Tag Archives: dental flipper

maryland bridge before a dental implant

I’m trying to figure out what to do. My daughter has a congenitally missing lateral incisor. We did orthodontics to open the space. Now we’re working on the temporary tooth replacement. Our dentist decided on a Maryland Bridge. We did non-metal wings because I wanted them to be as natural-looking as possible. The problem we’ve had is the bridge has fallen off twice in just a couple of weeks. After the first time, she (our dentist) tried a different bonding cement, but that didn’t make it any stronger. Now she wants to try doing it with metal wings. Here’s the thing. My daughter is 14. She’s going to have to wear these for a few years. I don’t want her to feel self-conscious. I have two questions:
1. Will these stay on better? 2. Will the metal be a better choice?


Dear Karyn,

I’m a little concerned about some things I’m hearing here. First, I would not consider a Maryland Bridge a temporary replacement. This requires tooth preparation, which means you’re reducing tooth structure. If you’re doing that, you might as well stick with a dental bridge and not get a dental implant.

Another thing is the bonding issue. It doesn’t sound like your dentist understands bonding principles. She placed the bridge with a cement and it fell off. Then, she gets (I’m assuming) a stronger cement and it still falls off. Her next thought is to switch to metal wings.

Maryland Bridge Preparation

That’s not likely to work out any better for her. The non-metal (zirconia) wings are usually easier to bond than the metal ones. My guess is the problem is with her tooth preparation. If you look at this image on the left. You can see that a groove should be cut into the tooth to support the wings. Without this, she’s likely to have trouble no matter what type of bonding she uses.

While she could go back and make the correct grooves, I am going to recommend a completely different direction. While you can go ahead with the bridge, once she gets her dental implant, you’re going to need another procedure to have these grooves filled in. Why do that when you can instead get a temporary tooth which will not require any modification to her adjacent teeth?

I’m not trying to discourage you from your future plans of getting her a dental implant. It is the best tooth replacement around. It will be a great solution for her when her jaw is fully developed.

I am trying to discourage you from the dental bridge. Instead, I’m going to recommend something else.

Removable Partial Flipper

A removable partial flipper will be perfect for her situation. When well cared for it can last long enough for her to get her dental implant. Even if something happens, it is significantly less expensive than any other tooth-replacement option. You could replace several of them for the cost of a single Maryland Bridge.

They can be made to look beautiful too, so your daughter won’t look self-conscious.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

When a Tooth is Knocked Out

I was at the playground and saw a boy who was hit in the mouth and lost a tooth as a result. His mother just tossed it because it was a baby tooth, but it got me to wondering. What would I do if it was an adult tooth?


Dear Melissa,

a hockey player with a knocked out tooth

Whenever a tooth is knocked out, it’s a dental emergency whether it’s a baby tooth or an adult tooth. Even though the baby tooth doesn’t need to be saved the dentist needs to check the pulp of their tooth to make sure no damage was done which will affect the adult tooth underneath.

With an adult tooth, it’s even more serious. You have about 30 minutes to try and save the tooth. Call your dentist right away and let them know what happened. They’ll be available and ready as soon as you get there.

If you don’t have a dentist, you can do an internet search for an emergency dentist. These are general dentists who will see non-established patients in cases like yours. Again, let them know you’re trying to save a tooth so they’ll be prepared. Time is of the essence.

You’ll only want to handle the tooth by the crown (the part which is visible when you smile). Try never to touch the root. Additionally, you’ll want to keep it moist. If you can, put it in a glass of milk. If that’s not available, you can just place it between your gums and your cheek.

If Your Tooth Can’t be Saved

There are times when a tooth can be saved. In that case, you’ll have options for your replacement. Ideally, you’d want a dental implant. That’s almost like having a natural tooth. However, if it’s a teenager or child you’re talking about an implant isn’t possible. Their jaw has to be finished growing.

After a dental implant, the next best option is a dental bridge. This suspends a false tooth between two crowns. There are other options as well if neither of those work for you such as a removable partial denture or a dental flipper. A flipper is only meant to be temporary though, while you are waiting for a better replacement.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.