After two unsuccessful root canals, my daughter is having her left front tooth extracted. She fell skateboarding, and the tooth can’t be saved. After the extraction, is a flipper, a Maryland bridge, or something else best for her. What about a mini implant? Also, I’m concerned about the oral surgeon removing the entire tooth ligament and potentially toxic materials she will use and how it will affect my daughter in the long term. My daughter is 13 years old. What questions should I ask the surgeon? Thanks. Faith from Fayetteville, AK

Faith,

It’s common for people to say that an oral surgeon suggested replacing a front tooth with a Maryland bridge until a young person’s jawbone growth is complete and they can receive a dental implant. Why should dental implants be placed in fully developed jawbone?

• Natural teeth move as the jawbone develops, but dental implants don’t.
• Eventually, the vertical position of natural teeth and the implant won’t match.
• As teeth shift, pressure from the dental implant might affect their growth and position.

In some cases, a dentist might use a mini implant for a small tooth. But they are commonly used to support dentures. In your daughter’s case, a dental implant is best in her late teen years when jawbone growth is complete. At that time, an implant dentist will use a standard implant to replace her front tooth. Standard implants are strong enough to withstand the force of biting with front teeth.

Concerns About Extraction

When a surgeon or dentist removes a tooth, the periodontal ligament usually comes out with it. If the dentist doesn’t remove the ligament, your body will resorb it. Surgeons and dentists don’t use any toxic materials during an extraction.

Dental Flipper vs Maryland Bridge

An overview of each treatment option can help you decide what’s best for our daughter’s oral health and the appearance of her smile.

Dental flipper

A dental flipper, or a flipper partial, is inexpensive and will look good. A flipper can be made with our without metal clasps that clip over teeth. Although a child might lose the flipper, you can purchase several of them for the cost of a single Maryland bridge.

Maryland bridge

Often, a dentist needs to prepare the adjacent healthy teeth to keep a Maryland bridge in place. Drilling will leave permanent marks on your daughter’s teeth. Although the oral surgeon views the bridge as a temporary form of tooth replacement, it has lasting effects on supporting teeth. If your dentist can position a Maryland bridge without preparing adjacent teeth, it will be difficult to remove it without damaging those teeth. A metal Maryland bridge is attached to the backs of adjacent teeth. The metal will show through and make your daughter’s teeth look dark.

Coordinate your daughter’s care with your dentist and the oral surgeon. If your general or family dentist doesn’t have advanced cosmetic dentistry training, you suggest that you schedule a consultation with a cosmetic dentist. The cosmetic dentist will discuss options for an affordable, natural-looking form of tooth replacement.

Dr. Ryan Perry, a Baton Rouge family dentist, sponsors this post.