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dentistry

I Need Options for My Tooth

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I had an accident on my tooth when I was a child. Over the years it has turned more and more brown. It’s causing me to not want to smile. I went to see my dentist about it and he said there isn’t a root there anymore and I should just remove the tooth and put a fake one there.  Is there a way to have a pretty tooth if it is fake?

Rebecca

Dear Rebecca,

What you are suffering from is root resorption. It is a shame your childhood dentist didn’t give you a root canal treatment when you had the injury. That could have prevented the resorption. It isn’t a guarantee, but not doing anything definitely leads to resorption. He is right that at this point the tooth cannot be saved. It doesn’t sound like he spoke to you about any of your options.

The top of the line option is to get a dental implant. This places a prosthetic root in your jaw and once the bone has integrated with the implant a dental crown will be placed. It has the benefit of being the most secure option and the closest thing to having a natural tooth. However, it is the most expensive option.

If that isn’t for you, the next step would be to get a dental bridge. This suspends a false tooth between two dental crowns. This makes sense if either of those teeth already need crowns. If they don’t, you may not want to grind down healthy tooth structure unnecessarily.

There are less expensive options as well such as a removable partial denture or a dental flipper. Neither of those will be secured to your teeth, so just be aware they come out.

Is Your Dentist Serving You Well?

I’m a tad concerned that your dentist isn’t taking adequate care of you. This is especially true if this is the same dentist that didn’t deal with your tooth injury to begin with that is especially concerning.

It also sounds like he’s leaving you to figure out what to do about replacing your tooth. In reality, he is ethically bound to give you all your options. It may be time to ask why he isn’t doing that.

Will a False Tooth Look Attractive?

As to your concern with how the false tooth will look, that depends completely on the cosmetic dentistry skill of the dentist doing the work. Creating beautiful smiles is an art form. The best cosmetic dentists are AACD accredited, which is completely different from membership, which any dentist can do.

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

Will Dental Implants Help if I Still Have Baby Canine Teeth

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Both my upper and lower canine teeth are still baby teeth. I recently removed the bottom ones, but now there is a space because the adult teeth came up behind them.  I know I need to take the upper baby teeth out too, but I’m worried about there being a space there too. I’m a senior this year and will be taking my senior pictures. I don’t want to look ridiculous in my pictures. Could I just take them out and replace them with dental implants so I have teeth?

Penny

Dear Penny,

Illustration of a dental implant next to a natural tooth

I am very surprised your dentist hasn’t taken care of this. We are taught in dental school exactly what to do in these situations. I’m concerned that you may need a new dentist.

Your canine teeth are very important both to the form and function of your smile. It is important this is fixed. How it is handled will depend on whether you have adult canine teeth and, if so, the position they are in.

The first thing you need are x-rays to determine what is going on with the canine teeth. Often when they haven’t erupted, it means they are impacted. In this case, you will need some brackets and braces to help the tooth come up in the right position. Because your baby teeth are smaller, there may not be enough room for the adult teeth. Your canine teeth are very important as I mentioned earlier, so you will need to open up room for them. It is often advisable in this case to remove a first premolar to make room for them, but this is best addressed by an orthodontist.

A dental implant will only work if there are no adult teeth at all. When this happens, it is called congenitally missing teeth. If you have any adult teeth there, it is best to get those into proper position.

I’m sorry you are going through this. It would have been much easier for you if your dentist would have addressed this early on.

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

Can My Smile Be Pretty after Dentures?

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Around 30 years ago, I lost all my teeth. My dentist never mentioned dental implants so I don’t think that was an option. I have a friend who has them and her smile is so much prettier. Plus, she can eat anything she wants. I don’t know which I’m longing for more, but I think it is a pretty smile. If I got dental implants now, could they be as pretty as her smile?

Alice

Dear Alice,

Illustration of a dental implant next to a natural tooth
I’m so sorry you have been going through this for so long. It is not the dentures that are the reason your smile doesn’t look pretty to you. Both dentures and dental implants can be beautiful giving you a smile you are proud of. The problem lies in the artistic skills of the dentist. My guess is your dentist thirty years ago had good intentions but not the skill. I truly wish he would have mentioned dental implants to you. They were available then and it would have made the last 30 years significantly more pleasant for you. However, that is water under the bridge and all we can do now is go from here.

There’s one obstacle you will face when it comes to dental implants— the aftermath of facial collapse. When your teeth were first removed, your body decided without the roots of your teeth you no longer needed the minerals in the jawbone that are used to help retain your teeth. After all, they are already gone. Slowly, that leeches your jawbone away. After 30 years, I’m guessing you are having quite the time keeping those dentures in any more.

As you can see from the image above, like your teeth, dental implants need bone to keep them secured in your jaw. There is a solution to this, though. There is a bone grafting procedure that can build that missing bone structure back up for you. Once that is done, you will be right as rain for dental implant again.

How to Get that Beautiful Smile

As I mentioned earlier, it is the dentist who does your procedure that determines how beautiful your smile is. You need a dentist who is both qualified to give you dental implants along with the artistry to make the dentures that anchor to them beautiful. My suggestion is you start by looking for an AACD accredited dentist. These are proven artists when it comes to dental work. You will finally have that smile you have always wanted and you can share it while you eat some steak!

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

Dentist Won’t Match Implant Crown

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I have had the dental crown placed on my implant three different times and none of them matched the adjacent teeth. My dentist said I’m being too picky and my tooth color is between A1 and A2 and I will never be satisfied. She’s refusing to do it again. I hinted I will try somewhere else and she said that puts my dental implant in danger of coming loose because she’s already removed the crown two other times. Now I’m worried. Am I stuck with mismatched teeth? I don’t want to risk the implant itself. Could I just whiten everything, crown included?

MaryAnne

Dear MaryAnne,

Using teeth whitening won’t help in this case. It will whiten your natural teeth, but the crown will stay the same shade, making the differences even more obvious. I’m very sorry that your dentist is treating you this way. She seems to be transferring her inability to match the crown for your dental implant to you. This isn’t your fault. Based on what you said, there are probably two problems going on with this. My first guess is this is a front tooth she’s trying to match. Those are trickier than others. Even top cosmetic dentists will do several try-ins before getting an exact match.

Notice I said try-in. There are temporary try-in pastes which allow you and the dentist to see what the dental crown will look like in place without using the permanent bonding materials that require her to grind your crown off every time you request a change. These are inexpensive. There are usually only two reasons a dentist doesn’t carry them. The first would be they don’t care what you think and will only look at it themselves. The second is they don’t know about it because they have not invested in cosmetic training, which has to be done in a post-doctoral setting. I believe your dentist falls into this latter category.

This leads me to her second problem. She’s just going by the standard Vita shade guides and expecting your tooth to be a perfect match. But, your teeth are between an A1 and A2. For back teeth, her method would work fine. However, a front tooth gets all the light when we smile, which shows the color and variations in striking clarity. The standard shade guide isn’t enough.

diagram of a dental color map This is an example of a color map a cosmetic dentist will send to the ceramist. Yes, it will have the basic shade, but there are also instructions for different tints to go in a variety of sections on the tooth, which changes the visual perception of the color. Our natural teeth aren’t one flat color. There are differences in opacity throughout the tooth. This is how you get a tooth to look natural and perfectly match its neighbor.

The truth is your dentist is in over her head. Ask for a partial refund and go elsewhere to get it done. See if you have an AACD accredited dentist in your state. They’re at the top of their field.

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

Titanium Versus Zirconia Implants

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I have two traditional titanium dental implants in my mouth. I recently read in a natural health magazine that they are discovering titanium can have a negative neurological impact. It’s got me worried about the current implants I have. Should I switch them to the zirconia implants? Are the zirconia better?

Carol

Dear Carol,

metal-free dental implants

First, I want to assure you that you are safe. There is a lot of information swirling out there. Much of it causes unnecessary panic. Before believing anything, ask yourself if they cited the studies. When you looked at those studies were they done scientifically? I once read an article which cited a “study” where there was only one patient who suffered the negative effects discussed. To top that off, there was no direct correlation.

Titanium has been used as biological replacements, including joint replacements, for decades now and is one of the most biologically compatible materials out there. I’m am aware of no legitimate studies indicating there are any negative neurological effects.

I rarely recommend replacing dental implants which are thriving well. The reason for that is you will lose bone structure as a result of removing the implants. In order to place new implants in, you would have to add an additional bone grafting procedure to build back up the bone. Then, after that heals you’d need another surgery with the zirconia implants. In my opinion, that is too great a risk. However, that is not my decision to make. You have to do what makes the most sense to you.

As to whether or not the metal-free dental implants are better, there isn’t a way to answer that…yet. While we have decades of data on titanium implants along with their longevity, zirconia is in the newer stages of use in dental restorations. Therefore, we don’t have long-term data on them yet. It doesn’t mean they are better or worse. Just that we don’t know.

The bigger key to any dental implant success is the training and experience of the dentist doing the procedure. I hope this helps.

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

Will Dentures be Ugly

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I’m losing my teeth. It’s too late to do anything about that, but I’m in a tough spot. I can’t yet afford dental implants, though I am saving up. I need teeth so told my dentist to go ahead and start the process for dentures. He told me I am going not going to be happy with dentures. I”m in tears. Does this mean my smile will be ugly? I know that’s better than no teeth, but I just want to be prepared.

Sylvia

Dear Sylvia,

The way your smile looks depends more on the cosmetic skills of your dentist more than it does on whether you get dentures or dental implants. In reality, when you lose all your teeth, what you get is implant-supported dentures. Your dentist would know that, so this tells me he meant something else when he told you that you wouldn’t be happy with dentures.

The Problem with Dentures

Two profile photos of a woman who experienced jawbone shrinkage and facial collapse, which can be prevented with implant overdentures, available from Philadelphia cosmetic dentist Dr. Michael Weiss.

The results in facial collapse

Even the best fitting dentures will reduce your chewing capacity by 50%. Additionally, there isn’t anything keeping them in so they will move around. The top arch is held in by suction, but also requires a plate to do that. Some people find that difficult to deal with. Those with a sensitive gag reflex find it almost impossible.

The bottom arch simply rests on top of the jawbone. Therein lies the biggest problem with dentures. When your teeth are removed, your body recognizes that. As a result, it begins to slowly resorb the minerals in your jawbone. This shrinks your jawbone. After around ten years, you no longer have enough jawbone left to support your denture. This is known as facial collapse.

If you place dental implants in your jawbone, the prosthetic roots signal to your brain that you need your jawbone to sustain the roots.

I do know you said you couldn’t afford dental implants. As you’re saving up for them, you should be fine. You could start with snap-on dentures which use as few as two dental implants and then work your way up to more. However, there are some options you can use for paying for this you may be unaware of.

Generally, the procedure is paid for in two installments. The first when you have the implants placed. The second, after a period of healing, when they place the dentures. In addition, most dentists are willing to work through Care Credit which is a medical payment plan. This can break up the payments even further for you.

Getting a Beautiful Smile with Dentures

before and after smile makeover

A case done by Dr. Weiss

A great cosmetic dentist can give you a beautiful smile, even with dentures. I would do your research on the dentist before deciding. Your family dentist may not be one who is capable of the artistry and skill necessary to give you a smile you’ll be proud of.

The top of the line cosmetic dentists are AACD accredited. You’ll want one who is also highly trained in dental implants. This way he can plan ahead for when you are able to get the implants you want.

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

Gross Dental Implant Incompetence

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I am not sure where to go from here and need some advice. I had a dental implant placed. It felt like the crown was loose so I went to see my dentist. He said the crown was loose and needed to be re-cemented. When he tried to take the crown off he had a bit of trouble. His next step was to use a special tool, but when he got the crown off the dental implant came with it. What do I do now?

Phylicia

Dear Phylicia,

Three stages of a dental implant

Can you get a dental implant while on Fosamax?

I hate to be the one to tell you this, but your dentist is completely incompetent. First, if a dental crown is loose, it is incredibly easy to remove them. Most often, they fall off of their own accord. What was actually loose was your dental implant. If your dentist wasn’t incompetent then he was incredibly dishonest. Neither scenario bodes well for you as his patient.

Some Reasons for Loose Dental Implants

If the implant came loose right after the dental crown was placed, then it means the crown was placed prematurely. Before you can place an implant crown there has to be sufficient osseointegration. Without that, the crown will pull the implant loose. Another option is there wasn’t enough bone support to begin with. Doing implants requires substantial diagnostics. A dentist should determine how healthy the bone structure is. Then, if there isn’t enough, suggest bone grafting to make sure you have the best chance of a successful outcome.

Some implants fail because of an infection. You didn’t mention either pain or a fever. In most cases of infection, one or both of those would be present.

Fixing a Failed Dental Implant

The first thing you need to do is demand the dentist who botched this so badly pay to get it fixed by a dentist you choose. That is important. Fixing this involves more than your original procedure, so just getting a refund will not be enough. You also want it to be a dentist you choose, so you can make sure they have the expertise to do this right.

It will require significant post-doctoral training. For instance, Dr. Weiss trained at the esteemed Dawson Academy. He’s also an instructor at the Academy of Osseointegration. This is what you want to look for. Not only that, he’san AACD accredited dentist which means he can create a beautiful crown.

I’m sorry this happened to you. Hopefully, this can be rectified soon.

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

Dental Insurance for Dental Implants

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I want to replace all of my teeth with dental implants. They are in pretty bad shape and I want a smile I can be proud of. Is there a dental insurance that will cover these?

Kevin C.

Dear Kevin,

When you say your teeth are in pretty bad shape, you didn’t specify whether you meant in appearance or in health. If it is just an appearance issue, getting dental implants would be an overtreatment. This is designed for patients who need to replace their teeth because they have to be removed as a result of decay and infections. If that’s not you, a great cosmetic dentist can create a stunning smile for you, while enabling you to keep your natural teeth using porcelain veneers.

If, however, the teeth are unhealthy and have to be removed, then dental implants will be the right way to go. If you already have dental insurance, they will cover part of the cost but probably not as much as you would hope. Dental insurance tends to only want to cover the least expensive option. For tooth replacements, that is dentures. Though I only recommend dentures as an absolute last resort for reasons I’ll go over in a moment.

If you don’t already have dental insurance, be aware that most policies have a waiting period for anything other than cleanings and checkups. That may defeat the purpose if your teeth need to come out right away.

Why Not Dentures?

Two profile photos of a woman who experienced jawbone shrinkage and facial collapse, which can be prevented with implant overdentures, available from Philadelphia cosmetic dentist Dr. Michael Weiss.

Jawbone shrinkage results in facial collapse

When your teeth are removed, your body begins to resorb the minerals in your jawbone to use elsewhere. This is in an effort to be efficient with its resources. Unfortunately, this also has the result of slowly shrinking your jawbone. Eventually, you won’t have enough jawbone left to retain your dentures. This is known as facial collapse.

Getting dental implants signals to your body your jawbone is still necessary and will leave the minerals in place, thereby protecting you from facial collapse.

Implant Overdentures

Implant overdentures

Implant overdentures are a combination of dental implants and dentures

You don’t have to get a dental implant for every tooth. Instead, you can get implant overdentures. This will use between four and six dental implants and will anchor a set of dentures to them. This has the benefit of being more affordable while still providing you with all the benefits of dental implants.

If You Want a Stunning Smile

Whether you get dental implants or porcelain veneers, you still need a dentist who is skilled in cosmetic dentistry to give you that gorgeous smile you want. The top cosmetic dentists are AACD accredited. When you’re looking for natural results that look great, then you need to see an accredited dentist.

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

Will Dental Implants Look Fake?

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My mother had dentures and, to me, they always looked fake. I now need to get my teeth replaced. I want to get implant-supported dentures and am hoping they look more natural these days. I’m rather young for dentures at 40 so I don’t want to look old before my time.

Pamela

Dear Pamela,

Implant overdentures

Implant overdentures are a combination of dental implants and dentures

First, I’m going to say you were wise to choose implant overdentures, especially at your young age. Once your teeth are removed, your body will recognize that and begin to resorb the minerals in your jawbone to use elsewhere in your body where it perceives it will be more useful. Eventually, you won’t have enough jawbone left to retain your dentures. This is known as facial collapse.

Getting implant-supported dentures, puts prosthetic roots into your jaw. This tells your body there are still “teeth” that need to be retained, therefore preventing facial collapse. You’ll also find it will improve your chewing capacity.

The Secret to Beautiful Dental Implants

Both dentures and dental implants can be made to look both natural and beautiful. That was true when your mother received her dentures. The beauty of dental implants is correlated to the artistic skill of the dentist. If you want a gorgeous smile, you need to find a dentist who creates beautiful smiles.

In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry (AACD) dentists have done extensive training and are the top cosmetic dentists in the country. They will give you a stunning smile. You’ll actually be thrilled to share your smile with the world.

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

Are Implant Overdentures Permanent

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I need to replace my dentures, but this time I’m looking for something that stays put and is permanent. My dentist only does dentures and can’t help me figure out what’s best. I keep hearing dental implants are better than implant overdentures, but overdentures are more affordable. Are the overdentures permanent like the implants?

Morgan

Dear Morgan,

Implant overdentures

Implant overdentures are a combination of dental implants and dentures

I’m afraid you are getting some mixed information. Implant overdentures use dental implants. The reason they are considered more affordable is because with a traditional dental implant you are using a single implant with a dental crown on top. You are talking about replacing every tooth, as I’m assuming you had complete removable dentures. To put a dental implant and crown on every single tooth would have an astronomical cost, as it would require 32 implants.

To make that more affordable implant overdentures use around six dental implants per arch. Then a set of dentures are anchored to the implants. They are definitely permanent and stable. Like all dental implant procedures, their biggest benefit is that they protect you from facial collapse.

Implant Overdentures and Facial Collapse

When your teeth were removed for your dentures, your body recognized you no longer had any teeth roots in your jawbone. In an effort to be efficient, your body begins to resorb the minerals in your jawbone to use elsewhere throughout your body where it perceives the need to be greater.

This has the unfortunate result of shrinking your jawbone. Eventually, you won’t even have enough jawbone left to even keep your dentures in. Getting dental implants prevents this because the implants themselves stand-in for your tooth roots, allowing your body to recognize there are still “teeth” there.

Depending on how long you have had your dentures, you will have lost some jawbone. There is a chance you won’t have enough jawbone left to secure dental implants. If that is the case, you can still get that treatment option; however, you’ll need to have one additional procedure done. Bone grafting can build up the bone loss in order for you to get the best procedure.

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

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