Tag Archives: tooth replacements

Dental Implants

Trying to Get Answers About Beautiful Restorative Work

I am having a hard time finding the right information just by looking online on the internet so I am hoping you can help me sort through some things. I need a bunch of restorative work including ten dental implants on my upper arch and five on my lower. I’m not as worried about what my lower arch will look like, but I do want my upper arch to look natural. Here are some of my questions.

1. Which brand of implants is best?

2. Would I be better off with zirconium of porcelain crowns?

3. I had one dentist tell me that white colored metal fused to porcelain, or gold fused to porcelain, will not show a black line, Is this true?

4. Are zirconium abutments for my implants, more aesthetically pleasing than all white abutments?

Kevin

Dear Kevin,

Implant overdentures illustation

I can tell you are working hard to do your research and you have some great questions. I’d like to steer your questions in a slightly different direction. All of your questions are about the materials. What you should be asking, if you are looking for great aesthetic work, is whether the dentist has the post-doctoral training and accuracy to provide you with solid, yet beautiful work.

If you wanted to commission a beautiful portrait of your family, you probably would not be asking about which type of canvas or paint brushes should be used, but rather who would be the best artist to do the work. It is the same with cosmetic dentistry.

First, I would look for someone with post-doctoral training in dental implants. It won’t matter how beautiful they are if they don’t end up failing. After you have narrowed down some implant dentists, I would then look for their cosmetic qualifications. Have they done post-doctoral training in cosmetic work. Smile makeovers and other types of cosmetic work are not taught in dental school. Have you looked at their smile gallery to see if they produce beautiful work? Even better, do they have someone on staff that is AACD accredited?

These are the questions you need to look into. I will correct one piece of bad advice you were given. Any dental crown that is fused to metal will eventually show that black line. Additionally, it will end up looking more opaque because of the metal base that needs to be covered.

I hope this helps you.
This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Dental Implants

Cancer Patients Losing Teeth

I have had a long year and a half of cancer treatments. My teeth are an absolute wreck as a result. I have several teeth needing crowns and two that are so bad they need to come out. I did brush during my treatments. Though, I threw up a lot so that might be why my teeth are so bad. I heard that vomiting can cause problems for teeth. My problem now is what to do about it. I’m on a break from treatments but need to replace these teeth and I’d like to see if I can prevent this from happening further. Do you have any advice for someone in my position?

Sarah

Dear Sarah,

I am so sorry for what you are going through at the moment. I know cancer survivors and they are a tough group of people. The treatments are as hard on your body as the disease itself. Don’t be too hard on yourself about your teeth. If you underwent any radiation, that is likely a strong culprit in the deterioration of your teeth.

diagram of a dental implant next to a natural tooth

First, let’s talk about replacing the teeth you lost and then we can give you some ideas about how to prevent this during the next round of treatments. The best tooth replacement is a dental implant. It will be the closest thing to having a healthy, natural tooth in your mouth again. I would actually wait until your treatments are done because it requires a prosthetic tooth root to be surgically implanted. You want to wait until you are feeling your best for that. In the meantime, I’d get a dental flipper. It will give you a temporary tooth replacement until you are ready for the implant itself.

Caring for Your Teeth During Cancer Treatment

One thing I would recommend is that you ask your dentist for a Fluoride prescription. This will help you keep your teeth as healthy as possible during treatment. A second thing to do is deal with any vomiting situation immediately. It is the acid from the situation that eats away at your teeth. The best thing for you to do is rinse out your mouth immediately after in order to neutralize any acid.

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

Dental Implants

Is My Husband Reacting to His Dental Implants?

I am quite sensitive to smells and I’m wondering if my husband is having a reaction to his dental implants. His mouth and breath smell awful. He’s had the implants placed and his dentist has given him temporary, acrylic dentures. Eventually, he’ll have porcelain dentures. However, I’m wondering if we need to switch his dental implants before that happens. His dentist gave him the metal implants. I’m wondering if he is reacting to the metal and that is what is causing the horrible odor I keep smelling. I mentioned to his dentist the possibility of switching him to the zirconia implants but he acted like that was a ridiculous idea. Is it?

Kaitlyn,

Dear Kaitlyn,

Metal and Zirconia Dental Implants

I wouldn’t say you were being ridiculous. It sounds to me more like you are trying to make sure your husband is okay. Even if he doesn’t think that the dental implants are an issue, he should have been more respectful of your care and concern for your husband. I am sorry you were treated that way.

That being said, your husband’s metal implants are made from titanium, which is not only one of the most biocompatible materials around, it is also inert. The inert part will tell you the metal doesn’t really have a smell. The biocompatible part means it is highly unlikely he is having any type of reaction to it. It would be foolish for me to say that no one is allergic to titanium. Each person’s body is unique. However, I would look at more common issues first.

The first thing I would check is to see if food or other debris is getting caught in his temporary dentures. This is fairly common and can cause a putrid odor. Using something like a WaterPik, will clean things out. A second possibility is an infection. However, that almost always has other symptoms such as pain or fever. You did not mention either of those.

Switching Dental Implants

Without an extremely good reason that cannot be solved any other way, I do not recommend switching his dental implants. I am not opposed to zirconia implants. They do a fine job. The problem is what would be involved in switching them out.

First, he would need his implants removed. This takes bone structure with it. Because of that, he will no longer have enough bone to retain the new dental implants you want to place. Now, your husband needs a bone grafting procedure done to provide him with the missing structure. Once that has healed, he is onto another surgery to place his new implants. If that is succesful, he will be back to where he is now.

Each of those additional procedures has a risk of failure. If he has successful implants. Keep them.

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

Dental Implants

Temporary Tooth Replacement before Dental Implants

My daughter has a congenitally missing tooth. Our plan is to replace it with a dental implant once her jaw is completely developed. In the meantime, we have done orthodontics and have the space opened up. Our dentist provided a Maryland Bridge for the temporary tooth replacement as we wait for her jaw to grow, The problem we are having is the bridge keeps falling out. She used the ceramic wings. At first, she thought she’d just need to try a different cement, but that didn’t help. Now she’s thinking that maybe metal wings will stay better. My only concern about that is the metal will look darker and affect the appearance of her teeth. Is there something we are overlooking?

Lacey

Dear Lacey,

I can tell you are a good mother and are doing everything in your power to give your daughter the best care possible. Your choice of a dental implant is a great one and will serve your daughter well.

One of the things you are running up against here is your dentist, though I am sure she has good intentions, does not understand how a Maryland Bridge works.

First, you should know these are not meant to be temporary tooth replacements. In order to get these to stay on your teeth properly, there actually needs some tooth preparation on the adjacent teeth, as seen in this image below.

Maryland Bridge Tooth Prep

A small notch needs to be added to the tooth to help keep the bridge in place. My guess is your dentist is just trying to keep these on with the bonding alone, which will not work.

Switching to metal wings, won’t be a great solution either. It is actually easier to bond porcelain to natural tooth structure than it is to bond metal. So by switching, she is actually making it more difficult for the Maryland Bridge to stay on.

What Makes a Good Temporary Tooth Replacement?

The reason I do not consider the Maryland Bridge a temporary tooth replacement is because of the necessary tooth preparation. The structures of the prepared teeth are not permanently damaged. Once you remove the bridge to place her dental implant, those notches will still be there and y ou will need to fill the are with some composite bonding.

Demtal flipper

Instead, I am going to recommend you get your daughter a dental flipper. Because these are much less expensive, not only will you save a lot of money over a Maryland Bridge, but they will do no damage to her teeth, so it is a safer option as well.

My suggestion is you ask for a refund on the Maryland Bridge and get a dental flipper instead.

When it is time for your daughter to get her dental implant, make certain you research the dentist carefully. This is an advanced procedure that requires post-doctoral training. There are many dental implant horror stories that would have been avoidable if the patient knew to check the dentist’s implant training.

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

Dental Implants

Dental Implants for Hockey players

Help! My son is a recent professional hockey player. He recently had a tooth knocked out. We’d done some research and read that dental implants are the best replacement. However, his teammates who have been in hockey longer have told him that implants aren’t a good idea. But, we don’t want to leave the space open because he’s getting married in a little over eight months. Do you have any suggestions?

Karlee

Dear Karlee,

I’m glad you wrote. What his teammates are trying to prevent is secondary injury. When you get a dental implant, a root is surgically placed into the bone of his jaw. Then, after a time of integration with the bone, there is a dental crown bonded to the root implant. Here’s the problem with that for your son.

If he has another puck or hockey stick to the mouth, which is likely in his sport, because of the bonding of the crown and implant, it will likely damage the bone in his jaw, requiring serious reconstructive surgery to fix. However, that doesn’t mean your son has to go without a tooth until the end of his career, and certainly not for his wedding.

Here is my suggestion. When a tooth root is missing in a jaw, your body begins resorbing the minerals from the bone in the area. This will lead to serious problems, so you don’t want to leave the area of the tooth root empty. Because of that, go ahead and get the implant surgery done. This will place the root form into his jaw and protect him from bone resorption. However, do NOT have the dental crown bonded.

Instead, he can use a temporary tooth replacement that is removable, such as a dental flipper. It will give him a tooth for the open space, but if his mouth is hit again, it will give without any consequences to your son’s jaw.

Once he is no longer playing hockey, then he can have the dental crown permanently bonded onto his dental implant giving him a secure tooth.

Best of luck to both of you and congrats on the upcoming wedding.

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

Dental Implants

Zirconia or Titanium Implants

I have three titanium dental implants and recently read that the titanium can cause neurological ill effects. I am now in need of another dental implant. Should I get the zirconia kind this time? Are they better? Should I switch out the titanium ones as well?

Carolyn

Dear Carolyn,

zirconia dental implants

I’m not sure where you read that titanium causes neurological effects. As far as I know, there are no studies with data that supports that. On the contrary, there are decades of data that show titanium to be highly biocompatible in dental implants as well as a large number of other titanium prosthetics, such as knee and hip replacements.

If you want to get a zirconia dental implant, for your new tooth replacement that is fine. You may need to do a bit of internet searching and phone calls to find a dentist who does them. Because they’re considered new, not all dentists are using them yet. You will be able to find someone though. Zirconia is definitely strong enough to work and more dentists are starting to use them. The only concern you may run up against is we don’t have the same data on their longevity the way we do their titanium counterparts. That doesn’t mean they won’t last as long, just that we don’t have the data.

As to whether or not you should switch out your current implants, I wouldn’t recommend it without a good reason to remove them. It is not simply a matter of taking out the old implants and then putting in new ones. When you remove the implants, bone will come with it. In order to place the new dental implants, you will need to have an additional procedure known as bone grafting done. Then, once that has had time to heal, you can then have the new implant placement surgery.

It’s a lot to go through and a huge expense when your dental implants are probably just fine. Plus, there is always a risk the new implants will fail. I’m sure you will find a dentist willing to do the procedure. I just want to make sure you understand what you’re getting into before moving forward.

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

Invisalign

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.

Uncategorized

Can an Adult Tooth Be Saved Once it’s Knocked-Out?

At my son’s football game one of the young men had a tooth knocked out. He just tossed it aside and kept playing. I’ve been wondering about that ever since. Could the tooth have been saved? Are there steps that need to be taken?

Arlene

Dear Arlene,

hockey player missing a tooth
How to Save an Adult Tooth

It’s good that you’re asking about this ahead of time because there is very little time to actually save a tooth during the trauma of the event. At max, you have 30 minutes. If a series of unfortunate events take place which causes an adult tooth to get knocked out here are the steps to take:

  • Grab the tooth by the crown only. That’s the visible part of your tooth when you smile. DO NOT touch the roots.
  • The tooth needs to stay moist. If milk is available, place the tooth in a cup of milk.
  • Call your dentist’s office and let them know you have a knocked out tooth and are on your way in. They’ll know time is of the essence and will be ready for you when you arrive.
  • It’s also a good idea to keep a short list of emergency dentist numbers on hand who see non-established patients, even after hours, in case you can’t reach your dentist.

What to Do if the Dentist Can’t Save the Tooth?

Sometimes you and the dentist can do everything right, but the tooth cannot be saved. In that case, you’ll want to know about your tooth replacement options.

Fortunately, the advances in dentistry have been useful. Your best option, if you’re a good candidate is to get dental implants. Depending on the age of your son, he may not be a good candidate. Teenager’s jaws are still developing.

If that’s the case, your dentist will go over temporary options for him that will give him a false tooth and hold the space available for implants in the future. Make sure he knows you son is in a contact sport so he takes that into consideration with any temporary replacement.

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