About Rishi Verma, D.D.S. Expertise General Dentistry, Cosmetic Dentistry, Restorative Dentistry, Esthetic Dentistry, Forensic Dentistry, Special Needs Dentistry, Pediatric Dentistry
Experience Columbia University School of Dental and Oral Surgery, Brigham and Women's Hospital/Harvard University General Practice Residency, Helen Hayes Hospital Fellowship in Special Care Dentistry, Montefiore Medical Center Certificate in Pediatric Dentistry.
Organizations American Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, American Society of Forensic Odontology, American Academy of Pediatric Dentistry, Special Care Dentistry Association, Academy of Dentistry for Persons with Disabilities, American Association of Hospital Dentists, American Society for Geriatric Dentistry
Education/Credentials D.D.S. degree from Columbia University's School of Dental and Oral surgery. GPR Certificate from Brigham and Women's/Harvard University. Currently pursuing a Fellowship Certificate in Special Care Dentistry at Helen Hayes Hospital.
Question QUESTION: I have a bridge on my upper right side. I have to extract the front tooth of that bridge because of abscess. Implants are not an option now so is it possible to put in a 4 tooth bridge? The 1st tooth of that bridge is number 5 I think.What are my options?
ANSWER: Hello Donna,
Just so I have a clear picture, it sounds like you have a bridge from tooth #3-5, and #5 has an abscess. Did your dentist state that a root canal is possible, or if the tooth has been root canal treated, an apicoectomy (a procedure where they drill into the bone near the end of the root and remove the infection) can be done?
If it is to be extracted, it is possible to do a bridge from tooth #3-6, but I would urge you to ask about the other two procedures before you go ahead and drill your canine tooth down, as your canine tooth is important in directing the movements of your jaw while eating.
Please let me know about the questions I asked so that I can try to help further.
Regards,
Rishi Verma, DDS
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QUESTION: If counting from the front right tooth as #1...5 is the abcess and 6 is missing center of bridge and 7 is back of bridge.Yes both teeth of the bridge have been root canaled but no one suggested the apicoectomy. They suspect that there may be a crack in abcess tooth but they are not sure.So the 4 tooth bridge would not start with my canine its the next one back. What are my options if I lose that tooth. There will be two spaces,Are there any snap on partials that look ok.Im still young!!!Thank you so much for your time. I appreciate it so much
ANSWER: Hello Donna,
So it sounds like you have a 3-unit bridge from teeth #2-4 (2nd molar to 2nd premolar), and the second premolar is the tooth with the abscess. I think that it is entirely possible to have a 4-unit bridge from teeth #2-5 (first premolar behind the canine), provided that the teeth do not have a significant amount of bone loss and are not preiodontally compromised (mobile, large periodontal pockets).
You may also want to consider having implants placed to restore the open space. You can then put a crown on tooth #2 or keep the crown that is on it now when you cut the bridge.
Hope this helps. If you have any further questions, please do not hesitate to ask.
Regards,
Rishi Verma, DDS
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QUESTION: sorry to keep asking you questions and thanks for your responses..I guess you start by counting from the back not the front right?It sounds like I do have alot of loss of bone by the absess(no pain though)looking at my x-rays. So they did suggest implant(s) but have to lift my sinus. That is too invasive for me so if they have to pull the tooth and i have 2 empty spaces is there a snap on retainer or something to fill the spaces? I would love to save the tooth but if that is impossible,I just dont want to look like Im from the 3rd world LOL Thanks again for you time
Answer Hello Donna,
Glad to help. Yes, we start counting from the back (upper right to be exact), so your 3rd molar (wisdom tooth --> if you have one) would be #1, then the 2nd molar (#2) and first molar (#3) and so on.
A sinus lift is a routine procedure that an oral surgeon or periodontist would be able to perform.
If you do pull the tooth, then you can have the bridge extended to the tooth next to the one with the abscess, making it a 4-unit bridge, which would be permanent.
Otherwise, you would have to cut the bridge at the #3 tooth, leaving the crown on #3, and wear a partial denture to close the space.
Hope this helps. It may make more sense when you speak to your dentist.
Hope this helps. If you have any further questions, please do not hesitate to ask.
