I have a 13 year old daughter who needed orthodontics and has a congenitally missing tooth. We’re finished with her braces and our long term plan is to get a dental implant for her missing tooth. We just need to keep that space open until she is old enough for the procedure, in the meantime.
Our dentist has suggested that we use a Maryland Bridge. He’s been doing one with a ceramic back, but it keeps falling off. He is talking about doing a metal one, but I’m not crazy about that. I worry it will stain her teeth. What do you think? Would a different cement on the ceramic one work better?
Abigail
Dear Abigail,

I’m glad you wrote. The good news is that your choice of a dental implant is perfect. It is the best tooth replacement you can give her once she is older. I don’t think this dentist is serving your daughter (or your bank account) well. I am sure he has the best of intentions, but I don’t like his choice of a temporary tooth replacement. A Maryland Bridge isn’t really a temporary tooth replacement. That is because in order for it to really stay in place, the dentist has to cut a notch into the tooth, such as in the image above. Anything that changes the structure of your teeth is not a temporary tooth replacement. Once she is ready for her dental implant, she will need dental bonding in order to fill in the notch needed for the bridge.
The fact that your dentist cannot keep the Maryland Bridge on makes me wonder if he did that notch. If he didn’t, don’t have him do it. Instead, I want you to get a real temporary tooth replacement— a dental flipper. In fact, get one either way and get a refund on the Maryland Bridge. As an additional benefit, not only will the dental flipper not change any of her tooth structure, but it is significantly cheaper than the Maryland Bridge your dentist suggested.
I hope this helps.
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