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Cosmetic and
restorative
dentistry

Replacing a Front Tooth While on Fosamax

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I had to replace a tooth adjacent to my right front tooth. Right now I have a dental flipper and absolutely hate it. I wanted a dental implant but my dentist said that’s not possible because I take Fosamax. I suggested a dental bridge and he doesn’t want to do that either because it will crown the adjacent teeth which he says are fine. That’s true, but I want to get rid of this flipper. Would an Encore Bridge be an option?

Bruce

Dear Bruce,

Three stages of a dental implant

Can you get a dental implant while on Fosamax?

It is possible to get a dental implant while on Fosamax. Your dentist’s concern has to do with the increased risk of local bone problems when having oral surgery. While the risk is small, the complications are serious. Don’t minimize the risk. One possibility is to temporarily suspend taking Fosamax, under the cooperation of your physician who should oversee this.

If you decide against getting a dental implant, a dental bridge is fine, and a better permanent option for you than a dental flipper. That being said, let your dentist pick the type of bridge. You definitely don’t want to be the first patient he or she has done an Encore Bridge on. Some dentists are your basic bread and butter dentists who can only do the “standard” work. That brings up an important point about your dental implant.

Who Should Place Your Dental Implant?

The concern your dentist mentioned is legitimate, however you should be aware that sometimes a dentist will steer you away from a procedure because they aren’t comfortable or qualified to do it. They don’t want a patient to lose confidence in them so instead they come up with reasons to discourage that particular procedure.

You don’t want to push a dentist into a procedure they are not comfortable doing. This usually ends in disaster.

Dental implants are an advanced procedure. You’re in a high-risk group, so it makes it even more important you have an experienced, qualified dentist to do it for you. Look at Dr. Weiss’ qualifications to get an idea of what type of dentist you are looking for.

Another consideration is cosmetic. You’re talking about matching a single crown to your front teeth. You want someone with the cosmetic skill to make it blend both beautifully and naturally. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry.

In your place, I’d look for an AACD accredited dentist who has a high success rate in dental implants.

This blog is brought to you by Philadelphia Dentist Dr. Michael Weiss.

Advice on Picking Dental Implant and Crown Materials

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I’m about to get my smile completely made over with dental implants and crowns. I want it done right so I have some questions.
1. Is Staumann or Nobel Biocare better for implants?
2. Is zirconium or porcelain better for the dental crowns?
3. My dentist said a white porcelain fused to metal crown will not show a black line at the gumline. Is this true?

I am spending a lot of money so want this to end up beautiful.

Laurie

Dear Laurie,

A woman smiling with a beauttiful smile

Getting a beautiful smile makeover requires an artist

I want to refocus your question using an analogy. If you were to commission someone to do a painting to be the centerpiece of your living room, would you spend time investigating paints or the artist? It’s the artist who makes the difference. They have the knowledge and skill to know which paints are good for which situation. Maybe a particular scene look does better with one brand, but for something else another is preferred for its pigment. The artist who works with the materials every day will know their strengths and weaknesses.

So, instead of researching which dental implant or crowns to use, research the dentist. You have a two-fold requirement. They have to be skilled in placing dental implants, including implant overdentures. But, they also have to be skilled cosmetic dentists.

Finding a Dentist Who Can Give You a Beautiful Smile Makeover

Doing smile makeovers aren’t taught in dental school. Instead, dentists who are interested in the art of cosmetic dentistry have to invest time in training for it post-doctorally. Even with that, there is no recognized specialty in cosmetic work. Because of that, patients often find it hard to know who is skilled and who isn’t.

Fortunately, the American Academy of Cosmetic Dentistry offers an accreditation program which gives patients a way to know who they can trust to give them a stunning smile makeover. In order for a dentist to reach accreditation, they have to pass stringent oral and written exams, as well as provide visual evidence of a large number of cosmetic cases they’ve done to show they are not just technically skilled, but artistic as well.

Any AACD accredited cosmetic dentist can give you a celebrity smile you’ll be proud to share. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Implant Overdentures with Diabetes

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I’ve had dentures for a few years and really hate them. Now I learned that they’re the worst replacement I could have gotten because they will contribute to my jawbone shrinking. I’d like to get implant overdentures to replace them, but I have Type 1 Diabetes. My dentist said that is a contra-indication for dental implants. If so, what can I do?

Martin

Dear Martin,

Implant overdentures

 

I feel like you haven’t been getting the best dental advice available. Your dentist should have forewarned you about facial collapse when he suggested dentures. He also hasn’t been completely forthright in regard to your question about diabetes. It is not a contra-indication. However, it does put you at a greater risk of implant failure than other patients.

What you’ll need is careful diagnostics previous to your procedure and close monitoring throughout. Make sure they are willing to take more care with you. I want you to see a dentist with significant post-graduate training in the dental implant procedure. Look for someone who’s trained at the Dawson Academy or the Las Vegas Institute of Advanced Dental Studies.

I think it’s also important you go to a dentist who is skilled in both the placement and the restorative (cosmetic) aspect of your case. If they can’t be the same person, they’ll need to work in close communication so there is complete coordination between them to ensure everything goes smoothly.

Benefits of Implant Overdentures

You’ve already mentioned the biggest benefit to implant overdentures. You will no longer have to worry about losing the minerals in your jawbone. Instead, having implants will signal to your brain that those minerals are needed. You will not suffer from facial collapse the way you will if you continue with dentures.

There are other quality of life improvements as well. You won’t ever have to worry about your overdentures slipping or sliding. They will be completely secure. You can eat what you want. You can brush and floss normally. It’s like having a healthy set of teeth again.

Who Should Do the Cosmetic Work?

When it comes to the appearance of your new teeth, you’ll want them to look natural. However, this is also an opportunity to improve the look of your smile at no extra cost. As I said earlier, your dentist should also be skilled in cosmetic work along with the implants. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry. He or she can help you design the smile of your dreams.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Safety of Dental Implants from a Dental Student

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I wanted to get a dental implant and spoke with my dentist about it. He said I was a good candidate, but the price he quoted me is beyond what I have. Someone from church mentioned I might be able to get it cheaper at a dental school. I’m all for more affordable, but wanted to double check this was a wise option. Would this be a safe way to get dental implants?

Lizzie,

Dear Lizzie,

Three stages of a dental implant

Going to a dental school will cost less. They do that both to draw patients in for their students to practice on and because you are getting a less experienced caretaker.

It is up to you to weigh the risk versus reward and decide which you think is the most important factor to you.

Dental Implants at Dental Schools

Dental schools are very careful. They are there to teach their students best practices. There is always an instructor there to check the student’s work. All that being said, this is an advanced procedure and even uncomplicated cases, such as yours, still require surgery.

It will be the dental student which implants the prosthetic tooth root. Even expert implant dentists who’ve been doing the work for years will sometimes have a procedure fail.

There are things which can go wrong and although there is an instructor there, it is a matter of whether or not this dentist is skilled at recognizing issues quickly enough to intervene.

Paying for a Skilled Implant Dentist

If you decide you’d rather see an implant dentist with more experience, then you can see if they have in-house payment plans. They may not. But, even when they don’t, dental implants are generally paid for in two phases. First, you would pay for the implant surgery. Then, after a period of healing, you would pay for the dental crown.

If that is still out of reach, there is a medical credit company that could pay the fee to the dentist and allow you to pay it out to them. You can apply for Care Credit online. They have low and even no interest plans. If you have basically good credit, you shouldn’t have a problem.

If it turns out you absolutely cannot have a dental implant, getting a dental bridge, which is simply a false tooth suspended between two dental crowns) is a perfectly acceptable tooth replacement option.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

3 Facts about Overdentures and Why They Matter

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For the past ten years, I’ve had my teeth examined and cleaned at the dental school. Although I haven’t been consistent with getting a cleaning every year, the dental school is my first option. It’s no fault of theirs, but I have lost several teeth. During my last visit, I learned that I have advanced gum disease. The dentist spoke with me and so did one of the hygiene students. The student mentioned that instead of getting all of my teeth extracted that I should consider overdentures. Whatever kind of dentures I need will not be provided by the dental school. Now I want to switch to a dental practice. I’m not satisfied with the hygiene student’s explanation. Can you give me some clarity on overdentures? – Carlo

 

Carlo – The term overdenture is used to describe dentures in a variety of situations.

1. General Overdentures

Diagram of an affordable dental implant, which is a snap-on denture hovering above two dental implants in the lower anterior gums and bone.

Snap-on dentures

A denture is made to fit over your remaining natural teeth. Your tooth roots will be kept intact, and the surface of the tooth above your gumline will be shaved down. The remaining tooth roots will continue to stimulate your jawbone and help prevent shrinkage.

2. Implant Overdentures

Implant overdentures are dentures supported by dental implants that are placed in your jawbone. After a healing period, your dentist will attach the denture to the implants.

Snap-on dentures, All-On-4 dental implants, and implant-retained dentures types of implant overdentures. What’s the difference?

  • Snap-on denture – Two dental implants are used to support a denture. The denture base snaps onto the implants. A bar can be placed over the implant fixtures to increase stability.
  • All-On-4 implants – Four dental implants are placed. The two implants closest to the back of your mouth are angled to increase contact with the bone. This technique was designed for patients who have begun to experience bone shrinkage.
  • Implant-retained dentures – This term refers to dentures that are supported by dental implants. It can include snap-on dentures, All-On-4 implants, and other methods used to stabilize dentures.

3. Implant Overdentures Improve Your Experience

Implant overdentures improve your experience with dentures and your quality of life.

  • Increase the comfort and efficiency of your dentures. You will find it easy to eat, speak, and smile with confidence.
  • Provide stability. You won’t have to worry about your dentures lifting, slipping around in your mouth, or falling out.
  • Stimulate jawbone. The more dental implants you have, the wider the area of bone stimulate. Intact jawbone will support your facial muscles and help prevent premature sagging.

Before you select a particular type of implant overdenture, consult with an experienced implant dentist. Your research in finding a highly qualified provider will help avoid costly implant mistakes and ensure you receive successful results.

This post is sponsored by Philadelphia, PA dentist Dr. Michael Weiss.

Dental Implant Doesn’t Match

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I’m devastated by how my dental implant turned out. I lost a front tooth due to a fall down the stairs. My dentist assured me that he’d be able to give me a new tooth that would help me smile again. The dental implant part is fine, but it doesn’t match my other teeth. It’s way more obvious because it’s a front tooth. I haven’t smiled since the fall. I just don’t know what to do. Can this be fixed or whitened? If not, I’m pretty sure I’ll never smile again.

Misty

Dear Misty,

A diagram of a dental implant

I have two pieces of good news for you. First, this can be fixed. Second, you won’t need to do the dental implant over. However, teeth whitening won’t be your solution for two reasons.

One, teeth whitening only works on natural tooth structure. What would happen is the teeth surrounding the implant crown would whiten but not the crown itself.

Second, even if it could whiten, you wouldn’t be able to get an exact match to your tooth that way. You might get close, but front teeth are very exposed. Any little difference is noticeable.

Matching a Single Implant Crown

Because of that, matching a single front tooth requires an expert cosmetic dentist. Only a small percentage of cosmetic dentists are able to do it well.

In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have passed stringent oral and written exams on technical skill and knowledge as well as submitted a large number of specific cases they’ve done in order to demonstrate their artistry.

If you don’t have one within a reasonable driving distance, a second option would be to look on mynewsmile.com to find one of their recommended dentists in your state.

Cosmetic dentists from either site can re-do your crown to match the adjacent teeth.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Do You Have to Implant Every Tooth?

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I’m losing my teeth and my dentist is highly suggesting I get dental implants. I’ve been figuring the cost and it is astronomical. Is there a way to do this without implanting every single tooth?

Karen

dentures versus dental implants
Implant overdentures combine dentures with dental implants

I wish your dentist would have done a better job of helping you understand your options. When you’re talking about replacing all your teeth, as you are, you don’t usually do a 1 to 1 ratio of teeth to implants.

Some people do, but that’s considered the luxury treatment for those with the funds. It’s definitely not necessary and not what most patients do. Instead, you’ll do implant overdentures. It places around four to six dental implants into your jawbone and anchors a set of dentures to the implants. This is much more financially reachable than the cost you’d calculated.

The Reason for Dental Implants

There is a very good reason why your dentist is suggesting you get dental implants instead of completely removable dentures. Once your teeth are removed, your body will begin the resorption of the minerals in your jawbone.

It does this because your body recognizes you no longer have teeth. Because of that it thinks those minerals will be more useful elsewhere in your body. This has the unfortunate result of shrinking your jawbone. In dental circles it’s known as facial collapse.

Eventually, you won’t have enough jawbone left to even support your dentures, leaving you with no way to eat.

Having dental implants placed, signals to your brain there are still roots there and your jawbone is needed, completely preventing facial collapse.

Getting a Beautiful Smile with Implant Overdentures

While you are getting a new smile, you may as well get a stunning one. In that case, you’ll want to make sure the dentist you choose is not just an experienced implant dentist, but also a skilled and artistic cosmetic dentist.

Not only will you have a healthy smile, but one you’re thrilled to share with the world, giving you a renewed confidence. Look for an implant dentist who is also accredited by the American Academy of Cosmetic Dentistry.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

3 Facts about Smoking and Dental Implants

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Dental implants can be used to replace individual missing teeth, anchor a dental bridge, or support dentures. But what if you smoke? Does it increase the risk of implant failure, or does it have no effect at all?

How Does Smoking Affect Dental Implants and Oral Health?

Smoking affects your oral health in several ways that directly affect the success of dental implants.

1. Narrows Blood Vessels

Nicotine causes blood vessels to constrict. Whether your nicotine intake comes from smoking cigarettes, chewing tobacco, or vaping, one result is the same—narrow blood vessels that limit the amount of oxygen carried to your oral tissues. And the slower the blood flow and oxygen, the longer and more complicated the healing process will be after dental implant surgery.

2. Reduces Blood Flow

A diagram of a dental implant
Dental implants fuse with the bone

Osseointegration is the process during which your jawbone and dental implants fuse together and form an incredibly strong bond. But healing depends on blood flow. If the bone and dental implants don’t fully integrate, the implants can fail and need to be removed and replaced.

3. Masks Gum Disease

Smoking narrows blood vessels. Narrow vessels are slower to bleed than healthy ones. But bleeding gums are an early sign of gum disease. If this warning sign of gum disease is masked, it will become more difficult to detect. An undetected infection around a dental implant will likely lead to implant failure.

What Does a Recent Study Show?

The results of one study were published in a 2017 article published in the Journal of International Oral Health. The report reveals the following:

  • Studies show that smokers have a higher risk of gum disease, tooth loss, and oral cancer.
  • Smoking is associated with bone loss, poor bone quality, decreased bone height, and peri-implantitis—an infectious gum disease that contributes to bone loss.
  • Bone resorption caused by long-term and frequent smoking increases the risk of dental implant failure.

What Can You Do?

Tell your oral surgeon – If you smoke or use products that contain nicotine, consider and carefully weigh the risks. Tell your oral surgeon that you smoke. It is vital to your oral health and the success of your dental implants that your surgeon knows about this risk.

Heed the advice – You may be advised to stop smoking for a specific period of time before implant surgery and throughout the healing process. If that’s the case, heed the advice. Dental implants are the most expensive form of tooth replacement. Protect your investment.

Get help – If you’re struggling with trying to break the habit, get help. Speak with your medical doctor and ask for advice or treatment that will help you stop smoking before you receive dental implants.

Schedule Consultations

When you’re ready to move forward with replacing your missing teeth, schedule consultations with a least two skilled implant dentists. Compare several factors to help you choose the right provider:

  • Explanation of your treatment options
  • Each dentist’s level of training and experience
  • Your interaction with the dentist and staff and the office environment
  • Cost

This post is sponsored by Dr. Michael Weiss, an accredited cosmetic dentist in Philadelphia, PA.