Tag Archives: Dental Implants

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.

Dental Bridge

a Maryland bridge is not a temporary tooth replacement

My daughter had a gymnastics accident which damaged a tooth. Three failed root canal treatments later and we need to extract the tooth. My plan is to eventually replace the tooth with a dental implant when she is old enough. In the meantime, we need a temporary replacement. My dentist suggested a Maryland Bridge. I just wondered what you’d think about that. I asked about a partial flipper, but he said she’d lose them because they’re removable and this will bond to her teeth in the back.

Patricia

Dear Patricia,

First, I want to say your choice of doing a dental implant for her permanent replacement is a fantastic idea. It will serve her very well. I’m glad you realize she will have to wait until her jaw is fully developed. Some parents mistakenly think they can get a dental implant right away, while their child is still a teenager.

dental flipper
Dental Flipper

As for a temporary replacement, your idea is better than your dentist’s suggestion. While a dental flipper is removable and, yes, there is always a chance that your daughter will lose her flipper. In all honesty, though, you could replace several of them for the price of one Maryland Bridge.

With a traditional dental bridge, a false tooth is suspended between two crowns. That requires grinding down the two adjacent teeth, which is definitely not something you’d want to do to healthy tooth structure.

While a Maryland Bridge does not require damaging the adjacent teeth, it is not the temporary tooth replacement your dentist is saying it is.

tooth preparation for a Maryland Brdige
Tooth preparation for a Maryland Bridge

While the Maryland Bridge has two metal “wings” which will bond to the back of the adjacent tooth, without cutting a little groove in the tooth for it to hook into, the bonding is not going to stay. Whenever you are doing any removal of tooth structure, that is not a temporary replacement.

Go with your original idea and get a dental flipper for your daughter.

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

Invisalign

Fixing long teeth

My two front teeth are insanely long. They also stick out a bit from the rest of my teeth. I feel like a beaver and hate all of my pictures. I’m trying to find a cosmetic solution but can’t find one. Do you think the only solution is for me to have my front teeth removed and have dental implants placed? I’m desperate.

Lucy

Dear Lucy,

Invisalign aligner
Invisalign can straighten teeth without anyone knowing.

Please don’t remove your front teeth!! There are always solutions. I am going to make a suggestion, but want to preface it with the precaution that I haven’t examined you. This is a solution based on my understanding of your description.

Your front teeth can be trimmed by an expert cosmetic dentist using diamond burrs and diamond strips. They can be filed down on the sides to narrow them and on the biting surfaces to make them smaller.

Once they’re a size you’re pleased with, Invisalign can be used to align them properly. An added benefit of Invisalign is the aligners can double as teeth whitening trays. This lets you get a mini smile makeover.

Depending on how much structure has to be removed, you may need porcelain veneers to cover any exposed dentin.

You Need an Expert Cosmetic Dentist

None of my suggestions matter, though. You need to see an expert cosmetic dentist and let them tell you what is the best solution. They’ll give you a smile you’ll be proud to share.

The best cosmetic dentists in the country are accredited by the American Academy of Cosmetic Dentistry. These are the top cosmetic dentists in the country.

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

Lafayette LA Dentist

dental filling disaster

I had never had a cavity until I switched dentists. My insurance changed so we needed to go to a different practice. On my very first appointment, he said I had a cavity, which surprised me. I went ahead and had it filled. The filling caused continual pain even after he adjusted it. It got to the point where he said I’d adjust to it. I waited out the full year with my insurance than switched to one that allowed me to go back to my old dentist.

When I did, he said I likely didn’t even need the filling at all. He said there’d been a spot on my x-ray for years that hadn’t changed. He said he’d replace the filling to make it better. The pain was instantly better, but the filling was uneven I guess and food would get trapped in it.

He decided to adjust that because he said it would become an issue. Since he’s adjusted it I’ve had problems with a serious sensitivity to hot and cold. Now my dentist is talking about extracting the tooth. I don’t want that so I’m afraid to go back. Is there anything I can do?

Betty

Dear Betty,

A blonde woman hodling her left cheek and jaw in pain

It’s unusual for a dentist to fake diagnose a single filling. It’s not a financial gain for him or her. In all honesty, it is more of a hassle. So, I don’t think you were taken for a ride by the new dentist. I’m actually more concerned that your original dentist saw a spot on your x-ray for years and never even mentioned it.

The trouble I’m seeing here is you have two incompetent dentists working on your teeth. The dentist who did your filling couldn’t do it correctly and rather than repair it he said, “You’ll adjust”. That’s dental speak for, “I don’t know what to do.”

When a dental filling is done right, you don’t even notice it.

Then, when you went back to your original dentist, he couldn’t get the filling right either. Now he’s talking about extracting the tooth?! I don’t think so.

My guess is your insurance has a preferred provider list. They do that to keep the fees cheap. But, the better dentists won’t sign on to plans like that. So often (not always) preferred provider means less than adequate dentist.

I’m going to suggest you go to an out of network dentist who has good reviews. You need this fixed. Don’t let your dentist extract your tooth.

The last thing you need after all of this is another expensive procedure and, believe me, tooth replacements cost a pretty penny.

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

Lafayette LA Dentist

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.

Cosmetic Dentist

Cosmetic Dentistry Tourism Disaster

I had porcelain veneers placed on my top teeth and a dental implant and crown on my bottom arch. In the U.S. it would have cost me over $60,0000 but I was able to get it done overseas for around $11,000. At first, I was pleased as punch, but now I’m four months out and the veneers are falling off. I’ve been cutting up the food the way he showed me and not eating with my front teeth at all. In fact, the last one fell off while eating spaghetti. That’s hardly anything to stress about. Three of the veneers have fallen off. They’re all intact. Do I need to have these re-done or can another dentist put them back on?

Catrina

A single porcelain veneer being held up by a dental tool

So, here’s the thing. Those instructions your dentist gave you about eating are a huge red flag to me. There is absolutely no reason why you should have any restrictions at all on what or how you eat. When properly bonded on, porcelain veneers will allow you to eat anything.

This dentist doesn’t know proper bonding technique. That alone, makes me question the skill of the rest of his work. For health and safety reasons, I’d like you to get a second opinion on the dental implant and crown you had done. This is especially important about the implant. If an infection develops it can lead to serious consequences.

Regarding your fallen porcelain veneers. You mentioned they’re still intact. In that case, it is possible an expert cosmetic dentist could clean them up and get them bonded back on properly. However, this is beyond the skill of almost all cosmetic dentists. You will need someone in the top 2%.

Finding an Expert Cosmetic Dentist

Cosmetic dentistry isn’t really taught in dental school so you’ll need to look for someone who invested the time and training into doing it well. In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of dentists. You can find them listed on aacd.com. Just make sure they’re accredited. They will know the right procedure to help you with your porcelain veneers.

The cost to get them bonded back on properly shouldn’t be too bad, if they can be saved. If they can’t be, these dentists will give you a list of options and let you determine which way you want to go.

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