Category Archives: Dental Implants

Should My Husband Get All-On-Four Dental Implants?

My husband needs to replace his bottom teeth. His upper teeth have been gone for a while and he has dentures there. We were told that you shouldn’t do dentures on bottom teeth because they won’t stay in the way the top ones do. Our dentist said he needs to get all-on-4 dental implants. I just want to explore if there are other options before we make a decision?

Pricilla

Dear Pricilla,

All-on-4 Dental Implants

I am curious why that is the only option he gave your husband. A dentist is ethically obligated to give his or her patients all of their options. He is correct that dentures are a bad idea on bottom teeth. While it is true that dentures will struggle to stay in on the lower arch, that does not happen right away. This is an issue because of bone resorption.

When his teeth are removed, his body recognizes that and begins to resorb the minerals in his jawbone in an effort to be as efficient as possible with his body’s resources. The big problem with that is after ten or so years, he will no longer have enough jawbone left to retain his dentures. This is known as facial collapse.

This bone structure is important no matter what tooth replacement option he chooses.

All-on-4 Dental implants (pictured above) are what dentists will sometimes offer to patients who have lost some jawbone structure but still want dental implants. However, there are other options.

Implant-supported denture

The first thing to find out is whether or not he has lost bone structure. If he hasn’t, then his best option is to get an implant overdenture. This uses between for and six dental implants and then anchors a denture to them.

If he is missing bone, depending on the amount, he has two choices. First, he can have the all-on-4 procedure his dentist suggested, as long as he hasn’t lost too much bone. The one downside to this procedure, however, is that if one implant fails, the entire unit has to be redone. A second option, no matter how much bone he’s lost, is to have a bone grafting procedure done to build it back up. Then, he can do implant overdentures if he wants. He could get a denture too, but bear in mind he will end up with facial collapse. Having dental implants in the jaw bone, prevents that from happening.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Is My Husband Reacting to His Dental Implants?

I am quite sensitive to smells and I’m wondering if my husband is having a reaction to his dental implants. His mouth and breath smell awful. He’s had the implants placed and his dentist has given him temporary, acrylic dentures. Eventually, he’ll have porcelain dentures. However, I’m wondering if we need to switch his dental implants before that happens. His dentist gave him the metal implants. I’m wondering if he is reacting to the metal and that is what is causing the horrible odor I keep smelling. I mentioned to his dentist the possibility of switching him to the zirconia implants but he acted like that was a ridiculous idea. Is it?

Kaitlyn,

Dear Kaitlyn,

Metal and Zirconia Dental Implants

I wouldn’t say you were being ridiculous. It sounds to me more like you are trying to make sure your husband is okay. Even if he doesn’t think that the dental implants are an issue, he should have been more respectful of your care and concern for your husband. I am sorry you were treated that way.

That being said, your husband’s metal implants are made from titanium, which is not only one of the most biocompatible materials around, it is also inert. The inert part will tell you the metal doesn’t really have a smell. The biocompatible part means it is highly unlikely he is having any type of reaction to it. It would be foolish for me to say that no one is allergic to titanium. Each person’s body is unique. However, I would look at more common issues first.

The first thing I would check is to see if food or other debris is getting caught in his temporary dentures. This is fairly common and can cause a putrid odor. Using something like a WaterPik, will clean things out. A second possibility is an infection. However, that almost always has other symptoms such as pain or fever. You did not mention either of those.

Switching Dental Implants

Without an extremely good reason that cannot be solved any other way, I do not recommend switching his dental implants. I am not opposed to zirconia implants. They do a fine job. The problem is what would be involved in switching them out.

First, he would need his implants removed. This takes bone structure with it. Because of that, he will no longer have enough bone to retain the new dental implants you want to place. Now, your husband needs a bone grafting procedure done to provide him with the missing structure. Once that has healed, he is onto another surgery to place his new implants. If that is succesful, he will be back to where he is now.

Each of those additional procedures has a risk of failure. If he has successful implants. Keep them.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Temporary Tooth Replacement before Dental Implants

My daughter has a congenitally missing tooth. Our plan is to replace it with a dental implant once her jaw is completely developed. In the meantime, we have done orthodontics and have the space opened up. Our dentist provided a Maryland Bridge for the temporary tooth replacement as we wait for her jaw to grow, The problem we are having is the bridge keeps falling out. She used the ceramic wings. At first, she thought she’d just need to try a different cement, but that didn’t help. Now she’s thinking that maybe metal wings will stay better. My only concern about that is the metal will look darker and affect the appearance of her teeth. Is there something we are overlooking?

Lacey

Dear Lacey,

I can tell you are a good mother and are doing everything in your power to give your daughter the best care possible. Your choice of a dental implant is a great one and will serve your daughter well.

One of the things you are running up against here is your dentist, though I am sure she has good intentions, does not understand how a Maryland Bridge works.

First, you should know these are not meant to be temporary tooth replacements. In order to get these to stay on your teeth properly, there actually needs some tooth preparation on the adjacent teeth, as seen in this image below.

Maryland Bridge Tooth Prep

A small notch needs to be added to the tooth to help keep the bridge in place. My guess is your dentist is just trying to keep these on with the bonding alone, which will not work.

Switching to metal wings, won’t be a great solution either. It is actually easier to bond porcelain to natural tooth structure than it is to bond metal. So by switching, she is actually making it more difficult for the Maryland Bridge to stay on.

What Makes a Good Temporary Tooth Replacement?

The reason I do not consider the Maryland Bridge a temporary tooth replacement is because of the necessary tooth preparation. The structures of the prepared teeth are not permanently damaged. Once you remove the bridge to place her dental implant, those notches will still be there and y ou will need to fill the are with some composite bonding.

Demtal flipper

Instead, I am going to recommend you get your daughter a dental flipper. Because these are much less expensive, not only will you save a lot of money over a Maryland Bridge, but they will do no damage to her teeth, so it is a safer option as well.

My suggestion is you ask for a refund on the Maryland Bridge and get a dental flipper instead.

When it is time for your daughter to get her dental implant, make certain you research the dentist carefully. This is an advanced procedure that requires post-doctoral training. There are many dental implant horror stories that would have been avoidable if the patient knew to check the dentist’s implant training.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Ordering Dental Implant Parts Online

I wear completely removable upper dentures that can snap on. I am on an extremely tight budget and it is starting to get hard to pay for my male retention caps. My dentist charges $30 for one individual cap. I see online that I can get a set of four for $25, which would save me a significant amount of money. However, you have to be a dentist to order them. Do you know of any place you can purchase these without being a licensed dentist?

Travis

Dear Travis,

Snap on Denture

I have a couple of ideas that may help you. First, I would just talk to your dentist and explain the hardship. While I understand that there is a need to mark some things up in order to cover overhead expenses, this is such a small profit margin that I don’t think he will care about selling them to you at cost or at least much closer to it. If he or she does, you still have a couple of options.

First, you can call around to other dental offices explaining your situation. In most cases, dentists and their employees chose their profession because they want to help people. You would not have to speak to the dentist directly. It is generally an employee who orders all the supplies for the dentist anyway. You may be able to work out a deal with them.

If both of those things fail, I see that you can purchase retention caps for dental implant supported dentures on Ebay from overseas dealers for about $20 a set. They do not require verification that you are a dentist. The only downside to this is you need to know exactly what you want including strength and resistance, as well as how to place them on your denture.

I hope this helps.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Dentist Said I Have to Get Dentures

I have dental insurance for the first time and just started going to the dentist. My teeth are pretty bad and some of them have started coming out. My dentist said I have advanced gum disease and will need to extract my teeth and get dentures. Is it at all possible that I could get dental implants instead?

Susan A.

Dear Susan,

Implant Overdentures
Implant Overdentures

You are in a tough position. At some point, dental implants will be possible, but you are going to have to get that periodontal (gum) disease under control first. That will be imperative. After that, I would make sure your dentist does adequate diagnostics. That would need to include a CT for two reasons. First, you want to make sure you have enough bone structure left to retain your dental implants. Second, dental implants are a 3D procedure and you need 3-Dimensional images in order to ensure proper placement.

If you don’t have enough bone structure, you will need to have a bone grafting procedure done first. Then, after a time of healing, it will be okay for you to go forward with your dental implants.

What you will want to get is called implant overdentures or implant supported dentures. With this, you will have between four to eight dental implants placed and then, after a period necessary for osseointegration (meaning bone integrating with the implants), have a denture anchored to them.

This blog is brought to you by Lafayette, LA Dentists Drs. Foremen and Thimmesch.

Dental Implant Deception

I had a full mouth reconstruction. Much of it was done with dental crowns, but quite a few teeth required dental implants. All of my teeth were either extracted or ground down to nubs to make way for the new teeth. Since its completion, my crowns have been falling off, including those from the implants. I’d say only half the crowns are left. I had tried contacting my dentist several times, to no avail. When I finally went down there, the place was deserted. It’s like they all just left. I don’t know what to do.

Melanie

Dear Melanie,

dental implant diagram

It appears you have been taken in by a crook who realized he was about to get caught and skipped town. While you have a great case for malpractice, you’d actually have to locate the dentist first. None of this helps your immediate case.

You are probably in a lot of pain trying to eat. What you need is teeth. I’m going to suggest you see another implant dentist to have this repaired. Given your situation, I am sure you will find someone compassionate who will be willing to work with you financially while you get this repaired.

Don’t be tempted to find the cheapest dentist or you can end up in a similar situation. Find a dentist with post-doctoral training in dental implants and go from there.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

South America or Clear Choice?

I was thinking of going to Clear Choice Dental Implants. They want to do all-on-four dental implants which would not require any bone grafting. That sounds okay, but a friend of mine that went there said she had no follow-up and had a complication that required her to go to her regular dentist to have it fixed. I have another choice of going to Mexico where I can have bone grafting and implant overdentures for less than what Clear Choice is offering for the lesser procedure. Which do you think is the better option for me?

Leslie

Dear Leslie,

Implant Overdentures

I am glad you wrote. I want to make sure you understand that if you go to Mexico, you are not likely to get any follow-up either. Another thing to consider is that while the care is cheaper there, it is up to each dentist what type of standards they hold to. They do not have the same regulations we have in the United States. That even includes sanitation. There are no laws that say a dentist has to sanitize their equipment between patients. While some dentists will be diligent and careful others will not. If you develop an infection, not only will your case fail, but you will risk serious complications.

My sincere suggestion is you see a skilled implant dentist in the states. If you want the all-on-four procedure, that is fine. The problem most people have with Clear Choice is not usually their dentists. They are usually qualified. The issues I have with them are their high-pressure sales tactics as well as their tendency to do a one-size-fits-all type of care. Not everyone needs all-on-four. Plus, with that procedure, if one dental implant in the unit fails, the whole thing has to be completely re-done.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

An Adult with Baby Canine Teeth

I’m 23 years old and still have two baby canine teeth. I would love for my smile to not look so childish. Would dental implants be a good solution for me?

Mona

Dear Mona,

Everyone wants a smile they can be proud to share

Dental implants will be a good solution for you as long as there are not adult teeth underneath waiting to erupt. Let’s go on the assumption you have congenitally missing canine teeth.

The first thing you will need to do is open the space up enough to ensure that you have enough space for the dental implants as well as that your bite is in the correct position. My recommendation, at your age, is to use Invisalign for that. No one will even know you are straightening your teeth.

The next thing to consider is tooth color. If you are happy with the color of your teeth, then you can skip this step. If you’re not, the time to whiten them is before you have your dental implants done, that way the porcelain crowns placed on your implants can match the right color you want for your teeth. Crowns do not whiten, so the color you make them will be permanent. If you decide to do this, your Invisalign aligners can double as teeth whitening trays. If you are in a hurry, you could do Zoom Whitening instead.

Finally, it will be time for those dental implants. Once completed, you will have a smile you love.

This blog is brought to you by Lafayette, LA Dentists Drs. Thimmesch and Foreman.

Should I Keep My Last Two Teeth?

I am about to have another tooth extracted. This will leave me with only my two front teeth on my upper arch. They are fairly healthy and should last a good while. Most of my lower teeth are still there. I am wearing a partial denture right now to accommodate the upper partial. It’s really uncomfortable and makes it difficult to talk. Because I can eat everything but meat with it, I rarely put it on, unless I am going somewhere to socialize. Some people are telling me that I would probably be happier with a complete upper denture instead of my partial. There aren’t really people I know who have been in this situation where I can ask them if they thought removing those last two teeth was worth it. Have you an opinion on this issue? I’m kind of torn and having a hard time making my mind up. It’s not like I can change my mind after extracting those last two teeth.

Brent

Dear Brent,

Implant Overdentures

I am going to start with a tiny disclaimer that I can only give you general principles here. I don’t have your x-rays and haven’t examined you, so I am strictly going off the information you have provided me with.

In almost all cases it is better to preserve as many natural teeth as possible. That being said, your situation is unique. Yes, those two front teeth are healthy, but they are all you are eating with most of the time and the stresses on them will be tremendous. I don’t think they will last as long as you are hoping. In your case, I am going to suggest that you remove those last two upper teeth and replace the entire arch.

Tooth Replacement Options

The ideal would be for you to replace those teeth with implant overdentures. That would mean getting four to six dental implants and then anchoring a complete dentures to them. It is the most secure replacement possible. The only real downside to them is their expense.

Facial Collapse

The effects of facial collapse.

If these were your bottom teeth, I would tell you to do everything possible to ensure you get the implant supported dentures. This is because when your teeth are removed, your body immediately begins to resorb the minerals in your jawbone to redistribute them elsewhere in your body. With your bottom teeth, this is devastating. Not only does it age your appearance by decades, but your bottom denture simply rests upon your jawbone for its base. After ten or so years, you will not have enough bone left to retain your dentures. This is known as facial collapse.

Because you are dealing with your upper teeth, you are at a slight advantage. These are h eld in by suction and not your jawbone, so you will have more security and retention. Getting complete dentures in this case will be okay if you cannot afford the implant overdentures.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Dental Implants Keep Falling Out

I have dentures and have for the last year. I thought I would adapt to them but really hated them. I finally decided nothing was going to change so I opted to get implant-supported dentures. I had six implants placed. In less than a week two of them have fallen out and I can tell a third one is loose. Here are my questions. Should I have to pay for the ones that came out? Do you think more of them will come out? Is there any way this can be fixed?

Clarence

Dear Clarence,

Implant Overdentures
Implant Overdentures

I will say right off the bat that you made a good choice in what procedure you chose to replace your removable dentures. Dental implants are the closest thing to having healthy, natural teeth in your mouth again.

Your big problem here is your dentist. He doesn’t seem to have any idea what he is doing. With dentists who know what they are doing, there is a 95% success rate. Your dentist has about a 50% success rate and that is just in the first week. Plus, I do not have high hopes for the remainder of your implants. I would not expect them to last.

To answer your questions, no, you should not have to pay for the dental implants that fell out. As I mentioned earlier, I don’t think you should hold out much hope on the others. What I would like you to do is see a dentist with more expertise. I’d like him or her to examine your dental implants and tell you the cause of the dental implant failure.

Reasons for Dental Implant Failure

There are quite a few reasons why dental implants can fail. Here are just a few:

  • One of the major causes of dental implant failure is infection. Often this is the result of poorly fitting dentures.
  • Some dentists try to increase their profits by purchasing sub standard implants from overseas.
  • Inadequate bone support. This is completely preventable if your dentist does the correct diagnostic procedures. If you know ahead of time (as you should from the diagnostics) that you do not have enough bone support, there is a simple solution of having a bone grafting procedure done.
  • Incorrect placement of the implant. It is important that your dentist does 3-dimensional diagnostics, such as a CT scan so that the dental implant is placed correctly. Without that, there can be poor placement that results in serious damage such as damaging a nerve or perforating your sinus cavity.
  • Premature loading—It is important that you wait for your implants to integrate wtih your jawbone. If you don’t and put weight on it with the dental crown before integration, it will cause your implants to fail.

Once you know the cause of the dental implant failure, then you can formulate a plan to get the implants you need for your implant overdentures. I think you will be better off getting a full refund from your dentist and then following the treatment plan of a dentist with a lot more experience who can do this properly.

Then, you will have a stable smile that you will be proud to share.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.