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Alternatives to Dental Implants?

I had an accident that caused me to lose a tooth. I was hoping to get a dental implant for it, but my dentist said I wasn’t a candidate because it is a front tooth. I was disappointed but need to find a replacement for this tooth. What are my next best options?


Dear Corinne,

Diagram of dental implant components and a dental implant in the bone next to a natural tooth

I am sorry to hear about your accident. Given what you’ve said, My first suggestion is that you find another dentist. You can absolutely get a dental implant on a front tooth. My guess is your dentist does not do dental implants because he doesn’t have the training. It is a procedure that he would have needed to get post-doctoral training in. Rather than send you to a dentist that could do the procedure, he lied and said you were not a candidate. Not the best dentist for you.

I would like you to get a second opinion from someone else. In most cases, if you are in good general health, then you should be a fine candidate for dental implants. There are exceptions, of course, which is why I want you getting a second opinion.

If for some reason it turns out you are not a candidate for a dental implant, you do have other options. Your next best option is to get a dental bridge. Though, that does require the two adjacent teeth to have dental crowns placed on them. Your false tooth will be suspended between the two crowns. Like the dental implant, it is permanently placed.

I would not give up on the idea of the dental implant yet. Get that second opinion.

Whichever procedure you end up with, you may want to consider teeth whitening first, depending on how satisfied you are with the current color. Once your dental implant crown is made, the color is permanent and will not respond to whitening. If you have the bleaching done first, you can match your new crown to the color you’ll be proud to keep around.

This blog is brought to you by Moline Dentist Dr. Goebel.

Are Dental Implant Tax Deductable?

I’m scheduled for dental implant surgery tomorrow and it just occurred to me that it MIGHT be tax deductible. If so, is there anything I need to know or hoops I have to jump through? I’ve only got a day to figure this out.


Dear Jake,

Diagram of dental implant components and a dental implant in the bone next to a natural tooth

You’ve made a great choice on your tooth replacement. Dental implants are the closest thing to having a healthy, natural tooth in your mouth again. Your question is also perfect timing for the end of the year! To answer your question, yes, dental implants can be tax deductible under IRS Topic 502: Medical and Dental Expenses. However, as you would expect with the government, there are some catches.

7.5% of Your Gross Income is the Magic Number

It’s not a straight forward deduct the cost of this procedure type of thing. First, you will have to itemize each expense. Then, you can only deduct the cost of what goes above 7.5%. Let’s say your gross income is $50,000 to make this simple. That means the first $3,750 you have to cover without claiming it. Anything over that is deductible.

The good news is this does not apply to individual procedures. You can itemize all your medical and dental expenses. Then, anything over whatever your magic number is will be what is deductible. Be aware, that whatever your insurance covers cannot be applied to the cost.

Consider an HSA for Next Year

Health Savings Accounts (HSAs) allow people to deduct pre-tax money to place into an account for use in medical and dental costs. Typically, these funds are placed on an HSA Debit Card that you can use with your medical and dental providers. Human resources should be able to set you up with one if you don’t have it already. This is just one more way to keep some of your hard earned money.

A word of warning for future readers. Tax laws change each year, but these are accurate as of the date at the top of this post. It is always best to check with a tax professional.

This blog is brought to you by Moline Dentist Dr. Thomas Goebel.


Should I Update My Dental Implants?

I have had my current dental implants since the late 1990s. There are two of them on my lower arch. I keep reading about the updates in the dental implants technology and materials and have lately been wondering if I should update mine for the newer materials, such as zirconia rather than titanium. What do you think?


Dear Pricilla,

Diagram of three phases of a dental implant: separate compoonent, implant screw in the bone, and the crown attached

It is wonderful that you keep up with the developments in the dental field. That combined with how long your dental implants are lasting tells me you take very good care of your smile. Do the developments that have taken place in recent years warrant you updating your current dental implants, though?

Replacing a dental implant is not as simple as taking out the old ones and switching them with the new ones. When the older implants are removed, some bone structure will go with them. This means you will need to have some bone grafting done in order to place the new dental implants. Then, once that has had time to heal, it will be another surgery to get the new implants followed by another period of healing while osseointegration takes place. Only then, will the implant crown be able to be placed. That is a LOT to go through when you have solid, functional dental implants.

Zirconia is tempting for many people because we love the idea of metal-free dental implants. I’m not saying don’t switch out. That, of course, is up to you. However, I would say that there is no evidence that the zirconia is either superior or inferior to the implants you currently have so it may not be worth the unnecessary surgery.

What to Look for With Dental Implant Failure

When you would want to take action is when the implants seem to be nearing the end of their life. Here are some things you can keep an eye out for when it comes to failing implants:

  • Discomfort and difficulty biting and chewing. This may signify a developing infection.
  • Pain and discomfort around the implant.
  • The implant shifting or feeling “loose”.
  • Gingival recession around the implant.
  • Swollen, inflamed gum tissue around the area.

If any of these symptoms occur I would consult with your implant dentist and evaluate whether it is time for a replacement.

This blog is brought to you by Moline Dentist Dr. Thomas Goebel.


Do I Need a Root Canal or an Extraction and Implant?

Dental implant with components identified - crown, abutment, and root formThree years ago, my wife and I got in an accident that released the airbags in our van. I took a hard blow to my face, and since then, my front left tooth has been sensitive on and off. My dentist said she would watch the tooth, but it began to turn dark last fall. I saw my dentist last week for the first time since Covid, and she referred me to an endodontist for a root canal. The endodontist will complete the root canal next week. Will the root canal improve the tooth color, or will I need to see a cosmetic dentist? Should I get an extraction and dental implant anyway? – Thank you. Gordon from St. Petersburg, FL


Thank you for your question.

Will Root Canal Treatment Lighten a Dark Tooth?

Root canal treatment will not lighten a dark tooth. It often makes a tooth darker. Why would root canal treatment darken a tooth? When a dentist leaves root canal filling material and cement in the portion of the tooth above the gumline, the tooth darkens.

Preventing a Tooth from Darkening After Root Canal Treatment

Your dentist can minimize the darkening effects of root canal treatment with these steps:

  • Remove root canal filling and cement from the tooth crown
  • Bleach the tooth internally
  • Seal the bleaching solution inside the tooth
  • Insert a flexible fiberglass post in the tooth and fill the tooth with composite, or correct the color with a porcelain veneer

When most of the structure is left on a front tooth, preparing it for a crown can weaken and increase the risk of breaking it. A cosmetic dentist can correct the color with a porcelain veneer after root canal treatment if your front tooth is intact.

Unless your tooth is severely damaged and the endodontist (a root canal specialist) cannot save it, it is best to preserve it and avoid extraction and a dental implant. We recommend scheduling a second opinion with an advanced cosmetic dentist to examine your tooth and discuss your treatment options.


Moline, Illinois dentist, Dr. Thomas Goebel, sponsors this post.

Why Are My Gums Bleeding Around My Crowns?

I got five new crowns three years ago, and I think I may be allergic to them now. For the past few months, I have noticed bleeding between two crowns and my gums. My dentist says my crowns are GC LiSi Press ceramic, so it is unlikely that it’s an allergy. Is it possible that I am allergic to the material? What could be irritating my gums? Will I need new crowns, or am I at risk of losing my teeth? Thanks for your help. Jayla T. from TX


Thank you for your question.

Dr. Goebel would need to examine your crowns and gums to determine what is irritating your gums. We will provide information on sensitivities to lithium disilicate.

What Are GC LiSi Press Crowns?

GC LiSi Press crowns are ceramic, lithium disilicate crowns. You would unlikely be allergic to only two of your five GC LiSi Press crowns. We have not heard reports of lithium disilicate allergies, but it is not impossible for someone may react to it.

What Causes Bleeding Around Dental Crowns?

Diagram of dental implant components and a dental implant in the bone next to a natural tooth
Dental crown irritation should not be a cause for tooth removal and an implant

Food particles caught between your gums or a functional problem with the crowns near your gumline may cause bleeding and irritation. When you floss, try to discern whether anything around your crowns is catching the floss or preventing it from moving freely. Snagging floss usually means your dentist must correct an overhang or ledge on the crowns.

It is unlikely that your concerns are related to a condition leading to tooth loss and the need for replacement options, such as a dental implant.

Schedule an appointment with your dentist for an examination. If your dentist cannot resolve the issue, get a second opinion from a skilled cosmetic dentist.

Moline, Illinois dentist, Dr. Thomas Goebel sponsors this post.


I Still Have Two Baby Teeth

On the upper left side of my mouth, the incisor and canine teeth are still the baby teeth, even though I am 28 years old. The missing adult teeth never grew in. My smile really looks funny because the two teeth are very noticeable. I don’t want porcelain crowns or veneers. Is it possible to remove the teeth and replace them with implants? – Thank you. Karson from Lincoln, NE


Thank you for your question.

If You Still Have Baby Teeth Will Dental Implants Work?

Diagram of dental implant components and a dental implant in the bone next to a natural tooth
An x-ray may locate your adult teeth instead of getting dental implants

If you still have two baby teeth, dental implants can replace them if there are no impacted permanent teeth beneath the primary teeth. In many cases, the permanent teeth are impacted. You cannot replace the teeth with dental implants until a dentist takes x-rays to locate the permanent teeth. Afterward, the dentist will determine your treatment options.

Your dentist may refer you to an orthodontist who can help impacted teeth erupt into the correct position. It is common for lateral incisors, premolars, and wisdom teeth not to form. The orthodontist may open your gum tissue to expose each tooth. If the teeth need assistance emerging into the correct position, braces can guide them.

An orthodontist will determine whether there is enough room for each tooth to erupt or if they must reposition or remove any teeth to help impacted teeth emerge. Dental implants may be an option for underdeveloped or malformed impacted teeth.

Moline, Illinois dentist, Dr. Thomas Goebel, sponsors this post.

How Long Can I Delay Root Canal or Tooth Removal?

A crown on my upper left first molar broke. My dentist said that the tooth had died, and if he could not remove all the decay, he would refer me to an oral surgeon to remove the tooth. Then, he would place a dental bridge. I asked my dentist to refer me to an endodontist, and I have an appointment in two weeks. I read online that a dental implant is better than a bridge. Is there any reason I should have the tooth removed right away? How long can I wait before this becomes a bigger problem? – Thank you. Selina from Allegheny, PA


Thank you for your question. Dr. Goebel would need to examine your teeth and x-rays. But we can offer some insight.

Removing vs. Saving a Tooth

Diagram of three phases of a dental implant: separate compoonent, implant screw in the bone, and the crown attached
An implant dentist or root canal specialist can help

If a tooth is healthy enough to save and will not negatively affect your oral health, it is best to save it. Although dental implants are a highly effective tooth replacement, healthy natural teeth are better. We recommend that you keep your appointment with the endodontist (root canal specialist) for a second opinion.

How Long Can You Wait Before a Root Canal?

You did not mention if your tooth hurts, but the specialist will need to check for the extent of the infection. Without treatment, infection will continue to spread. So, the condition of your teeth and your oral health will continue to decline without root canal treatment.

Also, if the tooth requires removal, leaving the space without a dental implant will allow other teeth to drift into the area. Tooth misalignment can lead to other issues like jaw pain or the need for orthodontic treatment.

Get a Second Opinion

Your dentist seems uncomfortable replacing your tooth with a dental implant and crown. Even if your dentist would refer you to an oral surgeon for implant placement, we are concerned about his experience with implant crowns and crowns in general. After your appointment with the root canal specialist, we recommend scheduling an appointment with an experienced dentist to discuss your options after root canal treatment or extraction.


Moline, Illinois dentist, Dr. Thomas Goebel, sponsors this post.

Which Implant and Crown Brands Should I Ask My Dentist to Use?

I am searching for a cosmetic dentist because I need extensive work done. So far, I have had two consultations. One dentist recommended ten implants for upper teeth. The other dentist wants to do a CT scan before defining her treatment plan. I have a few questions about some of the research I have done.

  1. Are Astra implants from the UK a quality brand?
  2. Is there anything a top cosmetic dentist can do to give Cercon® smart zirconia crowns a more natural look? I have read that they are as strong as PFM (porcelain fused to metal) crowns.
  3. Is it true that white or gold metal is a good foundation for a crown and will not make my gum line dark?
  4. What looks better, zirconium or white abutments for dental implants?

Thanks for your help. I cannot seem to find the answers to those four questions. If the solutions are online, maybe I do not understand the technical terminology.

Thanks. Roman from Seattle


Our recommendation for any cosmetic dentistry patient is to focus on the dental artist instead of the dental materials. If you try to decide what is best for your smile, you will be directing your dentist. And that is not the right approach. Try to put yourself in the dentist’s position.

Reasons Not to Dictate to Your Cosmetic Dentist

Suppose you are an artist contracted to paint original works for a high-end corporate building. You consult with the building manager, who is not an artist, to find out what type of paintings she would like in the hallways. She gives you the information you need about the type of artwork to create, but she also gives you the following list:

  • Types, brands, and sizes of brushes
  • Paint brands and where to buy them
  • Which stool to use as you paint the pictures
  • The exact color palette for each painting

Although your signature will be on the paintings, the building manager’s list might negatively influence the results. Her micromanagement disregards your artistic talent and choice of materials, some of which are brands you prefer not to use. Her preferences make you uncomfortable.

An advanced cosmetic dentist is an artist with extensive training and experience in aesthetic dentistry. They know the factors that influence the health and beauty of your smile, including:

  1. Materials – Knowledge of the pros and cons of dental materials, their mechanics, and if they will work for your case
  2. Manufacturers – Ability to evaluate their claims about dental materials, products, and devices, and confirm that research supports the claims
  3. Clinical use – Understanding how materials, tools, or parts will function in an actual patient case
  4. Technique – Ability to predict how an element or component will work in the dentist’s hands based on their skill and experience

Which Metal-Based Crowns Will Not Show Through Your Gumline?

Neither porcelain-fused-to-white-metal nor porcelain-fused-to-gold crowns will prevent a dark line at the gumline. Consider a few facts:

  • The color of every metal used in porcelain-fused-to-metal (PFM) crown is either white or gold.
  • A dark line at the gumline is the cement line.
  • When cosmetic dentists combine bonding techniques with pure ceramic—not metal color—it eliminates darkness at the gumline.
  • Another method to minimize the dark line is for the dental ceramist to cut back the metal at the margin and replace it with porcelain.


Dental implant complete with a crown and an unattached crown to the left of it
You will get natural-looking implant crowns from a cosmetic dentist

Zirconium oxide is an opaque white, but a ceramist can cover it with a translucent ceramic. You will have an extraordinarily strong crown that looks natural.

Choose an accredited cosmetic dentist who is experienced in implant dentistry, too. They will consider your case and choose high-quality materials that function well and look natural.


Dr. Thomas Goebel, a Moline, Illinois dentist, sponsors this post.

Why Can’t the Dentist Find the Source of My Toothache?

Man holding the side of his face, portraying dentist cannot find source of toothacheI don’t have a regular dentist, but for the past 2 months my tooth and gums have been hurting and getting worse. Last Wednesday a dentist took me as an emergency patient. After the exam he only gave me something for pain. He said that he wasn’t sure where the pain is coming from and I need to see a specialist. Why wouldn’t a dentist be able to figure out why I have a toothache? He just looked at my tooth. Would an x-ray have helped? Do I really need to see specialist, or can I look for another dentist? Thank you. Thomas


Thank you for your question.

Pain in your tooth can originate with an infection in the tooth, or with an infection in your gums. If an infection is both in your tooth and your gums, it would make it difficult for the emergency dentist to make that determination.

What Causes a Toothache?

  • Root canal infection – An infection in the root canal of a tooth can spread into the bone and tissue around the tooth, which help to support and stabilize the tooth. With a history of the progression of your pain, along with x-rays, a dentist can determine that the problem started in your tooth and spread to your gums and jawbone.
  • Gum infection – Another possibility is an infection that starts in the gums and spreads to the tooth. An advanced gum infection can spread into the tooth roots and up into the pulp of the tooth, causing a very painful toothache.
  • Gum and tooth infection – It is possible that both your gums and tooth are infected. If that’s the case, a dentist needs to carefully review the history of your toothache, take an x-ray of the tooth, and test the sensitivity of your tooth to pressure and temperature. Another dentist may be thorough enough to determine the cause of your pain. Otherwise, you may have to see an endodontist (root canal specialist) or a periodontist (specialist in the gums and supporting structure of the teeth).

The infection will continue to spread until it is treated, so please do not delay treatment. An experienced dentist can save the tooth and prevent the need for an extraction and implant.


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

Dental Implant Delayed Due to a Sinus Infection

Can you tell me why my dentist can’t clear my sinus infection after tooth extraction? This issue prevents me from getting a dental implant. After removing my upper left tooth, my dentist prescribed clindamycin antibiotics for a week, but the infection isn’t gone. I finished the antibiotics, but I still feel pressure in my face and nose. I have tried nose spray and decongestant. Before I call the office back, can you give me an idea of what my dentist should recommend?

Also, if his recommendation does not match yours, should I ask for another round of clindamycin? Is this a routine problem that my dentist should have known about? I am afraid it will not heal, and I cannot get an implant. Thank you. Jeremiah from Columbia, SC


Dr. Goebel would need to examine your tooth and review your x-ray for an accurate diagnosis. But from your description, your dentist is not negligent.

Upper molar tooth roots are often located close to the sinus. So, when your dentist removes a tooth, the sinus can rupture. Sometimes only a thin membrane separates tooth roots and the sinus.

A dentist may treat the issue with these steps:

  • Close the perforation
  • Use a surgical gelatin sponge or bone grafting if you need a dental implant
  • Stich the opening closed
  • Prescribed antibiotics if you have an infection

After finishing antibiotics, contact your dentist if the infection does not clear. Although you may need another course of antibiotics, your dentist may need to switch you from clindamycin. Sometimes bacteria become antibiotic resistant.

Dental implant complete with a crown and an unattached crown to the left of it
Dental implants thrive in healthy gums and bone

Afterward, if the infection persists, your dentist may need to refer you to an otolaryngologist (or ear, nose, and throat specialist). The specialist will coordinate your care with your dentist to ensure the infection is gone before dental implant surgery.

You can expect about four months of bone graft healing before you get a dental implant. And after implant surgery, it takes three to four months for your jawbone and implant to fuse. Then, your dentist can complete the implant with a dental crown.

Cosmetic dentist Thomas J. Goebel, DDS of Moline, Illinois, sponsors this post.