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Should I get my remaining teeth pulled and get dentures?

I want your opinion on getting my final two upper teeth pulled and getting dentures now. I have been wearing partial dentures for years. And they are so uncomfortable. My partial dentures are old, and it is time to either replace them or pull my front teeth and get dentures. My front teeth are healthy, and I have seen two dentists who are not helpful with my decision. They tell me it is my choice. I understand that. I have read many websites that say it is best to keep your natural teeth, but I only have two. What is healthiest for me? Thank you. Gerald B. from Kentucky

Gerald,

Thank you for your inquiry. We cannot give you an accurate diagnosis unless Dr. Goebel examines your teeth and reviews your x-rays. Although we will not advise you, we will provide you with dental principles to consider.

Saving Natural Teeth

Usually, it is best to save natural teeth. Except for dental implants, tooth replacement options have several disadvantages compared to natural teeth:

  • Do not function as well
  • Are not as comfortable
  • Do not stimulate the jawbone

Exceptions to Saving Natural Teeth

When few healthy natural teeth remain, functions like biting and chewing put excessive stress on the teeth. When most of your upper teeth are missing, and the remaining teeth are chewing against your

Full Upper Denture vs. Partial Dentures

Suction from the roof of your mouth keeps a complete upper denture in place. It is more comfortable than partial dentures and stays in place better than a lower denture, which rests you’re your gums and relies on gravity and your cheek muscles to remain in place.

Bone Loss from Missing Teeth

Tooth roots stimulate the jawbone, so when your teeth are missing, your body takes the minerals from the bone and uses them elsewhere. And with 10 to 20 years, your jawbone shrinks significantly, causing facial sagging.

  • Lower denture – It will be challenging to keep a lower denture in place on the bony ridge of your shrunken jawbone.
  • Upper denture – Your body only saves the bone in the area where you still have teeth. But even with significant bone loss, suction from the root of your mouth will continue to help keep an upper denture in place. When you chew with a well-made upper denture, the force from your bottom teeth against the upper denture is gentler than chewing with two natural teeth.

Treatment Options

Implant overdenture - snap-on denture with the denture hovering above the implants
A snap-on denture is an implant overdenture with just two implants

Although Dr. Goebel has completed your oral exam and checked your x-rays, below are two treatment options that can give you the healthiest results:

  • Complete removable dentures – Your dentist can extract your few remaining upper teeth and fit you for a removable upper denture. It will look, function, and feel better than partial dentures. It will also improve your ability to chew.
  • Implant overdenture – An implant-supported full or partial denture is the most expensive option. But dental implants, embedded in your jawbone would support your denture. If you have significant jawbone shrinkage, grafting may be required to anchor the implants.

Either option will be healthy for your lower teeth and prevent extreme stress on upper natural teeth. If either dentist you saw offers dental implants, check the bios on their website to see if they have post-graduate training in implantology. If not, we encourage you to find a skilled implant dentist, schedule a consultation, and discuss your options.

 

Dr. Thomas J. Goebel, a family dentist in Moline, IL, sponsors this post. Dr. Goebel works closely with an oral surgeon or periodontist for implant surgery.

New crown fell off 4 times, and my dentist charged me for it

My dentist removed a large silver filling from a top left molar and put a crown over the tooth. My temporary crown came off three times within the almost three weeks that I wore it. Of course, my dentist reattached it each time. I received the permanent crown in mid-January, and I have returned to the dentist four times to bond it back on.

The color of the crown is off too, but my dentist said that it would cost $385 to correct it. I decided not to argue with him about the color. But I wonder if he is treating me fairly. Isn’t he responsible for the crown color?

Two weeks ago, the crown came off, and my dentist said he would order a new crown. The lady in the billing department said they would try to return the crown as defective so that I will not be charged for it. I politely but firmly told her that I am not paying for a crown that does not fit and is the wrong color.

Last Thursday was my appointment for a new crown, my dentist drilled on the tooth and said he was reshaping it, inserting posts, and making new molds, so there was no new crown for that appointment, and I have to wait. When I was checking out, the billing rep told me that I owed money because my insurance would not cover the crown. The cost is $385, which my dentist initially said he would charge to correct the crown color.

I paid for the crown with a credit card because I hope there is a way to cancel the whole thing and get my money back. They tricked me, and I feel that I allowed it to happen. But I have no plans to return to the dentist. Can I stop this process and somehow get a refund? – Micah from Indiana

 

Micah,

What an experience you’ve had with your dentist! It’s among the worst we have heard this year. Your dentist’s policy to charge you so that he can correct his mistakes is unethical.

When Your Dental Crown Is the Wrong Color

If your dental crown is the wrong color, your dentist has not met his or her service agreement. You expect a crown that fits well, is in harmony with your bite, and matches your natural teeth. And it is your right as a consumer to receive what you paid for. It is the same with any major purchase. If you bought a new refrigerator with an ice maker, you expect all components to work. If the ice maker is defective, the seller will not charge you an extra fee for a new refrigerator with an ice maker that works. Please do not settle on faulty dental work.

When Your Dental Crown Keeps Falling Off

When your dental crown keeps falling off, either your dentist prepared it so aggressively that it will not stay on, or your dentist did not build up the tooth enough to retain the crown. It seems that your dentist used posts to help stabilize your crown and build up the tooth with composite. If your dentist cannot secure your crown, it is time to get a second opinion.

How to Deal with a Dishonest Dentist

Same-day crown CAD/CAM computer with scanner
CAD/CAM same-day crown technology helps restore molar teeth quickly

If your dentist is dishonest and you already paid for the service, there are several things you can do:

  • Reverse credit card payment – If you paid with a credit card, contact your credit card company and ask if they can reverse the charge.
  • Find another dentist – Look for a cosmetic dentist. Although cosmetic dentistry is not a specialist, look at dentist’s websites and check their bio for post-graduate training in cosmetic dentistry. Your new cosmetic dentist might be willing to help you get a refund if you did not pay by credit card.
  • If your dentist does not refund you – Explain to your dentist that you agreed to a crown that fits well and matches your tooth. It is the standard of care that every dentist must meet. Also, tell your dentist that you are ready to report the issue to the state dental board. And complain to your dental insurance company and let them know your dentist is overcharging and submitting claims to them. You can also feel free to submit negative online reviews on your dentist’s Yelp, Google My Business, or Facebook pages.

 

We hope your dentist will cooperate and that you can quickly find a cosmetic dentist who restores your teeth with crowns that fit well and match your natural teeth. You may find a dentist with in-office, CAD/CAM technology to restore your teeth in one visit.

Best wishes.

 

Timothy J. Goebel, DDS, a cosmetic dentist in Moline, IL, sponsors this post.

Her porcelain veneers keep falling off, but are they really veneers?

Last December, my dentist ground down my upper front teeth for porcelain veneers. Although I’ve had this dentist since 2008, I regret trusting him for the work. And after researching online, he probably should not have recommended veneers for the issues with my teeth. Two teeth had slight chips, and one tooth was shorter than the other. I also wanted whiter teeth.

After my dentist reduced my teeth to stumps, I wore temporary veneers for almost three weeks. Then he bonded on the permanent veneers. In less than a month, a veneer popped off. My dentist is so kind that he asked me to come into the office the same day that I called, and he bonded the veneer on again. But again, in less than a month, another veneer popped off. My dentist says that he doesn’t know why the veneers are coming off. He asked me if I wear my night guard every night because grinding my teeth could be weakening the veneers. Of course, I wear my night guard, and I don’t believe that this issue is my fault. I noticed that when I slide my tongue across the backside of some of the veneers, I feel a ledge on them. Those veneers seem to come off more frequently.

Two weeks ago, a dental assistant called from my dentist’s office and said that my dentist wants me to come in so he can try something else to keep my veneers on. It sounds like he is guessing about the problem. I can tell that another veneer is loose and will come off soon, but I am nervous about returning to my dentist. Although he is kind, I know that kindness cannot correct this issue. Before I agreed to veneers, he told me that veneers would last 15 to 20 years, but if I must return to the dental office every month for the next 20 years, it is not worth it.

Why can’t my dentist figure out why the veneers are popping off? Will another dentist eventually need to remove them and give me crowns instead? Thank you. Tanya from Springfield, MO

 

Tanya,

Thank you for asking us about your cosmetic dentistry nightmare. We are sorry to hear about the anxiety and frustration your dentist is causing. Although Dr. Goebel would have needed to examine your teeth before your dentist ground them down, it is possible that teeth whitening and composite bonding would have revived your smile.

Based on your description, your dentist might be liable for malpractice. We have several concerns.

You Received Porcelain Crowns, Not Veneers

Unfortunately, some dentists tell their patients that they are receiving porcelain veneers, but the dentist gives them crowns instead. If your dentist ground your teeth down to stumps, that form of tooth preparation says that you received porcelain crowns—not veneers. Please consider these facts:

  • A dentist removes only a half-millimeter or less of tooth enamel to prepare teeth for porcelain veneers, but your teeth are now stumps.
  • Porcelain veneers are bonded to the front of your teeth only, and they will not adhere to teeth that a dentist reduces to stumps.
  • You will not feel a ledge on the backside of a veneer, because the back of it is bonded to your tooth.
  • You may feel a ledge on a dental crown’s backside if there is a problem with it.

Unfortunately, the facts show that you received dental crowns, but they are problematic because they keep popping off.

Why Do Porcelain Veneers and Crowns Keep Coming Off?

The tip of dental forceps are holding a porcelain veneer next to a lateral incisor tooth
A porcelain veneer requires minimal preparation to bond to the front of a tooth

Porcelain veneers and crowns can come off due to over-preparation and incorrect bonding techniques.

  • Over-preparation for veneers – Only a fraction of a millimeter of tooth enamel must be removed to ensure veneers fit well on the tooth and at the gumline. Too much preparation causes loose veneers that fall off.
  • Over-preparation for crowns – Although your teeth must be shaved on all sides for a crown to fit over it, aggressive preparation results in a short, stubby tooth. And the crown is left with minimal tooth structure to adhere to (retention form), so it will loosen and come off.
  • Bonding techniques – A dentist must apply enough bonding material for a secure attachment and remove any excess bonding material between your tooth and the restoration. And the composite bonding must be cured properly for porcelain veneers.

When Your Dentist Did the Wrong Dental Treatment

If your dentist does the wrong dental treatment, they are responsible for correcting it or compensating you to have another dentist fix it. You agreed to porcelain veneers, but your dentist gave you crowns. The results from your crowns make it clear that your dentist does not have the skill to do either veneers or crowns.

  • Proper restoration – We believe that your dentist is responsible for paying to have your teeth restored correctly by an advanced cosmetic dentist who knows what they are doing.
  • Future problems – Your dentist should also be willing to compensate you for issues you can experience in the future from excessive tooth preparation.

How to Get a Refund from Your Dentist

You can get a refund from your dentist by explaining that you did not receive the agreed-upon cosmetic treatment. If your dentist resists, you can inform him that you will report the issue to the state dental board. And follow through.

But first, we recommend that you find a dentist with advanced cosmetic dentistry training and experience. You can schedule consultations with two dentists to examine your teeth and discuss your options. After you select a cosmetic dentist, you can talk to your current dentist and ask for compensation. And your new cosmetic dentist may be willing to provide documentation and help you request a refund.

Dentists have malpractice insurance, so hopefully, your current dentist will agree to pay for your dental care. If you need to hire an attorney, the judge or arbitrator will likely grant you a substantial award.

Unfortunately, your dentist prepared your teeth so aggressively that you will still need dental crowns. Porcelain veneers will not stay on teeth that a dentist ground down to tiny stumps. But a skilled cosmetic dentist can recreate your smile with dental crowns and make it look beautiful and natural.

Best wishes.

Dr. Thomas J. Goebel, a cosmetic dentist in Moline, IL, sponsors this post.