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.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Click here to learn about metal-free dental care.
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.
This blog s brought to you by Moline Dentist Dr. Thomas Goebel.
Click here to learn about zirconia crowns.
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.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Click here to learn more about affordable dental implants.
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.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
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.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Click here to read about teeth whitening.
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.
How to Keep Your Jaw Intact with Dentures
I am in my late 30s and have just been told that I should have all of my teeth extracted. I was recently diagnosed with a severe calcium deficiency. My dentist said that would explain why he’s always having to work on my teeth. As a result of the diagnosis, he think my best option is to extract my teeth and get dentures. I have been looking into it and there seems to be a complication with this that results in the jaw bone shrinking. I’ve seen the pictures and I am in tears. These people look ancient. Is there no way to save these teeth? I don’t want to look like that? If the teeth can’t be save, is there a way my jaw can be protected?
Kate
Dear Kate,
I am sorry you are going through this. I have to tell you that I have doubts that you need to have your teeth extracted. Some dentists really like to save teeth. Others prefer to extract them. I think your dentist does not enjoy working on teeth. He is more the extraction type and he’s using your diagnosis as an excuse.
The truth is that having a calcium deficiency in adulthood has zero effect on your teeth. There are serious problems associated with it, including nerve problems, cramps, and even osteoporosis. You will need to get treatment for your calcium deficiency.
As for your teeth, the first thing I would do is get a second opinion from a different dentist about the status of your teeth. Find a dentist who prefers to save as much natural tooth structure as possible.
In Case You Do Lose Your Teeth
On the off chance that you do need to extract all of your teeth there is a way to prevent the jaw shrinking. In dental circles, this is known as facial collapse. The reason this happens is because when your teeth are removed, your body recognizes this and, in an effort to be as efficient with your teeth as possible, begins to resorb the minerals in your jawbone to use elsewhere. The way to prevent that is by making your body think you still have teeth roots there that need to be retained.
My suggestion, if that happens, is that you get implant retained dentures. In this procedure, between four to eight dental implants are placed in your jaw. This signals to your body that you still have teeth and the jawbone needs to remain intact. Once the bone has integrated with the dental implants, then your dentist can anchor your dentures to the implants. You will have secure teeth and a healthy jawbone.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Dental Implants Keep Falling Out
You know that nightmare you have were some of your teeth just fall out? Well, I feel like I’m living that. I had four dental implant placed on my lower ridge. These were supposed to eventually have dentures anchored to them. I’m also getting two individual implants on my upper arch. Here is my problem. I’ve only had the implants about a week, and two of them have already fallen out. I have a few questions. First, should I be expected to pay for dental implants that fall out? Second, do I need to be worried about the other two? Third, should I bother getting the two upper ones? Fourth, is it possible to get working dental implants or do I need to find another alternative? Finally, if I do need to find the alternative, what do you recommend?
Wallace
Dear Wallace,
I am sorry this has happened to you. I will tell you that most trained implant dentists have a 5% failure rate. Even then, most of them won’t fail for at least a year. Your dentist has a 50% failure rate in a week. There is something really wrong here. Priority number one will be figuring out why your dental implants failed.
Some Reasons for Dental Implant Failure
- Development of an infection. This is generally accompanied by pain and/or a fever. This can happen if the dentures are not fit properly., often because of poorly fitting fixtures.
- Diagnostic shortcuts. It is important for your dentist to determine if you have enough bone to support the dental implants. If you don’t, there is a bone grafting procedure which can be done.
- The use of substandard implant fixtures. Some dentists will do this to increase their profits without raising their prices.
- Incorrect placement of the implants.
- Placing the dental crown before the bone has had enough time to fuse with the implant fixtures. Dentists call this premature loading.
As for your questions, here are my thoughts:
First, no, you should not have to pay for the failed dental implants, especially ones that failed this quickly. Should you be worried about the other two? Absolutely. Before you do anything else, I want you to see a dentist who has extensive post-doctoral training in dental implants. Don’t tell them who your dentist is, just what happened and ask if they can tell you what caused the failure. Without that information there is no point in moving forward.
Once that is pinpointed, he or she should be able to tell you how to proceed. If you are in good general health, there should be no problem getting dental implants or even the implant supported dentures you are working on. It will require some bone grafting first, but it is very likely you needed that anyway and, failure to obtain that information on the part of your dentist, was why they failed to begin with.
This blog is brought to you by Moline Cosmetic Dentist Dr. Thomas Goebel.
Painful Dental Implant Failure
I cracked an upper tooth and my dentist said it could not be saved. The best option he proposed was a dental implant. When he did the shot for the Novocaine I am convinced something went wrong because it felt like he hit my brain. Ever since them my whole palate has been burning. I mentioned it to the dentist and he told me some burning was normal after a procedure. I’d returned several times when the pain and burning didn’t subside. He then diagnosed me with with thrush and gave me a prescription. That prescription did absolutely nothing. My mouth burns constantly. I did some research on my own. I know… the old Google Medical Degree. However, I found something called Burning Mouth Syndrome and it fits my symptoms exactly. Is that a possibility?
That wasn’t the end of my troubles. When he placed the crown for the dental implant he had some trouble and had to press down extremely hard. It was excruciating. A couple of months later and the crown fell off. I was out of state helping my mother after her surgery. I went to a dentist there and they told me that the dental implant was infected and needed to come out. He did the surgery and removed the implant, then suggested a dental bridge in its place, which I did after some healing.
All totaled, I’ve been to the dentist almost twenty times and now have no dental implant to show for it. I’ve contacted a couple of attorney’s hopting to sue for damages to recoup my money. No one seems interested in the case though. What do I do? I’ve spent thousands.
Lana
Dear Lana,
Let’s start with the burning mouth syndrome. I do agree that this is a strong possibility. One of the causes of it is anxiety from a traumatic appointment, which you certainly had. Your problem in getting a lawyer likely lies in the fact that dental malpractice suits do not bring in a lot of money. Even if you had a lawyer take you on, then you would need an expert witness on your side.
I do think some mistakes were made. First, was the misdiagnoses about thrush, which frankly was laughable. Then, there was the crown falling off. I’m a bit sceptical about the infection. You didn’t mention anything about pain in the implant itself or a fever. These are common signs of an infection, plus I think the implant would have started to loosen.
I haven’t examined you, but based on your description of how the implant was placed, it sounds like your dentist placed too much force on the implant. That could have damaged the bond between the implant and the surrounding bone, leading to later implant failure.
Placing dental implants is an advanced procedure that requires post-doctoral training. Not many dentists invest in that training and there are countless dental implant horror stories to demonstrate that.
Unless you can get another dentist to diagnose why the dental implant failed along with some proof it will be hard to get money back on the implant itself. The misdiagnosis on the thrush and the crown falling off are easily proved. That would get you at least a partial refund.
I am sorry this happened to you.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Dental Implants and Hockey
My son is a freshman in college and plays for the hockey team. He hasn’t been playing that long but lost a tooth, which sounds like a hockey stereotype but it happened. We’d planned on getting him a dental implant. The prosthetic implant is placed. The crown is coming as soon as the bone is integrated with the implant. However, one of his teammates, who is a senior and has a lot of experience told him that a dental implant is a bad idea because he is likely to be injured again. Is that accurate? If so, what do we do? We want something that looks nice because he is getting married in a few months.
Lorna
Dear Lorna,
I had to think about this because I haven’t done much with hockey players in the past, but what the senior told your son makes sense. If your son is reinjured and the implant crown is attached to the prosthetic root, then it could do serious damage to his jaw by ripping through the bone. The good news is that you already have the prosthetic root in. This will protect him from bone resorption, which is one of the reasons dental implants are the best tooth replacement options.
My suggestion is that for now you get him a removable partial flipper for that tooth. This way if he does get in another accident the false tooth will not put his jaw at risk. If you go to a skilled cosmetic dentist, even a denture can look stunning. Once he is done with hockey, then you can have the permanent crown placed. It will be worth the investment to go to a top notch cosmetic dentist for this if you really want it to look perfect for his wedding.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.