QUESTION – Bridge Replacement
“I am unsure if you can help me or not, but I do need advice if possible. Perhaps you might be able to point me in the direction of that if you cannot answer this yourselves. This is the situation:
I have a large upper bridge. 7 teeth, four central and two to one side and one to the other. This is easily 30 years old. Recently three things happened:
1. My lovely dentist moved to London and the rest of her practice became private. As I am a pensioner, relying on State pension only, that is a luxury beyond me.
2. I finally found a new NHS dentist (seemingly rarer than hen’s teeth nowadays) and have to say that I am not entirely happy with her but do not wish to name her because that would savour of an official complaint.
3. The veneer on one of front incisors on the bridge, came off. My dentist glued it back on two occasions but it does not last. She also now (see below) says that the bridge is loose and needs to be replaced but does not want to do this herself and suggests I find a cosmetic dentist. This I cannot afford to do. She now says she can ‘try’ to take it out and give me a denture. I most certainly do not want that option. My questions are:
1. Is there a limit to the size of a bridge that one can have on the NHS?
2. Is there any way I could get this bridge replaced without having to pay privately – which I just cannot do.
As an aside, on my last visit this week, she started to excavate for two fillings, scraped out the small cavity on one tooth and had started to do the same for the other, which was adjacent to the bridge. I felt her pressing hard on the bridge and was about to raise my hand to stop her when she stopped herself and exclaimed that the bridge was loose. From my perspective it felt that she had dislodged it but as I cannot prove that and only have how it felt in my mouth as an indication, I would not wish to make that claim. She then said I should make an appointment for her to try and take the bridge off and then stick it back again! I asked if she felt sure she could do this i.e get it back again, and she replied that she was not sure. This is not a risk I feel like taking, especially as her replacement option is a denture. Also, I then came out of the surgery without the two cavities having been filled.
Is there any where I can go to get this sorted professionally on the NHS and without having to make a formal complaint against her? Many thanks for your help/advice.”
ANSWER
The most important thing about dental bridges are the supporting teeth. They have to be strong enough to functionally support the bridge. So are the teeth that are supporting your bridge in good condition? What did the x-ray show? Are the supporting teeth failing? If so this is no grounds for a complaint.
30 years is a very good age for your bridge to have lasted. You were probably told at the time that the bridge would last about 10-15 years, if not you should have been.
You need to talk to your dentist, she needs to explain more about your problem to you in a way you can understand. Discuss your fears with her. You cannot leave a loose bridge in your mouth because of the risk of infection. If the supporting teeth are in good condition she should provide you with a new bridge. If not then … she needs to tell you what your options are.
Best of luck
I think you should discuss the case openly with the dentist and if you feel that the treatment is quite costly than you can seek help of CARE CREDIT where the company pays for your whole treatment and you can pay company all the expenses in easy monthly installments. Else you can visit any nearby local dental school where, though, the treatment is done by studying dentists but it is strictly under the supervision of experienced and senior doctors. so, you will get the best treatment and very less or at no cost…
To be honest its HiGHLY unlikely you will be getting the treatment done by a dentist on the NHS in general practice. The fact is that if the bridge loose there is probably something wrong with either the underlying teeth or the surrounding gum tissues. All of this means there will be enough clinical reasons for a dentist to not replace it on the NHS.
It is highly likely that the bridge is loose and failing after 30 years. It has done very well.
There is no official limit to the number of teeth that can be supported by a bridge on the NHS, but the likelihood of you being treated by an NHS dentist who is prepared to do that is frankly, zero.
The dentist will receive a finite fee (approx £270) for the whole course of treatment (including any fillings to other teeth, examination xrays, gum treatment etc.). They will have to pay a laboratory fee of (at best) £50 per tooth. Without any additional work they are already out of pocket.
They cannot refuse you treatment on the grounds of this, however, and the reason for not treating you will most likely be along the lines of the treatment being of a ‘complex nature’ and ‘not within the skill and competency’ of the dentist. This is a perfectly justifiable excuse for referring you to another dentist, but is is surprising how highly skilled dentists suddenly become when you offer to pay them £400 per tooth!