Tag Archives: Dental Bridge

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.

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.

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.

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.

dental bridge or implant

I have to replace two teeth and get a dental crown on another one. I’m trying to decide between dental implants and a dental bridge. What do you think would best work?

Kevin

Dear Kevin,

Both a dental implant and a dental bridge are good tooth replacement options. Which one you get will depend on a couple of things. First, I’ll go over how both of them work. Then, we’ll discuss which to choose.

An illustration of a dental implant among natural teeth
A Dental Implant

With dental implants, a prosthetic tooth root is surgically placed into your jaw. There is a time of healing after the surgery and to allow the bone to integrate around the implant. After that time period, a dental crown will be placed on it

There are benefits to dental implants. They’re completely secure and the closest thing to having a healthy, natural tooth in your mouth again. Additionally, the root form signals to your brain the jawbone in that area is still necessary, thereby preserving it.

Illustration of a dental bridge
Dental Bridge

With a dental bridge, a false tooth is suspended between two crowns. This is secured by being bonded onto the adjacent teeth. It makes more sense when one of the adjacent teeth already needs a crown. Without that, you’re just grinding down healthy tooth structure.

Implant or Bridge?

If you need a false tooth next to the tooth which needs to be crowned, then it would be a good idea to get the bridge. If the tooth which needs a crown is elsewhere, I’d get the dental implants to replace the tooth and then get the single tooth crowned.

I hope this helps. This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

lumineers trouble

I had Lumineers placed on both my top and bottom teeth. The top ones did absolutely fine. It’s the bottom ones I am having trouble with. They’re in massive pain and I’ve already lost one tooth when a root canal didn’t help. My dentist is going to put on a bridge free of charge. He doesn’t know why there is so much pain. He’s trying to help but I’m living on pain killers right now. I don’t want this to be the rest of my life, especially knowing how addictive they are. Can you help? Have you heard of this happening before?

Margie

Dear Margie,

There are a couple of things going on here. First, Lumineers are often advertised to inexperienced cosmetic dentists as being easy to place. That gets many well-intentioned dentists in over their heads.

A lot of this is because the Lumineers’ company promotes them as being no prep. Sometimes that can work out well on top teeth, though not always. Many patients complain about them being bulky. The bottom teeth, however, are a completely different story.

Second, when you’re talking about a no-prep technique, the teeth are about two millimeters longer as well as sticking out a tad. On bottom teeth, this can throw your teeth out of their proper occlusion and cause lots of pain for you.

That is likely what is going on in your case.

Cosmetic Work on Bottom Teeth

When it comes to smile makeovers, unless there is something which needs to change structurally with your bottom teeth, we’ll put porcelain veneers on the top teeth, but only whiten the bottom arch. Though, there are times veneers make sense. In those cases, however, tooth prep is necessary.

It does sound like your dentist is trying to take responsibility and make things right for you. That’s a sign you have an ethical dentist who just happened to do a procedure he wasn’t ready for. Don’t be too hard on him. We all start somewhere with procedures that are new to us. It’s a good sign that he’s stretching himself and adding to his field of knowledge.

Make sure you are out of pain before the bridge is placed. If he’s having trouble with that, you can suggest he talks to an expert cosmetic dentist, who’s studied occlusion as well. I’d look for an AACD accredited dentist in that case. Feel free to show him this post.

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

Dental bridge before implant?

I’m a little concerned about what my dentist is recommending for a missing tooth on my 15-year-old daughter. We’re planning on getting her a dental implant when her jaw is developed enough for one. I was looking at some temporary replacements. I thought a flipper would be a good option, but my dentist wants to give her a dental bridge. I think that’s a bad idea, but he said flippers are too temporary. What do you think?

Mandy

Dear Mandy,

woman smiling with a dentist
It’s always okay to get a second opinion from another dentist

I’m glad you wrote about this. While a dental bridge is a more secure fit, I don’t think it is a good fit for a teen aged girl. There are two reasons for this.

First, just like her jaw is still developing for her dental implant, she will need new bridges. That is too expensive to keep replacing as she grows.

Even though the flippers are meant to be temporary, you can replace those in a much more affordable way than the bridge.

There is another reason too which has nothing to do with cost. A dental bridge requires her adjacent teeth to be crowned in order to support and suspend the false tooth. That will mean those teeth will always have to be crowned for the remainder of her life.

If those teeth are healthy, you won’t want to grind down the healthy structure.

It’s Okay to Get a Second Opinion from Another Dentist

A good dentist will give you all of your options. Even then, they will make a recommendation. if you don’t like their recommendation and they’re pressuring you to go with their option, I recommend getting a second opinion.

If your dentist refuses to do the treatment you want you can go to another dentist for that procedure. That means you could get your daughter a dental flipper elsewhere. You don’t have to switch dentists to do that, unless you want to.

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

Help! My Front Tooth is Loose

I am terrified. I discovered my front tooth is loose. I don’t remember hitting it and I don’t think the other teeth are loose. Can a dentist fix this? What if it can’t be fixed? Do they make dentures for one tooth? Help me!

Samantha

Dear Samantha,

A woman with a gorgeous smile created by cosmetic dentist Dr. Mike Malone
A gorgeous smile created by cosmetic dentist Dr. Mike Malone

First, I want you to take a deep breath. You will not end up with a space where a front tooth should be for the rest of your life. The first thing you need to do is schedule an emergency appointment with your dentist. If the tooth is loose, regardless of the cause, it needs to be splinted to keep it secure.

Next, your dentist will need to determine why it’s loose. Do you have gum disease? Was there trauma? He’ll want to do some x-rays to see if the pulp was damaged. If so, you’ll need a root canal treatment.

Dental Solutions for a Missing Tooth

If you do end up losing this tooth, which would surprise me if this is the first sign of a problem and you don’t remember any trauma, there are solutions. We’ll go over each of them, from the least desirable (and least expensive) to the highest quality replacement, which is also more pricey.

Removable Partial DentureYes, there are “dentures” for a single tooth. It’s called a removable partial denture. It connects onto your other, healthy teeth, with a false tooth attached. It does put pressure on the teeth it hooks to so it’s not the ideal solution, but depending on your budget, you might use it as a temporary solution while you save up for one of the more preferable treatments.

Illustration of a dental bridgeThe next best solution is a dental bridge. This suspends a false tooth between two dental crowns. In reality, this makes more sense if your adjacent teeth (which will receive the crowns) need work anyway. In that case, it’s like knocking out two problems with one. However, if they don’t need work, I wouldn’t want to remove any healthy tooth structure.

Dental Implant DiagramThe top of the line replacement is to get a dental implant. It’s like having a healthy, natural tooth back. If your budget allows, this would be the treatment I’d choose. A prosthetic root is implanted where the natural root was, then a porcelain crown is placed on top. You can eat, brush, and floss just like you normally would. They’re very strong and last for many years.

Getting a Beautiful, Natural-Looking Tooth

You’re talking about replacing a front tooth, so you want to be certain the dentist is also a skilled cosmetic dentist. Whatever crown he creates for your front tooth needs to look just like the adjacent tooth. Above all else, make sure they give you an all-porcelain crown and not a porcelain-fused-to-metal crown.

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

Do I Get a Dental Implant or a Dental Bridge?

I lost a tooth. It’s my own fault. I waited too long to deal with it and now I have to replace it. My dentist is suggesting a dental implant, but I’m not too keen on the idea of surgery. Would a dental bridge do something close?

Kevin C.

Dear Kevin,

It depends on how close you’re wanting to get. Both a dental implant and a dental bridge are acceptable tooth replacement options. Both are permanent and secure. There are important differences though. I’ll explain both options. Then, you can discuss with your dentist what fits your situation best. His job isn’t to pressure you into an option, but rather to give you your options and a recommendation. The final decision is yours.

Dental Implants

Dental Implant DiagramYou already knew that a dental implant required surgery. The diagram on the left shows why.

As you can see, the implant is placed directly into your jawbone. The benefits to this are it’s like having your own natural tooth back, it preserves your jawbone, and no other teeth need to lose tooth structure for its placement.

Dental Bridge

Illustration of a dental bridgeA dental bridge is also permanent however, in order to bond them, it requires grinding down the adjacent teeth. Additionally, if part of it breaks the whole unit will have to be redone. They also do nothing to preserve the bone underneath.

When Does a Dental Bridge Make More Sense?

While it may sound like I’m suggesting dental implants are the better option, there is a time when a dental bridge makes more sense. For instance, if the adjacent teeth need to be crowned anyway then it’s like getting two procedures in one. Then, you’re not grinding healthy tooth structure.

The key is good communication with your dentist. He or she knows your teeth. If finances are a consideration as well, many dentists will let you pay out a procedure like dental implants which are a little more costly than simple procedures like a filling.

Who Should Do Your Tooth Restorations?

When you’re looking at replacing teeth, it’s important you choose the right dentist. The especially important when the tooth is in a visible part of your smile. You want it to look natural and beautiful. Not every dentist can pull that off.

Look for a dentist who’s accredited with the American Academy of Cosmetic Dentistry (AACD). These are the top cosmetic dentists in the country. One other thing to consider. Once your implant crown or dental bridge is made, the color cannot be changed. If you want a whiter smile, be sure to have your teeth whitened before your tooth replacement procedure is done. That way your restoration will match your bright white smile.

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

Could CEREC Crown Have Saved My Tooth?

I needed a root canal treatment and dental crown. I wanted to do a CEREC crown, but my dentist doesn’t have the machine. I considered going elsewhere, but felt guilty about going to another dentist. So, I thought the traditional crown would have to suffice. After he made the temporary, I had to go out of town for work. While I was gone, the temporary crown broke. I called my dentist and he said it would be fine, though to try and eat on the other side of my mouth. I was super careful. When I got back, I immediately went to the dentist but he told me that a crown would no longer work. First, the crown would no longer fit and we’d have to start over. But, that part of my tooth broke and the rest was brittle, so he’d have to do an extraction. Is this really my only option? Now what? I’m over $2000 into this crown which I can’t even have and now I’m losing the tooth. Should I have gone to a CEREC dentist?

Minnie W.

Dear Minnie,

A tooth receiving a CEREC crown

There are some things that bother me about what you’re saying. I’d like you to get a second opinion to see if your tooth can be saved. Preferably to a dentist who does provide CEREC crowns. Some dentists will even do free second opinions. While certainly, a CEREC crown would have saved your tooth, because it would have been protected from day one, there’s more at issue here.

If he’d have suggested you see an emergency dentist when your temporary broke, this would also have protected your tooth. It would also have allowed your permanent crown to fit. When you leave the space empty, it doesn’t always take very long for your teeth to shift leading to the crown not fitting properly. This was your dentist’s fault.

Something else which bothers me is how quickly the tooth became brittle. That’s uncommon.

If You Can’t Get a CEREC Crown and Lose the Tooth, What then?

If it turns out you can’t save the tooth, I’d first ask for a full refund from your first dentist. Then it’s time to decide on a tooth replacement. The two best options are dental implants or a dental bridge. A dental bridge would make more sense if either of the adjacent teeth need to be crowned.

If they don’t, then a dental implant would be a better option. It’s a great tooth replacement, but you don’t want just any dentist to do it. It’s an advanced procedure. Be sure to ask the dentist how many they’ve done and what their success rate is? It needs to be at least 98%.

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