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Should I Keep My Last Two Upper Teeth?

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,

Illustration of dental implant overdentures

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.

Filed Under: Dental Implants Tagged With: dentures, implant supported dentures, missing teeth, problems with dentures

Should I Switch Implant Dentists?

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,

Maryland Bridge Diagram

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.

 

Filed Under: Dental Implants Tagged With: dental flipper, Maryland Bridge, Switching dentists, temporary tooth replacements, tooth replacement options

Implant Teeth Don’t Match

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,

Diagram of a dental implant

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.

Filed Under: Dental Implants Tagged With: AACD accredited dentist, implant crowns, matching dental crowns, porcelain crowns

Will Medical Insurance Pay for Dental Implants?

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,

Illustration of dental implant overdentures

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.

Filed Under: Dental Implants Tagged With: dentures, facial collapse, implant overdentures, the problem wtih dentures

I Can Smell My Husband’s Dental Implants

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

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.

Filed Under: Dental Implants Tagged With: bone grafting, implant overdentures, smell with dental implants

Are All On 4 Dental Implants Okay?

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,

Illustrations of all on 4 dental implants

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

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.

Filed Under: Dental Implants Tagged With: AACD accredited dentist, all-on-4 dental implants, implant overdentures, mynewsmile.com, tooth replacement options

Gap After Congenitally Missing Tooth

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

Diagram of a dental implant

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.

Filed Under: Dental Implants Tagged With: congenitally missing teeth, dental bonding, dental flipper, Invisalign, orthodontics, tooth replacements

Dentist Placed Implant and Now Wants to Remove It

July 1, 2021 by writeradmin

I paid in full for a dental implant. Before the surgery, my dentist said that I was good and ready to go. When I woke up he told me that after he got in there the situation was different and I didn’t really have enough bone to support the implant. He went ahead and placed it but said he would prefer to remove it and give me a dental bridge. I have a couple of questions. First, should I be entitled to get some of my money back seeing as he is just going to remove it? I feel like he put me through unnecessary surgery and I have nothing to show for it. Second, am I really stuck getting a dental bridge? I would prefer a dental implant if that is even a possibility any more.

Ellie

Dear Ellie,

Illustration of a dental implant next to a natural tooth

You should not only get a partial refund but a full refund. I cannot think of a reason your dentist would think he could get away with this. When you provide a procedure, especially something as invasive as surgery, there is an implied warranty that you have a belief in its success. He placed it knowing there would be failure. That is malpractice.

Additionally, if he would have done adequate diagnostics this would never have happened. He should have done a number of x-rays and, preferably, a CT scan. The reason for the latter is the fact that doing dental implants is a 3-dimensional procedure and really requires a 3-dimensional map. Not to mention the fact that if he’d done these diagnostics, he’d have known right away that you did not have enough bone support, thereby protecting you from the hassle of a surgery bound to fail. Obviously, he did not do his duty with this either.

I would start by demanding a refund. You are certainly entitled to one. From there I would find a great implant dentist. You will not have to settle for a dental bridge. You need a dentist who has significant post-doctoral training. Take a look at the training Dr. Weiss has to give yourself an idea of what type of dentist you will need. In addition, however, you will need a bone grafting procedure in order for your implant to have a chance of succeeding.

If you have any trouble getting that refund, just mention you are going to take a little trip to speak with the dental board. That should sober him up a little.  I am so sorry this happened to you. Most dentists are not this irresponsible.

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

Filed Under: Dental Implants, Uncategorized Tagged With: dental bridge, dental implant failure, dental malpractice

Dental Implants for Hockey Players

June 3, 2021 by writeradmin

My son lost a tooth in a hockey game. Our dentist suggested we get him a dental implant to replace it, but his coach said that is a bad idea because of the chance of re-injury. What is the right choice? I want to do what is best for him, but the mixed messages are confusing.

Kami

Dear Kami,

Hockey player with a missing tooth

 

In a way, they are both right. Dental implants are the absolute best tooth replacement option. However, there is a risk for re-injury if he is continuing to play hockey. A dental implant consists of a prosthetic root form and a dental crown bonded on top of it to serve as the visible part of the tooth. If he is re-injured with both parts completed, there is a good chance he will lose some bone with the injury (and possibly even some of his jaw).

Here is my recommnedation. First, get the implant placed, but just the implant. This will allow him to get the benefits of the dental implant without having to worry about extra damage being done in case the tooth is lost again. You won’t want him going “toothless” in that area, so I suggest an inexpensive temporary restoration, such as you would get with a dental flipper. This gives him the best of both worlds.

Having the root form placed, ensures his jawbone can stay healthy and will not suffer any effects of the structural loss that normally occurs when you lose or remove some teeth. Having a dental flipper means if he is hit in the mouth again, the flipper will come out with ease and he won’t risk additional injury.  When he is done playing hockey, that will be the time to have the permanent dental crown placed on his implant.

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

 

Filed Under: Dental Implants Tagged With: facial collapse, hockey and tooth loss, implant crowns, tooth replacement options

Botched Implant Case

May 18, 2021 by writeradmin

A little over a year ago, I had four dental implants placed after a car accident left me with a lot of lost teeth. Since then, the crowns have broken or fallen off and the implants themselves are there but I don’t know how healthy or secure they are. I tried calling the office for quite a few weeks and they kept giving me the run around. Now I have discovered this dentist has left the country and no one can reach him. At first, I was worried about him, like maybe something happened to him on vacation, but it turns out he literally skipped the country. He’s emptied the practice account and they are closing the doors. What do I do now?

Andrew

Dear Andrew,

woman covering her mouth with her hand.

 

I am sorry this happened to you. First, the accident and then an unethical dentist. In all honesty, the only thing you can do now, is to have someone who is skilled with dental implants to look at your case and see how stable the implants are and what went wrong with the dental crowns. Hopefully, the implants themselves are fine and the dentist who did your case just did not bond them on properly.  Then, you will only have to replace the crowns. If it does turn out that your implants are poorly placed and at risk, you will have to replace them. Unfortunately, that will also mean getting one additional procedure, known as bone grafting, so that you will again have enough bone structure to retain your new dental implants.

There is an upside to these tragic circumstances. First, you can make any changes you want. If there was something you didn’t like about the earlier results, now is your chance to completely remake your smile. Make it gorgeous. Another opportunity is for you to whiten your teeth. If you decide to do that, do it before your new crowns are made. Whatever color they are fashioned with is permanent.

A second upside is that I am willing to bet that most dentists who hear the series of events that happened to you will be more willing to work with you on paying this out instead of having to pay up front, which is the typical requirement.

Again, I am sorry this happened to you. Hopefully, this next dentist will be just what you need!

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

 

Filed Under: Dental Implants Tagged With: bone grafting, dental crowns, dental implant failure, Teeth Whitening

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