology termed “Orofacial Myology”. In laymen's terms Orofacial Myology Disorder (OMD) deals with the establishment of correct functional activities of the tongue, lips and jaw. OMD is a motor speech disorder that impacts the normal flow of speech, chewing or swallowing.///// If you believe that your struggles with your teeth also present speech, chewing or swallowing challenges, you may want to seek out a licensed Speech Language Pathologist.....preferably one that has training with Orofacial Myology Disorder.

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Abridged Version of a Letter I Sent to a Health Care Professional (3/14/13): "..In my early 20's I had my wisdom teeth out. Almost immediately within a few days, something did not feel right in my mouth. I had trouble speaking. When I raised my tongue to try and touch my palate, I felt mostly just teeth. It is very cumbersome to talk and my bite also became a little bit off. If feels almost as if someone put a fork in my mouth and said "now try and speak." Very difficult. My articulation is fine, so to an observer I sound normal. But it takes a monumental effort, so I hate situations like talking on the phone or when somebody asks me to "tell them a story." ..I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. They just automatically gravitate to what they have heard about TMJ and assume I am either stressed, or just imagining it. Years later, I look back at all those dentists and doctors and I am amazed at how little they really knew about my condition. I have seen the best dentists, including my dad who is a Orthodontist in New York, to TMJ Dentists in Atlanta and Florida. No one ever suggested that Speech Pathology may be a direction I should explore. ..And I was frustrated by the fact that several MRI's over the years, showed nothing. How could the MRI’s show nothing, and at the same time, I know something does not feel right? I do wear a night guard to sleep in, but it does not fix the trouble that I have when I try to talk. ..I went with a Speech Pathologist friend of mine to the American Speech Language Hearing (ASHA) Convention last October in Atlanta...There was a Speech Pathologist at ASHA who was saying that sometimes when you have your Wisdom Teeth taken out "late" that it could possibly cause damage to the Trigeminal Nerve and surrounding muscles.” POSTSCRIPT: At ASHA, I discovered OROFACIAL MYOLOGY (OMD) which is a specialty in Speech Pathology that addresses Oral Muscular Issues.

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