Tag Archives: Dental Implants

Emergency Dentist

My husband Just Broke Off Two of His Teeth

My husband took quite a fall and broke his two front teeth. It appears the roots are still intact. We went to see an emergency dentist and he told us just to have the teeth extracted. Is there any way to save his teeth?

Brenda

Dear Brenda,

A hockey player smiling with a knocked out tooth

I am sorry about your husband’s accident. While it is possible to save these teeth with root canal treatments and dental crowns, there is not a guarantee. It is a bit tricky. A lot will depend on how much of the tooth is broken off, what condition the roots are in, and the comfort level of the dentist.

You may have some difficulty finding a dentist willing to do the procedure. Now that dental implants have grown in popularity and reliability, even fewer dentist will be willing than might have been twenty years ago. It’s easier just to replace them.

Here are some things to be aware of if you do find a dentist willing to try that will increase the chances of a succesful outcome. Whatever dentist you end up going to for this will need to bear in mind that the rotational forces are working against him or her.

Front teeth are rounded and the posts are as well. This does not bring much resistance to the rotational forces. You can increase your chances of the post working loose by putting two posts into the root, which minimizes the complication.

A second issue is that the post can crack at the root. Some dentists think using a rigid post will help this. However, with a front tooth, there are tipping forces to consider. Because of that, they would need to use a flexible post on the front teeth. Two I’d recommend are carbon fiber or fiberglass.

If it turns out that these teeth cannot be saved, don’t despair. He doesn’t have to look like the hockey player pictured above. Dental implants really are the closest thing to having healthy, natural teeth in his mouth again. I highly recommend them. Just make sure he goes to a dentist with post-doctoral training in dental implants.

Try to save these teeth first and then go from there.

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

Dentures

Can I Get Gold Teeth on Dentures?

I’m only 49 but I’m about to get dentures. I’m tired of these teeth hurting me, I’m ready to be rid of them! I’ve never had dentures before, so I’m kind of excited at the thought of looking good. I was wondering though, do they ever make them with gold-outlined teeth on the front? I just want the upper front two done. I love how that looks but I haven’t seen anyone with that in their dentures yet. So I didn’t know if it was something I could even have done.

Sasha

Dear Sasha,

Dentures

I’m glad you wrote. The short answer is yes, you can have gold teeth set in your new denture. There are a number of variations, from full gold crowns to small amounts that hardly show at all. It will be important that you are very specific with your dentist regarding exactly what your expectations are. The safest option would be to bring in a photo of what you want the teeth to look like to avoid any miscommunication.

As you might guess, adding gold to the denture teeth adds extra expense and your fee will be higher than that of a typical denture. This fee will vary according to the amount of teeth involved and the gold required to cover them.

Understanding Dentures

Before and after facial collapse
Before and After Facial Collapse

I know your teeth are killing you and you are ready to be rid of them, but I want to make sure you understand what you are getting into with dentures. Even the best-fitting dentures will reduce your chewing capacity by 50%.

However, the bigger issue is bone resorption. When your teeth are removed your body recognizes that and immediately begins to resorb the minerals in your body in order to use your resources most effectively. While great stewardship for our body’s resources, it will have the unfortunate effect of shrinking your jawbone. After ten or so years, you will not have enough jawbone left to retain your dentures. Plus, the loss of bone makes you look a couple of decades older than you are.

There is a Way to Prevent Facial Collapse

If you have dental implants placed then your body will interpret that as you still having tooth roots there which need the bone to keep them secure. This will prevent the bone loss from occuring. You can have implant supported dentures placed. This uses a minimum of four dental implants and then when the bone has had time to integrate with the implants a denture can be anchored to them. Not only does this prevent facial collapse, but it is completely secure. You will have no slipping or falling out. You can eat anything you want.

If you absolutely cannot save your teeth. This is what I’d recommend. Because of how young you are, completely removable dentures will be a disaster for you long term.

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

Invisalign

Help! I Look Like a Chipmunk!

Can you advise me? I’m looking for a second opinion. My two front teeth are long and stick out a bit from the rest of my teeth. I always feel like my teeth make me look like a chipmunk. My dentist is suggesting I extract them and get dental implants, but I want to make sure there is not another option before I go that route.

Avery

Dear Avery,

Invisalign aligners
Invisalign Aligner

Whatever you do, please do not have your teeth extracted. That is way too drastic a solution. I suspect your dentist said that because he doesn’t have any training or familiarity with cosmetic dentistry options for people in your place.

Bear in mind that I have not examined you. However, I do have some general advice. Though, I’d like you to see an expert cosmetic dentist and get his or her opinion. Look for someone who is AACD accredited.

One thing you can do is trim down the protruding teeth. This can be done with diamond burrs and diamond strips. A dentist skilled in this procedure can file them on the sides and bottom to make them match the remainder of your smile more appropriately.

The next step would be to move the front teeth back into place. You have a couple of options for this. The first is to get a retainer to move them back. The second would be to use Invisalign. That would be my suggestion.

If a lot of the tooth structure has to be removed in the trimming process, you may need porcelain veneers to cover the exposed dentin. The key to all this will be a great cosmetic dentist who looks at your specific case and makes recommendations. However, at least now you know you have good options and don’t have to remove your teeth and replace them with dental implants.

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

Invisalign

Will Invisalign Correct Misalignment?

I have some misaligned teeth but feel too old for traditional braces. I asked my dentist about Invisalign and he said it does not correct misaligned teeth. I sort of have my doubts and felt like he just wanted to refer me to an orthodontist friend of his. So, I thought I would double-check with you guys whether it would be possible for me to use Invisalign.

Karen

Dear Karen,

Invisalign aligners
Invisalign Aligner

It sounds to me like either your theory is correct or possibly your dentist is just not open to new treatment options. As such, he may be completely unaware of what Invisalign is capable of.

My suggestion is that you get a second opinion from a dentist who has experience with Invisalign and let them look at your case. When Invisalign first came out, many years ago, it was only able to do the more ideal cases. These days, however, they can fix all but the most complicated cases.

If your dentist isn’t willing to keep up with the latest technologies in his field, he may not be the best dentist for you. You want the top treatment possible. Let’s say you lose a tooth and need to replace it. Will your dentist only offer removable partial dentures or does he know about dental implants, which give you a permanent, secure tooth?

I’m not telling you to switch dentists. However, I would advise you to take a good look at what your dentist offers and see if he is keeping up in his field.

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

Emergency Dentist

Surgeon Won’t Take OUt Both My Teeth

I am very frustrated. I had a root canal treatment that I think has failed and the tooth needs to be removed. Near that, I have an impacted wisdom tooth that my dentist says is infected and he thinks needs to be removed. I am fine with that, but he refuses to remove the tooth on which I had the root canal treatment. Shouldn’t I be the one to decide that? I’m refusing the procedure because I do not want to do them separately and I am certain the other needs to be removed. What do you recommend I say to convince him to do both teeth?

Linda

Dear Linda,

I want you to be very careful here. An infected tooth is nothing to mess around with. It appears your dentist feels very strongly that this wisdom tooth IS, in fact, infected. If you think about how close your jaw is to your throat (which could swell up and close), heart, and brain, you definitely do not want this infection to spread. This is one of the reasons we consider tooth infection a dental emergency.

So, if your dentist is trying to get you to remove one tooth, why not two? He’d certainly make more money if he did. The only reason I can think of is that your dentist does not believe the tooth with the root canal treatment is infected and he has too much integrity to take your money on a tooth that is saveable.

I am sure if you searched you would find a dentist willing to remove both. While you do not have to replace an extracted wisdom tooth. The other tooth will need to be replaced. This will give the dentist even more money, especially if you choose to get the best tooth replacement option, a dental implant.

If you choose not to replace it, the other adjacent teeth will either shift or tip into the tooth’s empty space. This will throw your bite off and can lead to painful TMJ Disorder.

The fact that your dentist is not wanting to remove this tooth and gain all this extra money tells me your tooth is healthy and you have a dentist of great integrity. I’d stick with him.

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

Invisalign

Invisalign and Missing Teeth

If I have a missing tooth and want to replace it, but have a crooked tooth too, how do I fix that? I was thinking of replacing the lost tooth with a dental implant and straightening my teeth with Invisalign. If so, would I do Invisalign before or after? If I have to do it after does Invisalign work with missing teeth or do I replace my teeth with something else?

Theodora

Dear Theodora,

Invisalign aligner

You have picked two wonderful procedures. Nice work! Dental implants will be a great tooth replacement and Invisalign has one of the highest patient satisfaction rates of any dental procedure.

Between the two, you will want to straighten the teeth before replacing the tooth.

Invisalign does a great job of working around missing teeth. It uses a sophisticated software program to design the ideal treatment plan for you.

Aside from being comfortable, allowing you to straighten your teeth invisibly, and working in a fraction of the time of traditional braces, the aligners can also double as teeth whitening trays. This means you can straighten and whiten your teeth at the same time, giving you a mini smile makeover at a fraction of the cost.

Then, once all your teeth are in place it will be time to get your dental implant. You will want to go to a dentist who has post-doctoral training in placing dental implants. It is not something taught in dental school.

When you are done, you will have a beautiful straight smile.

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

Pediatric Dentist

Adult Teeth Behind Baby Teeth

Can you help me? I am 16 years old. I’m with a new foster family who wants to help me with my dental care and we’re trying to figure out what to do. I asked my foster mom if I could research. She agreed so I thought I’d start here. I have both baby teeth and adult teeth but my adult teeth all came in behind my baby teeth. It’s been like this for a long time and it is very embarrassing. Is there a good way to fix this?

Celia

Dear Celia,

Young woman smiling

I am glad to hear you have a foster mom that is being proactive with your oral health care. I’m sorry you had to wait this long for it to happen. Had you been under the care of a good pediatric dentist this would not have happened to you. The good news is all of this is repairable.

The first thing they’ll want to do is extract all of your baby teeth. I know you had no control over this, but for the sake of parents out there reading this, I want to discuss what to do when you have adult teeth ready to erupt when the baby teeth are not coming loose.

The best thing to do in that case is to simply extract them, as I am suggesting to you. However, sometimes you have retained baby teeth when there is no adult tooth to come in. This is called a cogenitally missing tooth. In that case, there is a different plan of attack.

In that case, there are two scenarios. If it a molar or premolar. It is helpful to maintain those as long as possible and then when they finally fall out, you can replace them with a dental implant.

If they are not molars, we usually will extract the baby teeth and separate them with orthodontics in order to make the appropriate space. Then, depending on your age, you can replace it with a dental flipper (which is removable and inexpensive). Then, when your jaw is fully developed replace those with a dental implant as well.

Once Your Baby Teeth are Extracted

Now, back to your case. Once you have your baby teeth removed you will want to straighten the adult teeth. You sound like a very responsible young woman. With teens like yourself, I tend to recommend Invisalign teen. It can straighten your teeth comfortably and invisibly. It is removable so it requires patient compliance. I don’t think that will be a problem for you.

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

Emergency Dentist

Root Canal FAilure

I’m a bit worried about something. I had a root canal treatment done about 3 years ago. About a month ago it started hurting. My dentist did a retreatment. A week later the pain increased quite a bit. I called him and he prescribed an antibiotic. It started to feel a bit better but now it is worse again. I called his office again and he said to give it time, some people take longer to heal than others. I am in tremendous pain. Is he right about this? If so, how much is a reasonable amount of time to give it?

Nicole

Dear Nicole,

Something isn’t right with how your dentist is handling this. It appeared like you said that your pain went down and then started back up. This is a clear signal you still have an infected tooth.

Though root canal treatments are successful about 95% of the time, when it does fail, the chances of a re-treatment being successful go down with each successive try.

That doesn’t mean it isn’t worth trying. It is always better to save a tooth whenever possible. I would consider your situation a dental emergency. This infection will continue to spread. Dental infections can turn life-threatening because they are so close to your heart, brain, and lungs.

Because of the severity of your situation, I am going to suggest that you call a prosthodontist. These are root canal experts. Explain the situation when you call. They will likely try to get you in right away. If they can’t, make sure they call in a new, different antibiotic for you.

If it turns out the prosthodontist tells you the tooth can’t be saved, then extraction will be the only option. When that happens, you will need replace the tooth. Ideally, you’d get a dental implant for that as it will help preserve the underlying bone structure.

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

Invisalign

Dealing with Congenitally Missing Lateral Incisors

My daughter never received one of her adult lateral incisors. When the baby one fell out, our dentist said not to worry about it because the adjacent teeth would shift to fill in the spot. While they did, it left a bit of a gap, which leaves my daughter feeling embarrassed by her smile. This is her senior year and I’d like her to be able to go off to college feeling good about her smile. I spoke to another dentist and they recommended we open up the space and then place a dental implant there. I don’t think she’d be too keen with a mouth full of braces during her senior year of high school. Is there another option?

Laurie

Dear Laurie,

a smile with missing lateral incisors
A smile with canine teeth where the lateral incisors would normally be.

The above image shows a smile with missing lateral incisors. In the place of them are her canine teeth. As you can see, the smile doesn’t look normal. Instead, it is almost vampiric. Your daughter’s smile would look even stranger with one canine tooth. The advice her childhood dentist gave you was horribly bad.

The second dentist’s advice is sound. Your daughter has other choices aside from a full mouth of metal. Her first option is Six-Month Smiles which will allow her to fix her front teeth quickly. A second option is for her to get Invisalign. These use clear aligners instead of wires and brackets. Most responsible teenagers do very well with these. Then, when that is ready, a dental implant will be a fantastic idea.

What Her Original Dentist Should Have Done

Ideally, when her baby tooth came out and there was no adult lateral incisor, her dentist should have provided her with a dental flipper. This would have held the spot open so when she was old enough you could have just placed the dental implant. Now, because of his bad advice, you are having to add orthodontics to the mix.

I say this as a cautionary measure to others reading this post in two ways. First, in giving them the correct way to handle this situation. Second, in knowing that anytime you have a major dental decision to make, there is never any harm in getting a second opinion before moving forward.

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

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.