Dental Implants Archives - Philadelphia Cosmetic Dentist

Is It Safe to Get Dental Implants with Osteoporosis?

Posted on February 2, 2023 by writeradmin.

I am on Boniva for Osteoporosis and have been for a few years. A month ago, I lost a tooth that was unsavable. I’m looking into options for replacing that tooth and was told that I cannot get a dental implant if I have Osteoporosis. Is this accurate? If so, what is my next best option?

Caroline

Dear Caroline,

You have asked a great question. For the benefit of others reading who may not be aware of osteoporosis, let me give a quick explanation. It is a degenerative disease that affects bone density, greatly increasing the risk of fractures. It has a tendency to affect women more than it does men. This is especially the case in post-menopausal women.

The good news is that it is possible to get a dental implant while dealing with osteoporosis, the iffy news is that there are some complicating factors involved. Your medication is one of several types of biophosphates. They work by preventing the breakdown of bone as well as bone fractures while building up the bone density. This is done by stopping the osteoclasts that eat up the bone.

Why is that a Risk Factor for Dental Implants?

Patients who take these medicines, show an increased risk of dental implant failure as well as osteonecrosis, which is death of the bone tissue. Because of that risk, it is considered important that you stop taking your medication approximately four months or more before getting your dental implant and staying off of it until the bone has had an opportunity to adequately integrate with the dental implant. At that point, you can safely start taking the medicine again.

Obviously, your osteoporosis needs to be under control for this to be a possibility, so it will be imperative that you contact your doctor and get his or her approval to pause the medication for the duration needed.

What If Your Doctor Says No?

If, by chance, you are one of the cases that cannot stop taking the medication even for limited periods of time, you do have other options. Your next best option would be to get a dental bridge.

Don’t worry yet. Talk to your doctor and get his assesment; then you can go from there.

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

Must I Have Bone Grafting Done in Order to get Dental Implants

Posted on January 20, 2023 by writeradmin.

My dentist and I have been planning on me getting four dental implants soon. I am so excited about the idea of having teeth again and no longer feeling (and looking) like a hillbilly. He mentioned I need some bone grafting done. I was totally fine with that. However, since then, I have done some research and learned that they do the bone grafting with cadaver bone. I have to admit that really gives me the heebie-jeebies. Is it at all possible for me to have the dental implants done without the bone grafting?

Jennifer

Dear Jennifer,

While you will need bone grafting done, I have good news for you. Let’s start with why the bone grafting is important first. The dentist recommended this procedure to you because you do not have enough bone in the areas where you are getting your dental implants to actually retain the implants. If you go forward without it, you will end up with dental implant failure and possibly even a cracked jaw. It is essential.

Cadaver Alternatives

Now for that good news I mentioned. Cadaver bone is not the only option for bone grafting. It may be that your dentist never intended to use that option. There are bovine options, and even synthetic bone, mixed with some organic materials. It is even possible for them to harvest and use your own bone, though that would entail an additional procedure.

I would start by talking to your dentist about what type of bone he planned on using for your case. If he says cadaver bone, then tell him your concerns and ask for an alternative option.

About Cadaver Bone

Before you decide against it, you should know a few things about the process. First, the bone was lovingly donated by people and/or their families to go to people in need after their or their loved ones’ death. The bone is thoroughly tested in order to make sure it is healthy and then goes through processing and sterilization.

Either way, it is up to you. Just have a conversation with your dentist to learn his plans and express your desires.

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

Are there Soft Dentures?

Posted on December 5, 2022 by writeradmin.

Do you know if it is possible to get soft dentures for the upper part? I have complete dentures, but the plate (I think that is what they call it) at the top is hard. Not only is that uncomfortable but sometimes the feeling makes me gag and I can’t even keep them in.

Daisy

Dear Daisy,

I am sorry you are dealing with this. Many patients struggle with dentures. Not just with the upper plates, but with the food that gets under them, with the slipping and sliding, and with the difficulty chewing. There are some soft liners that will help patients that have a bony ridge where the lower denture sits. However, there isn’t a soft plate for a denture.

Implant Overdentures Solve this Problem

While that may sound disappointing, I do have a solution for you. Your best option is to have some dental implants placed and then have your dentures anchored to them. These are called implant overdentures. This eliminates the problem you have with the plate because the plate is unnecessary. You will find that not only do you not have to worry about the plate, but that your quality of life goes up tremendously. You will even be able to eat whatever you want again, including steak!

One of the most important benefits, however, is the protection to your jawbone. When your teeth were removed, your body began resorbing the minerals in your jawbone perceiving that they were no longer necessary to retain your teeth roots. After ten or so years, there will no longer be enough jawbone left to even retain the dentures you currently have. This is known as facial collapse.

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

Why Won’t My Dentures Stay In?

Posted on October 10, 2022 by writeradmin.

I am a smidge over 60 years old and have trouble keeping my dentures in, this is true even when I put in the adhesive. They still slip right out of my mouth. Is there anything I can do to keep them in at this point?

Matilda Lynn

Dear Matilda Lynn,

I am so sorry you are going through this. You are in a tough spot. However, the good news is that there is a solution for you. I don’t know if the dentist who originally provided the dentures for you had warned you about bone resorption. When your teeth are removed, your body recognizes that and begins resorbing the minerals in your body to use elsewhere. This slowly shrinks your jawbone. Eventually, you lose so much of the bone that you can no longer retain the dentures in your mouth. This is known as facial collapse and why your dentures will not stay in, even with adhesives.

The Solution to Facial Collapse

The first thing you’ll need to do is have bone grafting done. This will build up the missing bone in your jawbone. After this is healed, you have two options.

Your first option is to have new dentures made. Now, you’re only in your 60s, so you should be aware that the cycle of resorption will start over again. Eventually, you’ll be right back to the situation you are in now.

A second option is to get implant overdentures (pictured above). This uses between 4 – 8 dental implants per arch and then anchors a pair of dentures to them.

Benefits of Implant Overdentures

Because the implants are prosthetic tooth roots, your body interprets that as you still having teeth and you will no longer have to worry about losing your bone.
Your dentures will be completely secure. No more slipping and sliding.
You will find your quality of life increases, including your chewing capacity. Even the best-fitting dentures will lower your chewing capacity by 50%. With dental implants, you’ll be able to eat anything you want, including steak.

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

Sinus Perforation with a Dental Implant

Posted on September 7, 2022 by writeradmin.

I had a dental implant placed on one of the teeth adjacent to my front teeth. The dentist told me at the time that the sinus cavity was perforated by just a few millimeters, which he said is fairly common. He did not put me on an antibiotic at the time because he said it was unnecessary. Just six months after the implant was placed it had to be removed because he said the bone was not developing properly. After the removal, he again gave me no antibiotics because he said everything went fine. My instructions were to wait a year for the bone to fill in and then we’d start again. He also said there was no need to repair the sinus perforation. A few weeks later, I started having problems. First, I was having crackling in my ears and congestion. I called and they said to use Flonase. I did but things seemed to get worse. I went in and they insisted everything looked fine. I disagreed because it felt like I was developing an infection. He reluctantly agreed to give me some antibiotics. Since then, everything started to clear up and I feel better. My question is should I have gotten an antibiotic from the beginning? Am I going to have any better luck the next time I go for the dental implant?

Cathey

Dear Cathey,

You’ve been through a lot. I’m impressed you are willing to give it another go to get your dental implant. Good for you! It definitely is the best tooth replacement option. Before you do, I want to make sure some things are addressed by your dentist. However, let’s start with your question. It was not really needed to give you an antibiotic from the beginning, but when you started having problems, that would have been a good time. Believe it or not, that isn’t the real issue with your case.

Two Big Mistakes with Your Dental Implant Procedure

The first issue I would want an answer about is the depth of the perforation. While some oral surgeons say sinus perforations happen sometimes, all of them would say that a few millimeters is too much. In the dental field, that is a huge amount. Huge! I would want an answer for that.

The second big issue is diagnostics. My suspicion is that he did not do adequate diagnostics in preparation for your procedure. This may also explain why the bone did not integrate properly.

There should have been a number of x-rays done, including a 3-dimensional one such as a CT scan. The CT scan is especially important so that there isn’t a sinus perforation, such as what you experienced. Additionally, those diagnostics let the dentist know if there is enough bone structure to support the dental implant.

Can You Still Get a Dental Implant?

The short answer to the above question is yes…but. It is not as simple as your oral surgeon made out. First of all, the bone is not just going to fill out on its own. You will have to have a bone grafting procedure done. Once that is completed, you will need a time of healing before starting over.

While you can have the dental implant done, I do not recommend you use the same dentist/oral surgeon unless they can tell you what they are going to do to prevent this issue in the future. Another important point is that it should be the dentist who determines the placement of the implant, not the oral surgeon. Make sure you visit the dentist first.

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

Implant Bridge Through Off My Bite

Posted on July 4, 2022 by writeradmin.

I received two dental implants in order to replace four teeth with a dental bridge. This is on my lower right side. My teeth meet up on that side. However, on the left side they don’t touch at all. It feels uncomfortable when I chew. Is there anything that can be done about this or is it normal?

Casey

Dear Casey,

No, this isn’t normal. They way your teeth come together is called occlussion. Your teeth should all mesh at the same time. When it doesn’t, not only does it cause the pain you are experiencing when you are chewing, but it also can lead to debilitating TMJ Disorder. Your dentist needs to fix this.

While dental implants are not a recognized specialty, they are an advanced procedure that requires additional post-doctoral training. Yet, there are no regulations for getting that training or, if they do, how much.

There are two possibilities for what went wrong here. First, the implants could have been restored incorrectly. However, the most likely scenario is whoever placed them during the surgery did not do the right placement. If two different people are working on the procedure, such as a dentist and an oral surgeon, it is important you see the dentist first and that he or she determines the placement. Additonally, they need good communication throughout the procedure.

You need to have another dentist look at this to tell you what went wrong. Look for someone with the credentials that Dr. Weiss has on his bio to make sure you get someone who knows what they’re doing.

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

Can I Get Dental Implants Instead of Dentures

Posted on June 15, 2022 by writeradmin.

I have to replace all my teeth and my dentist wants me to get dentures. I asked him if I can get dental implants instead, but he said because I previously had gum disease that is not possible. Is there any way around this? I really feel too young for dentures. I’m only 42 years old.

Paula

Dear Paula,

I am sorry you are having to go through this at your age. Before I answer your question I have one of my own. You said you previously had gum disease. Does that mean you have already undergone treatment and no longer have periodontal disease? If that is the case and you are otherwise in good general health then there really should not be a reason you could not have dental implants. If you currently have gum disease, you will need to deal with that first.

It is possible you will need to have some bone grafting done, depending on how much bone structure you lost during your period of gum disease. That can be done outpatient.

Dental implants are an advanced procedure and it really requires that a dentist has post-doctoral training. Often, when a dentist is telling a patient that they can’t have a procedure it is because they are not comfortable doing that procedure. Don’t pressure your dentist to do it, though. There are way too many dental implant horror stories from patients who had the procedure done by dentists without the necessary additional training.

Look for a dentist who has training at one of the following institutions:

The Las Vegas Institute for Advanced Dental Studies
Dawson Academy
The Kois Center

Why Dental Implants Are Important

When your teeth are removed, your body immediately begins to resorb the minerals in your jawbone in order to use those resources in other places in your body that may need them more. It does this because you no longer have any teeth roots there so there is no need for the bone to support the teeth. While an efficient way to manage your body’s resources, it has the unfortunate side effect of shrinking your jawbone. After around ten years, it will become difficult for you to keep your dentures in. Shortly after that, it will be impossible. This is known in dental circles as facial collapse.

At your young age, this would be devastating. Having dental implants placed causes your body to recognize there are still “roots” there for your teeth. Because of that it will leave your jawbone intact.

When you are talking about removing all of your teeth, it is common practice to get implant-supported dentures, also called implant overdentures. This uses between four to six dental implants and then anchors your dentures to them. That amount of dental implants will both secure your dentures and provide the protection you need from facial collapse.

One other word of caution. Make sure your dentist has the cosmetic skills to provide you with beautiful dentures. Look at their smile gallery to see what type of work they do.

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

Should I Keep My Last Two Upper Teeth?

Posted on May 2, 2022 by writeradmin.

After more problems with my teeth than I care to elaborate on, I am going to be left with most of my lower teeth and only my two front upper teeth. My main question is, would I be better off with removing those two teeth and getting dentures on my upper arch or keep those two teeth and work around them with partials? Those two teeth are healthy, but I cannot get a dentist to give me a good opinion one way or the other. I keep hearing, “Do whatever you want.” But, what I want is to know the best case scenario. I don’t really find the partial dentures very comfortable. I keep them out and mostly chew with those upper two teeth unless it is something that is too difficult for just those. But, if natural teeth are best I can keep doing it.

Ben

Dear Ben,

Implant Supported Dentures

You’re in quite a spot. In most circumstances, it is better to save your natural teeth. However, this situation is a bit different. Your upper teeth are going to hit those lower teeth when you’re chewing. Additionally, you are using those teeth more than usual and carrying the duty of the other teeth. I would not expect them to stay healthy at that rate. Dentures will be a little easier on those teeth, so that will work out well for you.

I did say in most circumstances it is better to keep your natural teeth, but that is more urgent if you are talking about lower teeth, not upper teeth. When your lower teeth are removed, it is more serious. This is because when your bottom teeth are removed, your body senses that and begins to resorb the minerals in your jawbone to use elsewhere in your body where you will get more use out of them. The big problem with that is that your jawbone slowly shrinks as a result. If you place dental implants in your lower jaw, it helps to preserve the bone. Without that, you will eventually not have enough jawbone left in on your lower jaw to keep your dentures in.

For upper dentures, that bone is not as essential because they are held in by suction. I would say, in your unique case, you would be better off removing those last two teeth. You’ll be much more comfortable and able to eat a bit better. Of course, getting implant-supported dentures is always better and will increase your quality of life, especially your chewing capacity. But, they are more expensive.

One thing to note. Whether or not you choose the removable dentures or the implant supported dentures, you will want them to be attractive. Make sure you see a dentist who creates beautiful smiles. One easy way to do that is to look on mynewsmile.com, They screen cosmetic dentists for their technical and artistic ability.

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

Should I Switch Implant Dentists?

Posted on March 1, 2022 by writeradmin.

I am getting two dental implants. I’m paying a LOT of money for this and am concerned that my dentist may be in over his head for reasons I am about to explain. I have had the teeth extracted and some bone grafting done. Then, my dentist provided me with two different Maryland Bridges as temporary replacements. They’ve fallen off several times each. This has made me wonder if he understands esthetic dentistry. Should I switch dentists in the middle of my procedure to a dentist who has more experience?

Misty

Dear Misty,

For those who do not know, a Maryland Bridge is a false tooth that is attached to the adjacent teeth with either metal or ceramic wings. I would not consider this a temporary tooth replacement because the adjacent teeth have to be etched and bonded on. If your dentist does not understand how to adequately place this, then I have concerns about two aspects of this. First, I have the same concern you do. If he doesn’t understand how a Maryland Bridge works you are not likely to get an attractive aesthetic result. A second concern is just the dental implant procedure itself. This is quite an advanced procedure. If he cannot do the Maryland Bridge, then I would have concerns about the implants.

You can switch dentists in the middle of a procedure. Your current dentist is ethically obligated to cooperate with your new dentist, including providing him with all the necessary diagnostics and notes that he has on your procedure. You will want to make certain that whichever dentist you go to has post-doctoral implant training. Some training to look for is someone who has been to the Dawson Academy, the Kois Center, or the Las Vegas Institute for Advanced Dental Studies. He will want to examine your implants and make sure they’re placed properly before moving forward. Don’t be surprised if the dentist suggests a different temporary tooth replacement. A dental bridge is the most common recommendation. The good news is that it is much less expensive than the Maryland Bridge.

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

Implant Teeth Don’t Match

Posted on January 30, 2022 by writeradmin.

I had to get two dental implants on teeth that you can see when I smile. One is a front tooth and one is a canine. The implants themselves seem okay, but the teeth parts don’t match my other teeth. I’m guessing if they were beside one another they’d match each other, but they look weird and matte compared to the rest of my teeth. Is there anything that can fix this?

Ruth

Dear Ruth,

There is always a way to get a dental crown to match your other teeth. However, your dentist may not have the cosmetic skills to do it. I would start by asking him to redo them. But, this second time, tell him you want them placed with a temporary try in paste, so you can make certain they match before they are permanently bonded on.

If he’s unwilling to re-do them, and the dental implants themselves are in good condition, you won’t have much recourse. You may have to bite the bullet and pay for new porcelain crowns by a dentist who has more cosmetic skills than your current dentist.

If it does come down to that, look for a dentist who is accredited with the American Academy of Cosmetic Dentistry or one recommended on the mynewsmile.com website. Dentists from either group will be able to create beautiful crowns that blend in perfectly with your natural teeth. Just make certain they have dental implant training as well so they understand how the crown will fit with the implant.

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