Tag Archives: Gum Disease

Dentist Said I Have to Get Dentures

I have dental insurance for the first time and just started going to the dentist. My teeth are pretty bad and some of them have started coming out. My dentist said I have advanced gum disease and will need to extract my teeth and get dentures. Is it at all possible that I could get dental implants instead?

Susan A.

Dear Susan,

Implant Overdentures
Implant Overdentures

You are in a tough position. At some point, dental implants will be possible, but you are going to have to get that periodontal (gum) disease under control first. That will be imperative. After that, I would make sure your dentist does adequate diagnostics. That would need to include a CT for two reasons. First, you want to make sure you have enough bone structure left to retain your dental implants. Second, dental implants are a 3D procedure and you need 3-Dimensional images in order to ensure proper placement.

If you don’t have enough bone structure, you will need to have a bone grafting procedure done first. Then, after a time of healing, it will be okay for you to go forward with your dental implants.

What you will want to get is called implant overdentures or implant supported dentures. With this, you will have between four to eight dental implants placed and then, after a period necessary for osseointegration (meaning bone integrating with the implants), have a denture anchored to them.

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

Invisalign Versus Smile Care Club

I’ve been wanting to straighten my teeth for some time. I’ve been looking at Invisalign and was pretty excited about it. I almost have enough money. Today, I received an advertisement for Smile Care Club. This is less money and I could get it right away. Are there big differences between the two? Is it worth it to wait for the Invisalign?

Callista

Dear Callista,

Smile Care Club is a do-it-yourself copy of Invisalign that was founded in 2013. They operate under the same concept as Invisalign, though they switch aligners every three weeks, where Invisalign switches every two.

For some people, this works fine, but when it doesn’t there can be rather serious consequences. Even starting out there is a danger. Before you get Invisalign, your dentist will give you a complete examination to make sure your teeth and gums are healthy enough to make it safely through the treatment. The biggest concern is gum disease. If your teeth are being shifted with orthodontics while you have gum disease, you risk them coming loose.

The only examination you get with Smile Care Club is done through photographs you send in. That is not adequate enough for the dentist to get a true sense of your oral health. Plus, there will be no x-rays which will be important as well.

There are other things to consider. The human body is unpredictable and that includes our teeth. Sometimes teeth need some aditional room to get into their proper position. If there is a lot of crowding then the dentist may remove a couple of back teeth. If there is minor crowding, then there would only need to be some mild shaving of the sides of your teeth. While they will send you to one of their dentists if that is necessary, I would not want someone doing that who is not really invested in my case. They could mess up the look of your smile quite a bit.

Bottom line: While for many this will work out fine and they can save some money, when things do not go well, there can be pretty serious consequences.

One thing I might recommend is you talk to your dentist about your desire. He may let you pay out your Invisalign and allow you to get started right away.

There is a hidden benefit too. Your dentist can provide you with some teeth whitening gel. Your aligners can double as whitening trays. This will allow you to straighten and whiten your teeth at the same time, giving you a mini smile makeover at a fraction of the cost.

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

Smile direct Club Safety

I’ve been wanting to straighten my teeth for years, but wasn’t able to invest the amount of money into it required. I’d run across Smile Direct Club on Facebook. They are significantly cheaper than Invisalign.I did wonder in the back of my mind whether they were too good to be true. Is it okay to use this? I was especially interested because we can’t go in to see a dentist at the moment for routine care because of COVID-19. This seems like a quick, easy way to get my teeth straightened while still social distancing.

Mercy

Dear Mercy,

Invisalign aligner
Invisalign aligner

Smile Direct Club advertises as a more affordable way to invisibly straightening people’s teeth by comparing themselves to Invisalign. While there are some similarities, the differences are the most striking. First, how they’re similar:

  • They use clear aligners
  • You switch your aligners out as your treatment progresses.

That’s about it.

The Shortcomings of Smile Direct Club

It’s the ways in which Invisalign is different that create my biggest concerns.

The Pre-Exam

With orthodontics under the care of a dentist, you get a thorough pre-exam. This is important. You need a dentist to look for things like decay, failing fillings, gum disease, and signs of TMJ Disorder. Ignoring these can have serious consequences. For instance, if you do orthotdontics with untreated gum diease, you could end up with you teeth coming loose.

With Smile Direct, there is no real exam, putting you and your teeth at risk.

The Impression

An accurate impression of your bite is essential for a proper treatment plan. It’s so imperative it’s done right that many dentists won’t even let their hygienists do it.

What you’ll get with Smile Direct is a do it yourself kit. If that impression isn’t free of imperfections, it will throw off your treatment.

The Treatment

Though many cases go as planned, not all of them do. Sometimes teeth don’t turn the way they should or you need more space opened up than originally planned. In that case, a dentist will need to carefully shave some of the sides to your teeth.

I honestly think you are safer waiting for COVID-19 to calm down. This will be the safest way to straighten your teeth.

An Added Benefit with Invisalign

In addition to being able to safely straighten your teeth, the Invisalign aligners can double as teeth whitening trays enabling you to straighten and whiten your teeth simultaneously. It’s like getting a mini smile makeover.

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

Popcorn Kernel Leads to open Heart surgery

Adam Martin in recovery. Photo courtesy of SWNS

I saw an article yesterday that emphasized how quickly things can turn dangerous with a dental issue. You can read the article in its entirety here, but I will sum it up.

Adam Martin, a 41-year-old man in the United Kingdom, had a popcorn kernel stuck in his tooth. He’d tried various ways to remove it with no success. Soon afterward, he started feeling sluggish. He thought is he was coming down with something. It quickly escalated and he took a trip to the hospital.

After some diagnostics they realized a tooth infection had quickly spread to his heart and ate away at his valves. He now required emergency open-heart surgery.

When Adam spoke to reporters, he said, “If I had gone to the dentist in the first place, none of this would have happened.”

Dental Infections Can Lead to Death

Your teeth and gums have direct and short pathways to your heart, lungs, and brain. Tooth infections and gum disease can cause serious problems, just as they did for Mr. Martin.

If you have tooth pain, it often means you have a tooth infection. It needs to be checked out as soon as possible. Most dentists reserve time for dental emergencies, such as an abscessed or broken tooth. You simply need to call your office and let them know what is going on.

Preventative Care Saves Money

I know dental care can sometimes seem expensive, but did you know NOT going actually costs you more money? Going to the dentist just twice a year prevents most cavities, especially if you are following up with good home care practices.

If you do happen to get a cavity, it is caught early. A small composite filling costs significantly less than letting it grow and needing a dental crown, which costs hundreds of dollars more. If you let it grow from there, you’re also talking about a root canal treatment or possibly even an extraction and dental implant. That is thousands of dollars more.

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

Is Orthly Equal to Invisalign?

I told a friend the other day that I wish I could afford Invisalign. I’ve spent a lifetime embarrassed about my teeth. She sent me this link to a company called Orthly. It looks like Invisalign, but it’s 70% cheaper. I just want to make sure it’s safe to do it and it’s similar to Invisalign.

Ellen

Dear Ellen,

Image top: A woman putting on her Invisalign aligners. Image bottom: a woman smiling with Invisalign on her teeth

It sounds like you have a friend who cares about you. It’s lovely to have friends like that. If you won’t hate me, I’m going to help you understand the differences taking you back to High School. Do you remember geometry class where you had similar triangles versus congruent triangles? As you recall, congruent triangles were completely equal to one another in both sides and angles. But, similar triangles were only that, similar but not equal. They had the same angles but not the same lengths.

That’s how I would describe Orthly to Invisalign. Similar but not equal. It will save you money. Unfortunately, it could also cost you some teeth.

The first thing you should know is it wasn’t founded by dentists or anyone with dental knowledge. The idea came to two students who wanted to get Invisalign but couldn’t afford it. Their company is very straightforward about that. They say, “Orthly does not practice dentistry nor do any employees in the company.” That alone wouldn’t make it dangerous. I’m sure they consulted with dentists and orthodontists as they followed through on their idea.

Where Does Orthly Fall Short of Invisalign?

The way Orthly saves money is by avoiding orthodontic appointments. You see a dentist a total of two times. They can request photos through the app, but that’s the extent of the “looking after” you get. You may think that’s no big deal, but here’s what worries me about that.

The reason dentists keep an eye on you throughout the treatment is to measure things like mobility, root absorption, periodontal disease, and oral hygiene. None of these can be tracked through a photo. If they don’t catch any one of these problems in time, it could lead to the patient losing their teeth.

Then you’re talking about a much greater expense then they’d have had if they’d done the best treatment to begin with. They’ll need to replace their teeth.

So, in your place, I’d weigh the benefits with the risks before you decide.

You could always talk to your dentist about your desire and ask if there’s a way he’d let you pay out “the real deal” in installments you can afford.

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

Can a General Dentist do Dental Implants?

I need to replace a tooth. Everyone says dental implants are the best replacement. Are there implant specialists or can a general dentist do them?

Max L. – Connecticut

Max,

First, I’ll say, yes, dental implants really are the top of the line tooth replacement. Be aware that not everyone is a candidate for dental implants. There are some conditions which are contra-indicative, like gum disease. Or, if you’re a smoker, you’ll be hard-pressed to find a good dentist willing to go forward with the procedure. If it turns out you’re not a candidate, there are other good options which we’ll discuss momentarily.

As to whether or not you need a dental implant specialist, that’s a yes and no. There isn’t actually a recognized specialty in implants, so any dentist who does them is a general dentist. However, it takes some additional training than what they get in dental school to be skilled in this procedure.

Dental Implants are an advanced procedure, with potentially severe complications if things go wrong. Because of that you’ll want to be bold in asking the dentist some blunt questions. Some things to ask are “What type of implant training have you had?” “How many implant procedures have you performed?” “What percentage of them are successful?”

So, what if you’re not a good candidate? Whatever dentist you go to should give you all your options. For instance, the next best procedure would likely be a dental bridge. In fact, if your adjacent teeth need a crown, a dental bridge might make more sense for you.

The important thing is you find a dentist you trust and then have them explain all the procedures you’re a candidate for.

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

Is there a way to floss between a bridge and the gum?

Is it necessary to floss under a bridge? I have read that these are tight-fitting against the gum to prevent food from getting trapped between the bridge and gum. I had gum disease over a year ago, had teeth extracted, and a bridge placed after everything was cleaned up. Now I am having problems with a swollen gum under the front bottom of the bridge. It’s swollen to the point of bleeding around the bridge even when the bottom lip is simply pulled back.

Thanks, Gary

Dear Gary,

Yes, it is necessary to floss under a dental bridge daily, even more so if you were previously treated for gum disease. Flossing daily will help in the prevention of further bone loss around the teeth. There could be two reasons why your gums are swollen and bleeding around your bridge. Due to the fact that you have not been flossing under it, there is a big possibility that your teeth anchoring your bridge are reinfected with gum disease and may need to be retreated. Another problem could be that your dental bridge was placed right after the teeth were extracted therefore the extraction site may have not had the proper time to heal which can cause a similar affect on the tissue under the bridge.

There are different types of bridge floss threaders available in the toothpaste isle at your local store to help you clean under your bridge. Ask your dental hygienist at your next cleaning appointment to show you how to floss properly around your bridge. We recommend you discuss this matter with your dentist to find the root of the problem with your bleeding gums.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

 

 

Do your gums grow back after quitting chewing tobacco?

I chewed tobacco for about 10 years and recently quit. I noticed that my gums had receded quite a bit. Will they grow back?

Thanks, Steve

Dear Steve,

It’s great that you were able to quit such an addicting habit that affects the entire mouth as well as your general health. Studies have shown that 10% to 30% of regular chew tobacco users have gum recession and develop some bone loss around the teeth. Besides gum recession other risk factors for tobacco use are sores in the mouth, oral cancer, tooth decay and sensitivity.

Unfortunately our gums do not grow back. Gum recession is usually permanent and difficult to repair. Stopping your tobacco use will prevent further gum recession; however you also have to make sure you have good dental hygiene by brushing and flossing daily as well as visiting your dentist every six months for your dental cleanings.

We advise you to address your gum recession concerns with your dentist who may recommend surgery of a more cosmetic or restorative nature to make your smile look more aesthetically pleasing.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist