Tag Archives: Dental Bridge

Dental Implants

Should I Switch Dentists in the Middle of My Implant Procedure?

I was getting a crown replaced and also needed to get a tooth replaced. My dentist suggested that I get a dental implant after some bone grafting to fill in the missing bone structure.  I agreed. We went ahead with the procedure. Once the bone grafting was done, he provided me with a Maryland Bridge for a temporary tooth replacement. The problem I am having is that he cannot keep the Maryland Bridge on my tooth. I was told it would last for several months while the surgery site healed. But, in three weeks the bridge has come off four times. This was done by an implant dentist. A friend suggested that I might need to see a different dentist because this isn’t usual. Should I switch dentists? The only thing I’ve actually paid for is the bone grafting and Maryland Bridge.

Romy

Dear Romy,

Maryland Bridge diagram

Now, I have not examined you and do not know the qualifications of the dentist doing your work, but I will admit that I have concerns. Implant dentistry is a very advanced procedure and there are countless dental implant horror stories where things went very wrong for the patient.

My concerns are two-fold. First, he gave you a Maryland Bridge for a “temporary” tooth replacement.  These would not be a good choice. In order to properly bond them, there will need to be some structural changes to the adjacent teeth. A notch, like the one pictured above, is required on the adjacent teeth in order to keep the bridge secure. Once the bridge is removed, that notch in your tooth has to be filled in with something like a composite filling. That’s not temporary.

Second, he can’t keep the Maryland Bridge secure. This gives me serious doubts about his technical skills and understanding of the procedures. If he doesn’t get something as basic as a bridge, I’m a bit concerned what would go wrong with something as serious as a dental implant.

It is perfectly fine to switch dentists even in the middle of the procedure. Your current dentist is ethically obligated to provide you and your new dentist with all his diagnostics and notes. Just make sure that whoever you go to in order to finish your procedure has post doctoral training in placing dental implants. You’ll also want to ask them what their success rate is.

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Dental Implants

Dentist Only Gave Her One Option, Which Is Unethical

I had a couple of accidents when I was in elementary school I had a couple of accidents that damaged my front tooth. Over the years it has turned an ugly brown. I want to get it fixed but my dentist said I’d need a dental implant to do that because there is not enough root to do anything else. The problem is this isn’t the only dental work that I need. I’m not sure I can get the crowns I need on my molars and fix my ugly tooth. Are there any other options for me?

Abigail

Dear Abigail,

dental implant diagram

First let’s talk about your root resorption. The accidents you had in elementary school damaged the nerve and blood supply on your tooth. That causes the tissue inside the tooth to die, which leads to an infection. A root canal treatment given at that time would have had a chance at saving the root. However that is not guaranteed. It only ups the chances.

While a dental implant is the best tooth replacement, it is also the most expensive. The good news is that it is not the only treatment option available to you. Your dentist is ethically obligated to give you all of your options. The fact that he didn’t makes me wonder about his motives. This may not be the best dentist for you.

Some of your other options include:

I would get a second opinion to discuss which of these will work best for you. I will say a dental bridge suspends a false tooth between two dental crowns. This option makes sense if you already needed a crown on one of the adjacent teeth, allowing you to deal with two issues at the same time. The dental flipper, while the least expensive option, is really designed to be a temporary option while you wait on or save up for the more permanent option.

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Dental Implants

Implant Bridge Does Not Match My Bite

I had a dental implant bridge placed, but it does not match up with the rest of my bite. Now the side of my teeth with the dental bridge hits first when I bite down, which hurts a LOT. I am wondering if the surgeon did something wrong. He insisted that he was in charge of the whole thing, but when I went to see an implant dentist after my surgery and he said that he would have recommended a different placement. I don’t know what to do here.

Kate

Dear Kate,

implant bridge
An example of a full arch implant bridge

I am glad that you wrote. It sounds like the surgeon threw off your bite with improper placement of the dental implants. This needs to be fixed. If it does not get fixed, it could very likely lead to TMJ Disorder.

It is a basic principle of implant dentistry that it is the restorative dentist who plans the placement, not the surgeon. Yet, your oral surgeon assured you he was in charge. If you can get your dentist to admit that the oral surgeon placed them in the wrong place then you can get a refund from him. I would also ask him to pay for the bone grafting you are now going to need.

Replacing dental implants is not as simple as taking out dental implants and then putting in new ones. When the implants are removed, they will take bone with them. That bone is necessary in order to retain the dental implants. Because of that, you will need a bone grafting procedure to build back up the lost bone.

Then, once the bone grafting is healed, you will be able to have the new implants placed for your implant bridge. Just make certain that your dentist plans the treatment and NOT the surgeon.

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

Dental Implant Failure Disaster

I had to get a dental implant because of a serious infected tooth. I had a crown but there was another infection, so the dentist said it had to be pulled.  He suggested I get a dental implant. When he gave me the Novocain for the tooth extraction, it felt like the needle went into my brain. Ever since then, I’ve had a burning in my mouth that is driving me crazy. I complained about it on every check up appointment for my dental implants, but he kept saying it was normal and would go away after a few weeks. Then, it came time to place the dental crown on the dental implant. He had trouble getting it on and had to press it super hard. It hurt like mad the entire time. While I was at that appointment, I told him the burning was still happening. He said it was Thrush, which seemed like an excuse to me. He did give me an antibiotic but that didn’t seem to help.

Then, a couple of months later, I was on vacation and the crown just fell off. I went to see a dentist there who told me that the implant was infected and needed to be removed. Now, I’m stuck with no tooth. I don’t think I want to go through everything with a dental implant, so am thinking of getting a dental bridge. Is there a way I can get the dentist to refund me for the failed implant?

Carl

Dear Carl,

illustration of a dental implant

I am sorry this has happened to you. What a disaster! The burning in your mouth that you’re feeling is burning mouth syndrome. It is obvious to both of us that you did not have thrush. He just used that as an excuse. The common denominator  for people with this condition is a traumatic dental appointment, which you certainly had.

As to whether you can get a refund, you can always ask. If the dentist has integrity he will want to do the right thing about a failed implant. I suspect he will not give you the refund. In that case, you have limited options. You could take him to court, but you’d have to prove that he was at fault. It would be helpful to have another dentist on your side for this. I think the failed dental crown is more easily provable.

I have some doubts about the infection because you didn’t mention anything about pain or a fever. Those usually follow an infection.

If you don’t want to start over with a dental implant, a dental bridge is your best second option. I still think an implant is possible, but you’d want to do it with a different dentist.

Given that you’ve had some traumatic dental appointments, I want to suggest  that you see a sedation dentist. This will give you a pain-free/anxiety-free dental appointment.

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

Dental Implants

Deformed and Missing Teeth

I have a problem with both of my lateral incisors on my upper teeth. One of them is completely missing and never came in. The other is smaller than it should be. I want to fix this before I go to college. I have a dental flipper for the missing tooth area currently, but my parents were told that the flipper should be temporary. They both passed my senior year of high school. I stayed with some friends until graduation. I was going to use their life insurance for college, but I received a great scholarship so now I am free to use the money to fix my teeth. Do you have any suggestions?

Caroline

Dear Caroline,

illustration of a dental implant

I had so many emotions reading through your question. First, I want to express my condolences at the loss of your parents while you are yet so young. Next, I want to say congratulations on your scholarship. That is absolutely fantastic, especially given all the difficulties which you experienced during your senior year. That says a lot about your perseverance.

As to your tooth, I am going to suggest that you replace the congenitally missing tooth with a dental implant. This is the most secure tooth replacement we have. It is expensive and does require surgery, but as young as you are, it will be important in order to preserve the bone structure. You may even need some bone grafting done before the implant is placed. There are other options, such as a dental bridge, but the implant is the best option.

As for the other tooth, I am going on the assumption that it is a deformed tooth and not a baby tooth still left in place. On that assumption, you will want to use either a porcelain veneer or a porcelain crown depending on how small the incisor is.

The trick with both of these procedure will be matching the color of the implant and other restoration to the natural teeth that are adjacent to them. These are very visible teeth, which means light hits them exposing all their variations.

You will need an expert cosmetic dentist to get this done right.

Best of luck to you at university. I have a feeling you are going to accomplish great things. This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Dental Implants

Dental Implant Failure…again

I went to my dentist for dental implants. He’s done quite a bit of them for other people so I felt fairly confident. When he went in for the first surgery, he ended up not giving me the dental implant because he said there was not enough bone structure to retain it. He suggested we do bone grafting. I agreed to that and had that procedure done. Two surgeries down. No implant. After had time to heal, we went in for the dental implant surgery again. Yet again, he said there is still not enough bone and he suggests now that I just get a dental bridge. Here’s what I want to know, is it still possible for me to get a dental implant? Did he do anything wrong?

Kevin

Dear Kevin,

diagram of a dental implant next to a natural tooth

I am sorry you’ve had this experience. You must be very frustrated. I have some good news for you. It is very likely you can still get the dental implant. You will just have to do it with a different dentist. You asked me if your dentist did anything wrong. That’s hard to say. I am curious what type of diagnostics he did ahead of time to determine if there was enough bone structure, but other than that, it seems like he was genuinely trying his best to give you a good outcome.

Truthfully, one thing to be grateful for about your dentist is his integrity and desire to add to his skill set. Not all dentists are even interested in learning about bone grafting let alone try and do it. Plus, when he attempted to give you a dental implant the second time, after you did the procedure he suggested, and there was still not enough bone, he was probably horribly embarrassed.

Some dentists, with less integrity, would have just placed the dental implant knowing it would fail in a few years. Instead of trying to make himself not look bad, he told you the truth, looking out for your best interest rather than his. To me, that says this dentist is a keeper. So, even after you go somewhere else to get your dental implant, I would still use this dentist for all of your other care.

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

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

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.

Emergency Dentist

She Shouldn’t Trust This Dentist

I am going to be honest and up front with you that I am not the best dental patient. Being in the dental chair makes me nervous in the best of circumstances so I tend to avoid dental work as much as possible. This is likely why this happened to me. I was in a lot of pain for about a week and finally caved to see a dentist. He did some x-rays and found a problem with a tooth that already had a filling. He told me there is very little chance that he can save the tooth and I should expect him to have to extract the tooth. From there, he wants to provide a dental implant. I’ll be honest that this whole thing sort of terrifies me. Is there another option?

Kelly

Dear Kelly,

A woman grabbing her jaw in pain, in need of emergency dental care

Please bear in mind that I haven’t examined your tooth so I can only go on what you’ve described. However, based on what you’ve said, I have my doubts about this dentist’s diagnosis.

If a tooth was truly that far gone, I don’t think your dentist would have even needed to take an x-ray. The decay would have been evident to the naked eye.

Even if it was under the filling, that extensive amount of an infection means the filling would have caved in or fallen out at that point.

Another issue is that type of dental infection takes a LONG time to develop. You would have been in a significant amount of pain for substantially longer than a week.

Before moving forward, I would like you to get a second opinion from another dentist. It could save you some unnecessary dental work. I do realize the idea of seeing another dentist probably doesn’t sound much better to you, but I believe I have a solution to that as well.

Your fears of the dentist are not at all uncommon. There are many people who struggle with fear of the dentist. Those who visit a dentist who offers some type of sedation tend to have an easier go of things.

When you get your second opinion, I’d like you to not tell the dentist what your first diagnosis was. Just allow him to look at your tooth and form his own opinion.

If Your Tooth Cannot Be Saved

Hopefully, your tooth is saveable. However, if it isn’t, the one thing I agree with the dentist you saw was his choice of tooth replacement. If you do have to replace a tooth, dental implants are the absolute best replacement. This surgically implants a prosthetic tooth root then attaches a crown to it. It is the closest thing to having a healthy natural tooth again.

Another option is a dental bridge. This suspends a false tooth between two dental crowns. It doesn’t require surgery. However, it does mean you have to crown the two adjacent teeth. Unless those teeth already need a crown then I don’t recommend grinding down healthy tooth structure.

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

Maryland Bridge

A maryland bridge between two crowns

I have two dental crowns that are on top of dental implants. I am now losing the tooth between them. Is it possible to have a Maryland Bridge placed there and attach it to porcelain crowns?

Kay

Dear Kay,

Diagram of a Maryland Bridge
A Maryland Bridge

While technically the answer would be “Yes, you can place a Maryland Bridge between two porcelain crowns.” it is not easy. Ideally, you would want to bond the wings of the bridge to tooth enamel, which would give you your strongest bond. Bonding to porcelain crowns is tricky, Very few dentists even know how to do that and it may not hold up.

Hopefully, your dentist had foresight. Realizing you had two dental implants with a tooth between them, he or she should have thought about what to do if the middle tooth needed to be replaced.

Planning ahead, you would place the implants in a way that the abutments are parallel to one another. Then, instead of cemented crowns, you would use screw-retained crowns. That way, when the middle tooth needs to be replaced, your dentist would simply unscrew the two crowns and replace them with a single dental bridge.

If your dentist didn’t plan ahead for that, you always have the option of having a third dental implant placed there.

Whatever you decide, it is going to take a dentist with advanced skills, so choose who does your procedure carefully.

This blog is brought to you by Lafayette Dentist Dr. Mike Malone.