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Dentistry/6 teeth on a fixed bridge

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Question
Right now I have 6 teeth on a fixed bridge in front of my mouth the 2 eye teeth with 4 missing teeth in between, I need the bridge replaced, the 2 eye teeth already had root canal treatment many years ago but the bridge held up fine. My dentist submitted the paperwork to my dental plan but they state that instead of replacing the 6 teeth on a permanent bridge like I already have,the alternative is to pay for the crowns on the eye teeth and pay for a removal denture with the other  4 teeth with wire clasp that would attach to the crowned eye teeth that had root canal treatment. My dentist and myself both agree that this is not the right way to proceed, are we correct.

Answer
Dear Anthony:
The question with the insurance company is not one of correct treatment planning or not. It is a question of what the policy guidelines are and what is the minimum cost restoration for which they are willing to pay.  The  purpose of any insurance company is to make money for their shareholders. Any  insurance company has to assess the risk of whether you need their services, charge you enough to cover the expenses and only payout minimally when they have to according to the agreed upon guidelines.  Dental insurance is a bit different.  It is more like buying a coupon book.  You can buy any services you desire, but the book only has coupons up to a certain value, and not for every procedure.
You are free to proceed with whatever treatment you and your dentist decide to do, but the insurance company will only pay for what they consider appropriate.
As to the proper treatment plan in your situation, a 6 unit Bridge is not the appropriate treatment at this point.  Your canine teeth are older, they already have had root canal treatment for years and are much more brittle.  Asking  them to take the burden of a 6 unit Bridge is asking too much.  They are likely to fracture and cause even a bigger problem in the future.  Generally,  in your situation, the most appropriate treatment is to place two implants to replace the lateral incisors and restore with a 4-unit front bridge on the implants and give the canines single crowns that will secure their longevity.  This is by far the most appropriate treatment in your situation.
Please  talk to your dentist about doing the most long-term, appropriate treatment in your situation. And as far as insurance is concerned, take the alternative treatment plan and use the money, just like a coupon, towards purchasing the more appropriate service.
Best of luck,

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Zev Kaufman, D.D.S.

Expertise

I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.

Experience

Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC. Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry. Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry. Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry. Former clinical and lecture faculty at Lincoln Hospital, Dental residency program. Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program. Lecture nationally on Prosthodontics and Implant Dentistry.

Organizations
Memeber of the American College of Prosthodontics. Memeber of the Acacdemy of Osseointegration. Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society. Member of the American Dental Education Association.

Education/Credentials
Graduated with Honors from New York University College of Dentistry. Post-Graduate training and certificate in the specialty of Prosthodontics. Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry. Honors-program in Comprehensive and Applied Practice Management. Honors-program in Orthodontics.

Awards and Honors
NYU Cervice award to the community. OKU honor society. National Dean's List. National Who's Who.

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