Category Archives: Dental Implants

Implant Placed With Poor bone Density

I need some advice about how to proceed. I went to a dentist about getting a dental implant. My dentist does not do them, so I looked for someone who advertised. We did a consultation, he took some x-rays, and said everything was fine. The day of the surgery, though, he told me when he went in he realized there wasn’t enough bone support. He put the implant in anyway. Now he wants to remove it and place a dental bridge. This cost me $3K. Should I be entitled to a refund? Am I stuck getting a dental bridge? I sort of had my heart set on an implant.

Ginny

Dear Ginny,

Dental implant diagram

I’m not sure how your dentist thinks he can get away with this. Of course you are entitled to a refund. When a dentist tells you he is providing you with a dental implant, there is a reasonable expectation that the implant will actually be able to support the implant crown. Yours will not, therefore as an implant it is absolutely useless. Your dentist should refund your money in full.

There is a bigger issue here too– Your dentist’s competency and integrity. First, if he had done adequate diagnostics, he would have known there was not enough bone support. This means he either was incompetent in reading the x-rays or he didn’t do the correct ones. Both of these mean he’s incompetent.

The other issue here is the fact that he placed the implants knowing there was not enough bone support. That is malpractice. If you decided to be nasty about it, you can get additional money. At a minimum, I think you should tell him that you want him to pay to get this done correctly. Don’t just let him give you a refund. While you can still get a dental implant and should not be relegated to a dental bridge, you will need an additional procedure.

Without the correct bone support, your implants will fail. There is a bone grafting procedure which can be done to build that back up. Once that is complete, you will be good to go for implants.

Best of luck!

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

Dental Implants for Hockey players

Help! My son is a recent professional hockey player. He recently had a tooth knocked out. We’d done some research and read that dental implants are the best replacement. However, his teammates who have been in hockey longer have told him that implants aren’t a good idea. But, we don’t want to leave the space open because he’s getting married in a little over eight months. Do you have any suggestions?

Karlee

Dear Karlee,

I’m glad you wrote. What his teammates are trying to prevent is secondary injury. When you get a dental implant, a root is surgically placed into the bone of his jaw. Then, after a time of integration with the bone, there is a dental crown bonded to the root implant. Here’s the problem with that for your son.

If he has another puck or hockey stick to the mouth, which is likely in his sport, because of the bonding of the crown and implant, it will likely damage the bone in his jaw, requiring serious reconstructive surgery to fix. However, that doesn’t mean your son has to go without a tooth until the end of his career, and certainly not for his wedding.

Here is my suggestion. When a tooth root is missing in a jaw, your body begins resorbing the minerals from the bone in the area. This will lead to serious problems, so you don’t want to leave the area of the tooth root empty. Because of that, go ahead and get the implant surgery done. This will place the root form into his jaw and protect him from bone resorption. However, do NOT have the dental crown bonded.

Instead, he can use a temporary tooth replacement that is removable, such as a dental flipper. It will give him a tooth for the open space, but if his mouth is hit again, it will give without any consequences to your son’s jaw.

Once he is no longer playing hockey, then he can have the dental crown permanently bonded onto his dental implant giving him a secure tooth.

Best of luck to both of you and congrats on the upcoming wedding.

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

Dental Implants After Ten Years in Dentures

I have been in dentures for a little over ten years. To be honest, I have hated them the entire time. I knew fairly quickly after getting them that I would need to switch to dental implants, but just didn’t have the budget for it yet. I’ve finally saved up enough. Is it too late for me? My dentist retired and the new one said I’ve been in dentures for too long to switch.

Avery

Dear Avery,

Implant overdentures

Technically, it is never too late to get dental implants. That being said, there could be the possibility of needing one procedure to get your mouth in the right condition for dental implants to have a chance to succeed. If that is the case, why did your dentist tell you it is too late?

During Dental School, students are taught that it is important patients are confident in them. Because of that, many dentists do not want to admit when there is a procedure they are not comfortable doing. Instead of risking the patient’s respect by admitting they can’t do something, some dentists will simply steer their patient’s to another procedure they are more comfortable with.

It is never a good idea to pressure a dentist to do a procedure that is out of their comfort zone. The results are usually disastrous. This is especially true with dental implants, which is a very advanced procedure. The training required to do this well has to be done in a post-doctoral setting. Not many dentists invest in enough of it, which is probably why it is one of the procedures that tops the malpractice suit list. I’m going to recommend, you find a different dentist to do your porcedure.

Dental Implants and Facial Collapse

The consequences of years in dentures.

When your teeth were first removed for your dentures, your body recognized you no longer had tooth roots and, therefore, didn’t need any of your jawbone to help keep them in place. Our bodies are always striving to be as efficient as possible with its resources. To help with that goal, it will resorb the minerals in your jawbone to use elsewhere in your body.

While remarkable, this will have the unfortunate side-effect of slowly shrinking your jawbone. Eventually, there will no longer be enough jawbone to even support your dentures. This is known as facial collpase (pictured directly above).

For dental implants to be retained, they need the surrounding bone to integrate with it and keep it secure. If you don’t have enough bone to start with, that is impossible. You have been in dentures for ten years, which is enough time for significant bone loss.

The good news is there is a fairly simple solution. You can have a procedure done, known as bone grafting. It will build back up the bone in your jawbone. Once you have healed from that, you can have your dental implants placed and then anchor your new denture to them–a procedure known as implant overdentures.

You will have the secure smile you’ve always wanted with none of the problems and consequences that come with removable dentures.

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

Can I Trust Comfort Dental?

A little over a year ago, I had a bridge put across my upper front using the canine teeth as anchors. Since then, the canine teeth have come loose and now they need to be replaced. Comfort Dental did the bridge so I went back to them for advice. They’ve suggested a partial denture. I did try that and it is massively uncomfortable so I went to another dentist for a second opinion. They suggested I get three full-sized dental implants. One on either side and another in the front between them. Then he’d attach a bridge to it. This plan was very expensive so I went back to Comfort Dental. They’re suggesting we replace all my upper teeth with mini implants which would cost less. I like the idea of the lower cost, but my experiences with Comfort Dental have not provided me any long term solutions and I’m wondering at this point if I should trust them. Do you have an opinion on which plan is better for me in the long run?

Maggie

Dear Maggie,

You have been through a lot with these teeth. I’m going to explain a bit about Comfort Dental which should help you understand the way they work. They are a corporate dental clinic with (at last count) about 150 locations. Consider them mass-market dentistry. They tend to be less expensive, which is attractive to many patients.

Often, their practitioners are just out of dental school and are there to get experience before they open a private practice. They won’t understand principles dentists who have been in their field for some time have picked up over the years. One of those, in your case, seems to be some basic engineering principles, which is an important part of dentistry.

You mentioned having a dental bridge on your upper teeth where they used the canine teeth as the anchor teeth, dentists would call these abutment teeth. There are twisting forces at play here and this type of placement will actually cause your canine teeth to come loose, as they did.

This is the reason the dentist you went to for a second opinion suggested that you have a third dental implant placed in the center. This is to prevent those twisting forces. It will keep the implants secure.

While Comfort Dental’s plan will be less expensive, mini implants are not strong enough to anchor dental crowns. They are mostly used to help keep a denture from falling out, but there will still be some movement. Like your other treatments from them, I wouldn’t expect this to last very long.

My suggestion is to go with the other dentist’s suggestion. Sometimes, the inexpensive treatment becomes the least affordable one because it doesn’t last and you have to keep adding treatments or there are complications.

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

Metal Allergies & Dental Implants

I need to replace a tooth and hope to get a dental implant. However, I do have some metal allergies and I don’t know if that will complicate anything. So far, they know I am allergic to nickel, mercury, and cobalt. Will this prevent me from getting the implant?

Dennis

Dear Dennis,

dental implants

You made a great choice in your desire to get a dental implant. They are the best replacement options for your teeth. In general, as long as you are in good general health, you should be able to get a dental implant.

None of the metals you listed are part of dental implants. Instead, these are made of titanium, which is quite biocompatible. Titanium has been used in prosthetics for decades with great success, including hip replacements.

In truth, you should have no problem with using traditional implants. If you are still nervous because of your allergies, you have two other options.

First, you can have an allergy test specifically to test for titanium. This will give you some peace of mind going into the procedure. A second option is to have zirconia implants placed. These are metal-free. They are newer and do not have much data as to their longevity, but there is nothing to indicate they won’t last as long as their titanium implants.

Where you may run into some difficulty with the second option is finding a dentist who works with them. That is mostly because they are new and dentists tend to work with what they’re used to and comfortable with. But, I’m sure if you called around, you’d be able to get someone.

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

Is it Possible to Get Dental Implants after 30 Years?

I’ve had dentures for around 30 years. I’ve never been crazy about them and always wanted to switch to dental implants. Now, I’m having trouble even keeping them in. I think this may be a perfect time to switch, but I don’t know if I waited too long. Is it still possible? If not, how do I get my dentures to stay in? Not even those nasty adhesives are working.

Marilyn

Dear Marilyn,

dental implant diagram

Technically, as long as you are in reasonably good health, you can get dental implants. Though, in cases like yours, an extra step will be needed. As you can see from the image above, your dental implant will need to be surrounded by bone in order to stay in place. This bone is also what holds your teeth in place as well, along with some ligaments. After this length of time with dentures, you are missing that bone.

You’re Dealing with Facial Collapse

When your teeth were removed 30 something years ago, your body immediately began resorbing the minerals in your jawbone to use elsewhere. It does this in an effort to be efficient with your body’s resources. It knows you don’t have teeth anymore and assumes that you won’t need the bones in your jawbone to hold them. True. However, your dentures rest on the ridgeline of your jawbone. As that shrinks, there is less and less of a ridge to hold your dentures in place.

After ten years, you likely noticed them starting to slip. By thirty years, it is almost impossible to keep them in. This is known as facial collapse. You’ve probably also noticed your jawline shrinking,, which makes you look much older than you really are.

There is a procedure to help with this– Bone grafting. You can have either natural or synthetic bone built back up in the area so that you’ll have enough bone there to integrate with your dental implants and keep them in place.

Implant Overdentures

implant-overdentures
Implant Supported Dentures

Once the bone grafting is complete, then you will be able to get the dental implants you hope for. You won’t want to do a one-to-one replacement for your teeth. That is way too expensive. Instead, you’ll get implant overdentures. With these, you’ll have four to six dental implants placed in each arch and then have a new set of dentures anchored to them.

Your dentures will be completely secure and will protect you from facial collapse in the future.

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

Zirconia or Titanium Implants

I have three titanium dental implants and recently read that the titanium can cause neurological ill effects. I am now in need of another dental implant. Should I get the zirconia kind this time? Are they better? Should I switch out the titanium ones as well?

Carolyn

Dear Carolyn,

zirconia dental implants

I’m not sure where you read that titanium causes neurological effects. As far as I know, there are no studies with data that supports that. On the contrary, there are decades of data that show titanium to be highly biocompatible in dental implants as well as a large number of other titanium prosthetics, such as knee and hip replacements.

If you want to get a zirconia dental implant, for your new tooth replacement that is fine. You may need to do a bit of internet searching and phone calls to find a dentist who does them. Because they’re considered new, not all dentists are using them yet. You will be able to find someone though. Zirconia is definitely strong enough to work and more dentists are starting to use them. The only concern you may run up against is we don’t have the same data on their longevity the way we do their titanium counterparts. That doesn’t mean they won’t last as long, just that we don’t have the data.

As to whether or not you should switch out your current implants, I wouldn’t recommend it without a good reason to remove them. It is not simply a matter of taking out the old implants and then putting in new ones. When you remove the implants, bone will come with it. In order to place the new dental implants, you will need to have an additional procedure known as bone grafting done. Then, once that has had time to heal, you can then have the new implant placement surgery.

It’s a lot to go through and a huge expense when your dental implants are probably just fine. Plus, there is always a risk the new implants will fail. I’m sure you will find a dentist willing to do the procedure. I just want to make sure you understand what you’re getting into before moving forward.

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

Can I Get Dental Implants after 30 years in Dentures?

I’ve had dentures for around 30 years. I’ve never been crazy about them and always wanted to switch to dental implants. Now, I’m having trouble even keeping them in. I think this may be a perfect time to switch, but I don’t know if I waited too long. Is it still possible? If not, how do I get my dentures to stay in? Not even those nasty adhesives are working.

Marilyn

Dear Marilyn,

dental implant diagram

Technically, as long as you are in reasonably good health, you can get dental implants. Though, in cases like yours, an extra step will be needed. As you can see from the image above, your dental implant will need to be surrounded by bone in order to stay in place. This bone is also what holds your teeth in place as well, along with some ligaments. After this length of time with dentures, you are missing that bone.

You’re Dealing with Facial Collapse

When your teeth were removed 30 something years ago, your body immediately began resorbing the minerals in your jawbone to use elsewhere. It does this in an effort to be efficient with your body’s resources. It knows you don’t have teeth anymore and assumes that you won’t need the bones in your jawbone to hold them. True. However, your dentures rest on the ridgeline of your jawbone. As that shrinks, there is less and less of a ridge to hold your dentures in place.

After ten years in dentures, you likely noticed them starting to slip. By thirty years, it is almost impossible to keep them in. This is known as facial collapse. You’ve probably also noticed your jawline shrinking,, which makes you look much older than you really are.

There is a procedure to help with this– Bone grafting. You can have either natural or synthetic bone built back up in the area so that you’ll have enough bone there to integrate with your dental implants and keep them in place.

Implant Overdentures

implant-overdentures
Implant Supported Dentures

Once the bone grafting is complete, then you will be able to get the dental implants you hope for. You won’t want to do a one-to-one replacement for your teeth. That is way too expensive. Instead, you’ll get implant overdentures. With these, you’ll have four to six dental implants placed in each arch and then have a new set of dentures anchored to them.

Your dentures will be completely secure and will protect you from facial collapse in the future.

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

Diabetes and Dental Implants

I have type 1 diabetes and need to replace a tooth. I was hoping to get a dental implant. Is that possible for me or is my condiation a contra-indication?

Aubrey

Dear Aubrey,

Diabetes is not a contraindication for dental implants, but you do need to be aware that it is a risk factor. A significant one. You will need careful diagnostics ahead of time. Don’t skimp on them. Make sure you get a CT scan.

You will also want a dentist who has done a LOT of dental implants successfully. Ask how many dental implant procedures they’ve done and what their percentage of successful cases is. It shouldn’t be less than 98%.

Ideally, the dentist will do the surgery and the placement. However, if they refer you to an oral surgeon, make certain your dentist makes the decisions about the placement and there is close coordination between the two of them.

Cosmetic Considerations

You did not mention where the implant was being placed. If it is on a visible part of your smile, you will want to think long term. If you are considering teeth whitening, you will want to do it before you get the porcelain crown that will go on the implant.

This is because, while the color of the crown can be made any color, the color is permanent. If you whiten later, your natural teeth will brighten, but the crown will remain the same color. If you want it to match your teeth, you will have to replace it. Getting the whitening done ahead of time means you will save money.

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