Tag Archives: tooth replacement options

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

Can a Maryland Bridge Attach to a Dental Implant

I have two dental implants that had a natural tooth between them. Now that natural tooth needs to be removed and my dentist is recommending a Maryland Bridge. Is it possible to attach a Maryland bridge to the dental implants? I was concerned about attaching the metal to the porcelain. Have you seen this successful?

Charlie

Dear Charlie,

Illustration of a Maryland Bridge

The short answer is yes, it is possible to bond a Maryland Bridge to a dental crown. That being said, it is tricky. The ideal bond is metal against enamel, not metal against porcelain.

It would have been better if your dentist had anticipated that when you have two dental implants on either side of a natural tooth it is very likely that the tooth will eventually need to be replaced. With that foresight, he could have placed the abutments parallel to one another so that you could have changed two screw-retained crowns to a dental bridge with little trouble.

As it is unlikely that your dentist planned ahead, I would suggest your best option will be to place a third dental implant in between the two others, if there is room.

If not, then you can try the Maryland Bridge, but it will take some preparation of the crowns to make it work.

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

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.

Dental Implants

Should I Keep My Last Two Teeth?

I am about to have another tooth extracted. This will leave me with only my two front teeth on my upper arch. They are fairly healthy and should last a good while. Most of my lower teeth are still there. I am wearing a partial denture right now to accommodate the upper partial. It’s really uncomfortable and makes it difficult to talk. Because I can eat everything but meat with it, I rarely put it on, unless I am going somewhere to socialize. Some people are telling me that I would probably be happier with a complete upper denture instead of my partial. There aren’t really people I know who have been in this situation where I can ask them if they thought removing those last two teeth was worth it. Have you an opinion on this issue? I’m kind of torn and having a hard time making my mind up. It’s not like I can change my mind after extracting those last two teeth.

Brent

Dear Brent,

Implant Overdentures

I am going to start with a tiny disclaimer that I can only give you general principles here. I don’t have your x-rays and haven’t examined you, so I am strictly going off the information you have provided me with.

In almost all cases it is better to preserve as many natural teeth as possible. That being said, your situation is unique. Yes, those two front teeth are healthy, but they are all you are eating with most of the time and the stresses on them will be tremendous. I don’t think they will last as long as you are hoping. In your case, I am going to suggest that you remove those last two upper teeth and replace the entire arch.

Tooth Replacement Options

The ideal would be for you to replace those teeth with implant overdentures. That would mean getting four to six dental implants and then anchoring a complete dentures to them. It is the most secure replacement possible. The only real downside to them is their expense.

Facial Collapse

The effects of facial collapse.

If these were your bottom teeth, I would tell you to do everything possible to ensure you get the implant supported dentures. This is because when your teeth are removed, your body immediately begins to resorb the minerals in your jawbone to redistribute them elsewhere in your body. With your bottom teeth, this is devastating. Not only does it age your appearance by decades, but your bottom denture simply rests upon your jawbone for its base. After ten or so years, you will not have enough bone left to retain your dentures. This is known as facial collapse.

Because you are dealing with your upper teeth, you are at a slight advantage. These are h eld in by suction and not your jawbone, so you will have more security and retention. Getting complete dentures in this case will be okay if you cannot afford the implant overdentures.

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

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.

Dental Implants

Metal Allergies & Dental Implants

I need to replace a tooth and hope to get a dental implant. However, I do have some metal allergies and I don’t know if that will complicate anything. So far, they know I am allergic to nickel, mercury, and cobalt. Will this prevent me from getting the implant?

Dennis

Dear Dennis,

dental implants

You made a great choice in your desire to get a dental implant. They are the best replacement options for your teeth. In general, as long as you are in good general health, you should be able to get a dental implant.

None of the metals you listed are part of dental implants. Instead, these are made of titanium, which is quite biocompatible. Titanium has been used in prosthetics for decades with great success, including hip replacements.

In truth, you should have no problem with using traditional implants. If you are still nervous because of your allergies, you have two other options.

First, you can have an allergy test specifically to test for titanium. This will give you some peace of mind going into the procedure. A second option is to have zirconia implants placed. These are metal-free. They are newer and do not have much data as to their longevity, but there is nothing to indicate they won’t last as long as their titanium implants.

Where you may run into some difficulty with the second option is finding a dentist who works with them. That is mostly because they are new and dentists tend to work with what they’re used to and comfortable with. But, I’m sure if you called around, you’d be able to get someone.

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

Lafayette LA Dentist

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.

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