Clear Choice or Costa Rica for Dental Implants
I’ve been researching options or dental implants. I looked at Clear Choice Implants but they prefer to do all-on-4 dental implants. I’ve heard that these have some downsides. Looking over their reviews, I also see a lot of people complain that there was no follow up with them as well. I’d really like to get traditional implant supported dentures, but they told me I’d need bone grafting for that so the all-on-4 is my best option. Another option that I looked into is going to Costa Rica to have the work done. Apparently, there I can have the bone grafting and traditional implant overdentures done and it would still end up cheaper than Clear Choice. Would that be my better option?
Viola
Dear Viola,
I’m glad you wrote. I would not go for either of these options for your dental implants, and here’s why. Let’s start with Clear Choice. You mentioned the problem with no follow up. That is true. You also mentioned that there were downsides with them. That is also true. A significant issue is that if something goes wrong with one implant, then the entire system will have to be replaced.
But going to Costa Rica will be much worse. Even in the United States, with all of our quality controls, when things go wrong with the implant procedure, there can be serious consequences. But take away those quality controls and you are looking at a potential disaster. The standard of care and even the quality and sterilization of equipment is different outside of the U.S. Plus, you will have no real follow up or any recourse if things do go wrong. The last thing you want is to be yet one more person in a long line of dental implant horror stories.
There is a third option. Go with a private dentist with post doctoral training in dental implants. Have the bone grafting done and then have the implant supported dentures you were hoping for. You will know the dentist is trained. Private dentists are much more invested in the success of their cases than corporate clinics like Clear Choice, so you should have excellent follow up.
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Dental Implants and Diabetes?
I lost a tooth and need to replace it. I asked my dentist about a dental implant. He hinted that because I have diabetes, I may not be the best candidate for it. I guess that means my best option is a dental bridge, but was hoping to avoid this. Is there any way for a diabetic to get a dental implant with some special procedures?
Carl
Dear Carl,
I am glad you wrote. A dental implant is a great choice for a tooth replacement. Having diabetes does not mean that you cannot have a dental implant, but there are greater risks. You won’t need any extra procedures in order to get it, but it will be important that you have extra diagnostics and careful care and observation throughout the procedure.
You will want to make sure you have someone with a high level of expertise and training in dental implants do your procedure. Dental school is not enough. You want them to have post-doctoral training in placing them as well of a success rate of at least 95%.
The fact that your dentist was steering you away from implants tells me that he is not as comfortable. Do not pressure him into it. This is an advanced procedure and you have more risk factors than most. You do not want him in over his head and you ending up with a dental implant horror story.
It is totally acceptable to go to another dentist to have the implant done, while your family dentist still oversees your normal dental care. If the dentist who you decide on sends you to an oral surgeon for the placement, it is extremely important that your implant dentist determines the placement and not the surgeon. Don’t do it the other way around.
I hope this helps. Don’t short cut the diagnostics.
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Can a Maryland Bridge Be Attached to Two Implant Crowns?
I have two dental implants, both on back molars. Until recently, the tooth before them was healthy. Now that one needs to be extracted. Would it be possible for me to place a Maryland bridge between the two implant crowns?
Dave
Dear Dave,
While technically you can use a Maryland bridge between the two implants, I would not recommend that option. First, to properly place a Maryland bridge your dentist would have to cut grooves into the crown, as shown above. Second, the best bond you can get is when you affix the wings to natural tooth enamel. The bond to the porcelain will not be as strong. I do not think that your bridge will hold long.
So, what do you do? Ideally, your dentist would have anticipated that you could lose the tooth between the two implants you already have. Then he would have aligned the implants in a way where you could unscrew the two adjacent dental crowns and affix a traditional bridge to the two implants. If that is not possible, then I would see if you can get an additional dental implant in the spot. If you’ve only recently lost that tooth, then there should still be enough space to fit another implant.
There are other options if that doesn’t work, such as a removable partial denture or even a dental flipper. Obviously, though, the ideal will be the implant, so start with those options. Either way you do need to replace the tooth with something. If you don’t it will throw off your bite. In addition to jaw pain, headaches and bite problems, you could end up with TMJ Disorder.
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Is It Too Late for Me to Have a Pretty Smile with Dental Implants?
I am a denture patient and have been wearing them for over 20 years. My smile has been unattractive this whole time. Is it too late for me to get a pretty smile with dental implants? I’ve seen pictures of them and they look much better than my smile.
Alana
Dear Alana,
I’m glad you wrote. Technically, it is never too late to get dental implants. Given that you have been in dentures for over twenty years, you will need one additional procedure to make it work, though. When your teeth were removed, your body recognized that and immediately began to resorb the minerals in your jawbone that you no longer needed to hold in your teeth. It does this in order to be efficient with your body’s resources.
However, the side effect for this is it slowly shrinks your jawbone. Your lower denture rests on that jawbone. You’ve likely started noticing that your denture is slipping more. Soon, you won’t be able to keep it in at all. This is known as facial collapse. Hopefully, your dentist warned you about this when you first discussed getting dentures.
The prevention of facial collapse is to place dental implants in your jaw and anchor your dentures to those. Some people call these implant overdentures. The implants signal to your body that you still have teeth to retain so it leaves your jawbone intact. You’ll also find that it increases your quality of life significantly. Even the best fitting dentures will reduce your chewing capacity by 50%. With dental implants, you’ll be able to eat anything you want again.
In order for you to get those dental implants, you’ll first need a bone grafting procedure. This will replace all the bone structure you lost while wearing dentures. This bone is essential in order to retain your dental implants. Then, once that is healed you can move forward with the implants.
One thing to be aware of is that the beauty of your smile will have nothing to do with whether or not you have dentures versus implants. Instead, it depends on the artistic skill of your dentist. You can have a skilled cosmetic dentist create gorgeous dentures. Ask to see their smile gallery of cases they’ve done to get an idea of the type of results they get. Also make sure they have post-doctoral training in dental implants. This is an advanced procedure and you don’t want to end up in a worse situation than you started.
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Maryland Bridge Before an Implant Crown?
My daughter has a congenitally missing lateral incisor. We’ve finished orthodontics and plan to eventually get her a dental implant to replace it. She’s too young for one right now. Our dentist suggested that we get her a Maryland Bridge as a temporary tooth replacement until she is old enough. The problem is the Maryland Bridge just won’t stay on. She’s tried different cements but that didn’t work. We were using ceramic wings. The dentist thinks that may be the problem. So now she’s thinking about giving her metal wings. I’m a bit worried. It will be about five years before she can get a dental implant. I have some questions that have me worried. Will the metal wings adhere that long? Will they damage the adjacent teeth that they are being attached to? Will people be able to see the metal behind her teeth?
Carol
Dear Carol,
I’m glad you wrote. First, let me say that I am glad you picked a dental implant for her permanent tooth replacement. It is the best tooth replacement you can get her.
I am not sure why your dentist recommended a Maryland Bridge for your daughter. One of the reasons that your daughter’s Maryland Bridge is not staying on because cement isn’t enough for this type of tooth replacement. There actually needs to be a bit of a notch made into the tooth, like you see in the image above. Because of that, I would not consider it a temporary tooth replacement. Once she is old enough and your remove the Maryland Bridge, that notch will have to be filled in with dental bonding material. So, yes, it will damage the tooth.
I would not let her do the metal wings. They will not stay any better without the notch we talked about and they will stain her adjacent teeth.
Instead, I’m going to suggest that you get her a dental flipper. This will hold the space open, it is much less expensive than what your dentist is currently using, and it will not damage her tooth in any way. Then, once she is old enough for a dental implant, you can replace her tooth permanently.
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Bone Grafting Did Not Work
My dentist has done hundreds of dental implants with great success, but for some reason mine was a bust. He did all these pre-diagnostics, which cost a fortune, then told me I needed some bone grafting done. He’d been training on that, so I went ahead and did that, too, with him. More money. After the required healing period, he went in to do the implant surgery but did not place the dental implant because he said there still wasn’t enough bone. He’s now offering to give me a dental bridge. Here are my questions. First, was he just milking me for surgeries? Second, should I get the dental bridge or go somewhere else to get the implant? Does the bone thing matter?
David
Dear David,
I’m going to start with your last question. Yes, the bone thing does matter. The only way for the dental implant to remain securely in your mouth is for there to be enough bone available to integrate with the implant. This bone is important even for your natural teeth. One of the reasons that people with untreated gum disease end up losing their teeth is because the disease eats the bone that supports their teeth.
As for whether he was just milking you for money, I sincerely doubt it. It sounds more to me like you have a fantastic dentist for two reasons. First, he’s trying to keep up with the developments in his field and learn them in order to serve his patients in the best way possible. You’d mentioned he’d been training on that. All people, no matter what the field, when they are learning a new skill will have failures. That’s what learning is like for everyone. But, he’s learning. That will only end up better for you in the long run.
Second, he has integrity. If he were trying to just take your money, he would have just placed the implant knowing the bone grafting did not work. Eventually, your implant would have failed, but it would likely take a year or more and have been impossible to prove that he was at fault.
As to whether you should get the dental bridge, that is a fine alternative to a dental implant. This is especially true if one of the adjacent teeth already needs a dental crown. Then, you’d be knocking off two procedures at once. You can certainly still get the dental implant if that is the replacement you really want. However, you’ll need to go to a different surgeon to have at least the bone grafting part done.
I know you’re frustrated, and I understand, but it does sound like your dentist was trying his best with a procedure that was new to him and was up front with you when things went awry.
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Ordering Dental Implant Parts Online
I have four snap on dental implants. I periodically need to replace the male retention caps. But, my dentist charges me $25 for each one. I’m on a very tight budget and the current economy has it to where I cannot even pay all my utilities without help. I have looked online and the price is much cheaper. You can get four of them for $20. The problem is that to order them you have to be a dentist. Is there any other way to get them at that lower cost than by being a dentist? I’m really struggling.
Dennis
Dear Dennis,
I know a few ways that you can go about getting these more affordably. First, I would start by just explaining to your dentist the financial situation. While dentists do need to charge extra for things in order to cover their overhead, such as the lease on their offices, staff salaries, etc., the percentage he would make on this is so small that I can’t imagine that he would not be willing to work with you.
If for some reason your dentist is not willing to cooperate with you on that, there are still a couple of options for you. First, you could call around to some other dental offices and talk to their staff. Most staff who work for dentists are compassionate people. It’s usually the staff that do the ordering for the dentist anyway.
If both of those things fail, then I have another option for you. I see on eBay where you can purchase dental implant parts, including the retention caps you need for the price you found online. These are sellers that do not require you to provide your dental credentials. The only downside to this is that you need to know what kind to get, such as the resistance. You would also need to know how to place them in.
By the way, if your dentist is not willing to work with you on this, I would say that you are not with the best dentist for your situation. There are a lot of dentists out there and you should look for one that works for you.
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I Think My Implant Dentist Scammed Me
I went to a dentist because of some jaw pain and he said I needed a full-mouth reconstruction. So, I poured a ton of money into fixing my mouth. He extracted many of my teeth and give me implants with crowns and then just crowns on the others. After just a few weeks, the crowns started falling off and I have either stubs or nothing but screws to chew with. I’m in extraordinary pain. The office keeps taking a message and then I don’t hear from the dentist, so finally, in frustration, I just drive up there. They were closing shop. Apparently, he has skipped the country. His staff said that they think he is in Egypt, but aren’t positive. I don’t know what to do.
Avery
Dear Avery,
I am so sorry that this happened to you. It sounds to me like you were dealing with a scammer. I wonder if he even had a dental license. There are horror stories about dentists who lose their license, yet still practice. Though, normally, they practice outside of the U.S.
Additionally, I’m afraid he took you for a ride twice. A full-mouth reconstruction is usually only done for the most severe TMJ Disorder, or for patients who grind their teeth down to nubs. There are several, less invasive procedures to try before doing something so drastic. Even when it is needed, your teeth aren’t extracted to do it. The dentist will just place a crown on every tooth.
If he did skip the country and is in Egypt, you may be out of luck. However, as his staff wasn’t sure, you could report him to the dental board and see if they have any idea where he is. This would certainly be something you could file a malpractice suit over if he is still in the country.
Other than that, all you can do is have this fixed. This is certainly going in the dental implant horror story file. When you do go to get this fixed. Make sure you check the dentist’s credentials, including their implant success rate which should be about 95%. Also check with review sites like Google and Yelp!, as well as the Better Business Bureau to make sure there aren’t any complaints against them.
Again, I am sorry this happened to you. Unlike the dentist who did your “treatment”, most dentists are in their chosen field because they want to help people.
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Antibiotics with a Sinus Perforation
I am a bit frustrated. I had a dental implant placed. Then, it was removed again six months later because the dentist said that the bone never filled in properly. He mentioned that the implant had perforated my sinus cavity, but that it was no problem because this happens all the time with dental implants and that it was only a few millimeters. I worried that I would need an antibiotic, but he told me there was no need. I started having some pain and popping in the nose area. I called the dentist and he told me to take some decongestant. I did that but it didn’t help. In fact, then I developed yucky drainage and a fever. I called back and this time insisted he give me an antibiotic. He relented and wrote me a prescription. That’s when I finally started getting better. Should he have given me the antibiotic to begin with? Also, he said we could try again in a year or I could just get a dental bridge. Do you have a recommendation?
Avery
Dear Avery,
I’m glad you wrote. There is an even bigger issues here that we’ll get to in a moment. First, I want to answer the question you wrote with. Not giving you an antibiotic at the beginning is not a problem. He’d want to wait until there were signs of infection. That being said, there was some sign there when you began having pain. I am glad that you had the courage to put your foot down when the fever developed. At that point, you should not have had to insist.
Now, let’s get into two huge issues I see here. First, the perforation of the sinus cavity. While it does happen sometimes, I wouldn’t say that it happens all the time, at least not with skilled dentists who do proper diagnostics. However, JUST a few millimeters is misleading. In most cases in life, a few millimeters is no big deal. In dentistry, however, a few millimeters is HUGE. He should not have made light of that.
When you have dental implants placed, it is important to have some 3-dimensional diagnostics done, such as a CT scan to avoid what happened to you, among other potential serious problems.
A second issue is the fact that your bone never integrated with the implant. This is why it had to be removed. In a way, you are fortunate that it did not integrate because if it did, your infection could have gotten into the bone and been very serious.
As for whether you should get a dental implant or a bridge, I would recommend a dental implant unless the adjacent teeth needed crowns anyway. If they do, you can knock two problems out with one procedure. If they don’t need a crown, it seems a bad idea to grind those teeth down if you don’t have to.
That being said, I would make sure you had a good explanation for why the bone didn’t integrate before you move forward.
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Titanium of Zirconia Dental Implants?
Can you tell me if I should get zirconia implants instead of titanium? The thing that has me worried is I read an article that said that the titanium will cause neurological effects. I already have two of them and this has me quite worried. I understand that there is a possibility that I can switch them out. Would you recommend that?
Eugenia
Dear Eugenia,
I would love to know what article you read. There are no studies that I know of that talk about neurological problems, or any biological problems, from titanium. I do tend to pay attention to these issues. If it makes you feel better to know this, titanium is one of the most biocompatible metals there is. It’s been used for decades as a prosthetic both in teeth, hips, as well as many other places in the body. There have been no reports of anything negative in all this time.
However, one thing I want you to think about before you make any decisions regarding switching your dental implants is the difficulty in doing that. First, the original dental implants will have to be removed. That is one surgery. When your implants are removed, it will take bone with it. In order to have dental implants, you need adequate bone support. To get that you will need bone grafting done. That is a second surgery. Once that has healed, you will then need to have the zirconia implants placed. That is a third surgery.
In other words, you will need three surgeries in which something can go wrong at any point. Currently you have healthy dental implants. If you give them up, you can no longer be sure of that. My suggestion is that you leave the current healthy implants where they are. If you ever need another dental implant and you want to try the zirconia, then I recommend you see an implant dentist who also provides metal free dental care.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.