4 tooth bridge - post came out of one of the teeth

[2muze]

I just had the final fitting/permanent cement for a 4 tooth bridge. It has been a problematic procedure from the beginning. The first bridge was immediately a terrible fit and had lots of food getting trapped under the fake tooth that had been extracted. The dentist cut the fake tooth out of the bridge and said to let the gum continue healing for 6 months, come back, and they'd redo the bridge. I went back in 6 months and he cut the remaining bridge pieces off (back molar and 2 teeth in front of the extracted tooth). When he put the 2nd bridge in, it was not applied with the permanent glue - but it was strong glue to make sure it was a good fit, etc. before making it “permanent”. Unfortunately, I immediately noticed that the 2nd bridge created a ridiculous cross bite that was not there before. After bringing in my original bleaching trays from another dentist, my dentist agreed. He used a long metal rod/pole "banged the bridge off", put temporaries back on and worked with the lab to add on material to fix the cross bite on the new bridge. We got the bridge back and my dentist again applied it with pretty strong glue, but not permanent glue to make sure I was happy with the esthetics before applying it with the permanent glue. Today was the final appointment and I was so excited to be at the end of this really long process. Immediately after he “banged” the bridge off I felt one of the teeth with my tongue and it felt different. I asked him if the tooth had broken off and he said "no just the post came out, but it was loose before and I had made a mental note to re-glue the post anyway." Note: This tooth had a prior root canal and post and from the beginning I agreed to do the 4 tooth bridge because he didn’t think it would hold with only a 3 tooth bridge, due to the post being inserted a little off center. I said the tooth size/loss felt fairly significant and he said “the tooth had a prefabricated post and they have composite added to them, no big deal”. He left the post glued to the bridge (it stayed affixed to the bridge when he banged it out) and then simply glued the entire bridge with post back in place. After dinner tonight I used my “super floss” and the floss came out bloody from the gum region of the tooth with the post and I am feeling pressure (but it could be in my head), but no real pain in that area. I am concerned that there is blood evident when there has not been any blood when flossing for more than 6 months. Should there have been some prep to the tooth with the post? Will the bridge protect the root and/or tooth structure if in fact it fractured when the post came out? Or if the tooth/root didn’t fracture but there is missing material/composite, will the bridge protect the area/tooth sufficiently if the tooth shape now differs from the original impression? I am so stressed out. I really thought the end of this ordeal was finally in sight and pray that what my dentist is saying/doing is correct. I certainly won’t have any money to redo this bridge should the fracture worsen or fail in a few years. It was all I could do to do this procedure and as it was, I had waited for 3 years before having the tooth extracted to begin with due to funds for the bridge. The tooth that was extracted was a root canal and crown from another dentist that had become infected after several years. Perhaps because a bit of the file had broken off and was left in one of the roots, or simply because one of the roots was a “leaker” or never properly filled to begin with, but the new dentist says it’s hard to say it could have been (c) all of the above. So I have had some bad dental experiences to say the least.

Your advice please to ease my mind or to get me motivated to see another dentist or make mine fix it….again. I really do like my dentist. He’s been patient and a nice guy, (within a reputable practice) through this all and he seems to know what he is doing, but my confidence has been shaken more then once during this process and now I am really worried that he just closed it up and sent me on my way to be done with it.

[Dr Vahid Motahar]

Hi,

Thank you for your question.

It is not possible for me to make comment on what appears to be a complex treatment and fixture. There is four unit bridge and some of the teeth apparently have had root canal treatment and posts and cores. But what I can tell you is that having some blood on the floss soon after fixing a complex bridge is not unusual and does not mean there is necessary a problem with the bridge. With regard to the root/tooth being broken in the process of removing the bridge, yes it is a possibility but if your dentist have been professional enough to cement the bridge several time with temporary cements to give you the best result they can, then it is less likely for them knowingly to cement a bridge with permanent cement on a broken tooth or root. I would just not think much about it and just monitor the bridge and see how it goes as they say.