How long should it take to finish a crown and bridge case:

Q: I have a permanent bridge that makes up about ten of my upper front teeth. It was done decades ago, and needs replacing due to decay under all the supporting teeth. The office staff told me that it would take two visits. I am on visit number four and would like to know is this normal or should I be worried.

A: Dr. J’s Weekly Rant: Ok, so last week a patient told me the most exotic “how I got Covid” story I ever heard. Here goes: “ I went to Egypt and bought a 4000 year old Mummy. Back home in Europe, the deliveryman arrived alone and needed my help carrying the mummy up the stairs in my home. He and I did not have masks on and were huffing and puffing during the delivery. I also shook his hand at the end. After that I spent six weeks at home with Covid.”

The mummy’s curse I suspect.

The most dangerous question we get in my profession is: “How long will the work take, Doc?” Ideally the best answer is: “As long as it takes to finish the treatment successfully.” In the real world, patients have a life, which includes travel, medical procedures and lifecycle events such as weddings and birthday parties. I often must give some type of time estimate to satisfy most patients.

Here is a possible scenario for all crowns and bridge treatment plans. The absolute minimum would be two visits over a three-week period, but be prepared for this:

Visit #1: Pre op pictures and digital No-Goop impression scans.

#2: Removal of old bridge and decay and placement of a temporary bridge. Many times the gums are bleeding too much to allow for an accurate final impression at this point. A prescription rinse called Peridex is prescribed followed by weeks of healing.

#3: Possible root canals if decay was near the nerve/pulp of the teeth, followed by reinforcement with small pins and composite build-ups called cores.

#4: Final digital impression. Followed by three weeks of lab work.

#5: A try -in of a sub-structure framework, before the final porcelain is added.

#6: Installation of the final bridgework, possibly with temporary cement

#7: Possible extra trips to the lab for final tweaks.

#8: Final permanent cementation of the permanent bridge.

As you can see, you must be a patient patient!