Dental Implants Archives - Philadelphia Cosmetic Dentist

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.

Will Medical Insurance Pay for Dental Implants?

Posted on November 20, 2021 by writeradmin.

I have been trying dentures. Really trying. The problem is the denture plate makes me gag every single time I try to wear it. I haven’t been able to eat solid food for weeks. I had a little weight to lose, but not as much as I am losing. Will medical insurance cover the cost of me getting dental implants because of the impact it is having on my health?

Madeline

Dear Madeline,

Implant Overdentures

The good news is that getting dental implants to support your dentures will solve the gagging problem you have been having. There is no apparatus to cause gagging. The dental implants serve as teeth roots and the dentures will attach directly to them. Not only will you be able to eat, but you will be able to eat absolutely anything you want to.

The bad news is that medical insurance will not cover them, even if not having teeth is having a negative impact on your health. Medical insurance always has a dental exclusion clause.

If you have dental insurance, that will pay for some of it. Probably not as much as you are hoping, but some. Most dentists have you pay in two parts, so that helps some as well. You’ll pay the first portion when the dental implants are placed. Then, after a period of healing and time for osseointegration to take place, you get your dentures and pay for the second part.

If you are in difficult financial circumstances, you may find a dentist who offers a further break down of payments.

I will tell you, in the long run, it will be much better and less expensive for you to get the implant overdentures now. The longer you are wearing dentures, the more jaw bone structure you will lose. In about ten years or so, there won’t be enough bone structure left for you to retain your dentures at all. This is known as facial collapse. Getting implants prevents this because it signals to your body that you still have teeth and it leaves your jawbone intact.

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

I Can Smell My Husband’s Dental Implants

Posted on October 30, 2021 by writeradmin.

My husband has received his dental implants for some implant overdentures. Currently, he has temporary acrylic dentures but will be getting porcelain ones soon. The problem is I can smell this awful rubber smell coming from his mouth and I am certain they are his dental implants. I even have to sleep under the blankets with my face to avoid smelling them while we sleep. I would like him to remove them and get some non-metal ones, but his dentist says that the implants are not causing any smell and doesn’t want to remove them. Is there a way to prove it is the implants?

Alison

Dear Alison,

Implant overdentures

I am inclined to agree with your husband’s dentist. The metal used in dental implants is titanium. These are very inert and are unlikely to release any smell. You can even ask the dentist to let you see an implant so you can smell it. You will see it does not give off a smell. Switching out implants is not as simple as just taking some out and putting in some others.

When the implants are removed, they will take bone with them. That bone is necessary in order to retain the new implants. That will mean a second surgery for bone grafting before a third surgery for the new implants. That is a lot to put your husband through unnecessarily.

If there is a smell, the most likely culprit will be food and other bacteria getting caught under his acrylic overdentures. I would try having him use a Waterpik for his flossing. It will help him to get that debris out better and will clear up any smell. Once a week, it wouldn’t hurt to rinse with some peroxide. I wouldn’t do it more than once a week though or it could lead to him getting an oral yeast infection.

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

Are All On 4 Dental Implants Okay?

Posted on September 2, 2021 by writeradmin.

My husband is losing his teeth and we went to see our dentist about some options for him. He said we should get the all-on-4 dental implants. Are these as good as the regular ones?

Esther

Dear Esther,

All-on-4 Dental Implants

First, I want to check something. Was this the ONLY option he discussed with you? If so, I’d be wary. There are many options for tooth replacements. I’d be careful with any dentist who does not give you all of y our options. It means they are pushing a procedure on you. Where the all-on-four procedure is useful is when a patient has lost bone structure, but is not a good candidate for a bone grafting procedure. If he has plenty of bone structure, then this would be a stupid option for him. Instead, I would get him the traditional dental implant solution.

I am unclear from your question if he is losing all of his teeth or if he is just starting to lose some teeth. If he is only losing some teeth, then getting an individual dental implant for each of the lost teeth will be fine.

Implant overdentures

If he’s lost all of his teeth, then the more affordable option would be to get implant overdentures. This will use four or more dental implants and then, after the implants have had time to integrate with your bone, a denture will be anchored to them. These are very secure. Another way these are superior to all-on-4 implants is in failure. If one dental implant fails, you will replace that implant. With all-on-4, if one implant fails then the entire unit needs to be replaced.

What I would like you to do is get a second opinion from a dentist with good post-doctoral training in dental implants. To get an idea of the type of training you want, look at Dr. Weiss’s bio. This is important because dental implants are an advanced procedure and they are barely touched on during dental school. That additional training can make the difference between a successful case and a dental implant horror story.

There is an additional consideration. This is his smile. You want to make sure the dentist has some decent cosmetic skills. I would either go to an implant dentist who is AACD accredited and/or recommended on the mynewsmile.com website. They will be able to give them a smile he will be proud to share.

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

Gap After Congenitally Missing Tooth

Posted on August 9, 2021 by writeradmin.

My daughter is about to graduate high school. Since childhood, she has only one adult of the teeth next to the front one. I think it is called incisor. Our family dentist told us that once it fell out, her other teeth would shift into that space. It sort of did, but not as much as we were expecting. Now there is a gap there. She just doesn’t like to smile and isn’t even interested in getting senior pictures. I mentioned it to my dentist and he said we could just fill in the gap. I’m hesitant to do that because I’m worried it will make the teeth on one side look bigger than the others. Is there a better way to do this?

Petra

Dear Petra,

I am very glad you wrote. It appears this dentist has given you bad advice on two fronts. First, the original advice was not only bad esthetically but for the health of her bite in the long term. Let’s start with esthetics first. The tooth next to her lateral incisor is her canine tooth. It is thick and pointy. The Incisor is thin with a more rounded bottom. There is no way her smile will look balanced and normal trying to interchange those two. It also appears you have more of an artistic eye and common sense than your dentist for his latest suggestion, so I am with you. No, don’t just fill in the gap with dental bonding.

As for the damage to her bite, the canine tooth is also different in its root. It has a much longer, stronger root and handles all the sideways stresses of our teeth. If you move that out of its place, as he allowed, she will have long-term consequences.

Dealing with Congenitally Missing Teeth

What should have happened in the beginning is he have you get an inexpensive dental flipper for her to hold that spot open once the tooth came out. Then when she is old enough, you can replace it with a dental implant. As it is now, you will have to use orthodontics to get the teeth back into their proper position. I am going to suggest Invisalign. This will work faster than traditional braces and no one will be able to tell she is straightening her teeth.

From there, get the dental flipper and then have a dental implant placed when her jaw is fully developed. It won’t be that much longer, given her age.

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