My dentist has said implants are not possible due to bone loss and has recommended a 4-tooth-bridge. Sound reasonable?

Q. Dear Dr. Caplan I wondered whether you could advise please. My front right tooth has suffered a lot of trauma over the years due to accidents. I am 34-years old. I have had it capped and I think I have had route canal treatment on it in the past also. However, I understand that it is now dead, my gums have receded a little to reveal the dark brown colour of the tooth underneath. The tooth has become very wobbly (enhanced by wearing for a while an anti snoring guard-which I regret buying!). Anyway my dentist has confirmed that the tooth now needs to be removed. We discussed the options of either an implant or a bridge. He has advised on a 4 tooth bridge and I wondered whether you could advise as to whether this is correct, as it seems to go against the grain compared with what other dentists are saying on the internet. He took some x-rays of the tooth and showed me that the the tooth’s bone is significantly worn down and fractured. He stated that if I went down the implant road then a bone graft would be required. He quoted a price of about £3,000 if I opted for implants. He also stated that he would have to refer me to another dentist to be the implant work. He suggested a bridge was the better option for cosmetic reasons. He cited a 4 tooth bridge would give a better alignment than simply fitting an implant (he may not have said this word to word– i’m afraid that have forgotten a lot of what he said). I think another reason is that he knew funds were a problem and a bridge would be cheaper. He has quoted £1,500 for a 4 tooth bridge. Your advise would be appreciated. Many thanks.,
A. Due to the bone loss around your failing tooth there is also a need for grafting prior to bridge placement. This is not necessary to secure the bridge ( unlike in the implant case) but would greatly improve the final appearance. Obviously your case needs to be properly examined but the current trend is for implants rather than bridges if finance allows
Dr Julian Caplan – Director on the board of the BACD View My Profile Dr Caplan

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