My Front Tooth Implant Makes My Gums Uneven

After getting an implant for my left front tooth, the gumline is still higher than my other teeth. My dentist said that the temporary crown would give my gumline a chance to settle, but it has been almost three months, and the unevenness makes my $5,400 implant look fake. Is this issue likely to resolve on its own? – Thanks, Jon from Allentown, PA

Jon,

Thank you for your question.

Before dental implant surgery, a dentist or oral surgeon must determine the optimal position for your implant so that it looks like it is coming out of your gums—not sitting on your gumline.

Sometimes a temporary implant crown allows the gum to grow down to the crown. But if it has been almost three months and you do not see any improvement, your dentist needs to intervene.

Especially if your gumline shows when you smile, you want it to be even with the rest of your teeth. You can insist that your dentist corrects the issue while you are wearing the temporary crown. Otherwise, your final implant crown may not look any better.

What to Do About an Uneven Gumline After Dental implants

If your gumline is uneven after dental implants, it could require additional surgery. If you have enough gum tissue above the implants, a dentist or periodontist can stretch and secure it over the edge of your dental crown. Otherwise, a dentist can take gum tissue from the roof of your mouth,

If your dentist is not skilled with gum grafting or contouring, you can look for a dentist with advanced cosmetic dentistry training to complete the work. Consider scheduling a second opinion with a skilled cosmetic dentist to discuss your options. You will get natural-looking results that help your dental implant blend with your natural teeth.

 

Thomas J. Goebel, DDS, of Moline, IL, sponsors this post.

How many times can my dentist replace my implant crown?

How many times can my dentist replace my implant crown without causing implant failure? My dentist says that getting the color right on my implant crowns is challenging. She said that after changing the crowns twice, I should be happy that the implants are still stable. Am I at risk for dental implant failure? I am concerned about my investment and my health. Thanks for your help. Jael from Chicago

 

Jael

We are sorry that you are having this experience with your dentist. We will explain the process and how you can find a dentist to match your crowns correctly. However, Dr. Goebel would need to examine your implant crowns for accurate diagnosis and treatment options.

Removing Implant Crowns Safely

A skilled dentist knows which tools to use to remove an implant crown without damaging the implant and risking failure.

Matching Implant Crowns

Without advanced cosmetic dentistry training, matching implant crowns is a challenge. Therefore, your dentist is unable to achieve natural-looking results.

Even a skilled cosmetic dentist must patiently achieve a perfect match. But cosmetic dentists who understand color matching take these steps:

• Try-in crowns at least three times to ensure a match
• Draw a color map for the ceramist
• Specify a basic shade in the written instructions
• Draw areas where the ceramist should add tints to match your natural tooth color
• Use high-quality, digital photographs to take pictures of the try-in
• Look for areas that need color adjustment and send details to the ceramist
• Avoid cementing the crown unless the color match is perfect

A general or family dentist is unlikely to go beyond finding a close match. They are often satisfied with making your crown look acceptable next to your natural teeth.

Schedule a Consultation with a Cosmetic Dentist

A cosmetic dentist will take time to ensure the variations of tooth color and translucence in your natural teeth are replicated in your implant crown. Look for at least two advanced cosmetic dentists in your area and schedule consultations.

 

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

What is this weird sensation I feel with my new dental crown?

I have a new crown but feel a strange sensation in it. After I received the crown in mid-July, I returned to my dentist about the problem. My dentist said he could re-cement the crown or make a new one. I thought that it was better to choose a new crown. The new crown was ready in early August, but my bite still did not feel right. The tooth is not painful, but it feels strange. Am I going to need another new crown? I am beginning to wonder if this is an issue with the crown or if the crown preparation somehow damaged my tooth. Thanks for your help and advice. Darren from Idaho

Darren,

When a dentist places your crown correctly, it should feel like a healthy natural tooth. You not notice that you have a crown. Sometimes, even bite adjustments are not enough to resolve the discomfort because the problem lies beneath the crown.

Uncomfortable New Dental Crown

If discomfort in your crown lingers, get a second opinion, and ask for an x-ray. Sometimes, decay beneath a crown can cause lingering discomfort. If the problem tooth previously had root canal treatment, you would not feel pain or have a toothache. Your symptoms might be vague and difficult to describe.

What Causes Tooth Decay Beneath Crowns?

Tooth decay beneath a crown can occur in these instances:

• Bacteria or plaque gets trapped beneath the crown
• Root canal failure
• Lingering decay or infection that a dentist covers with a crown

Depending on the condition of your tooth and how much tooth structure is left, the second opinion dentist may recommend

• Adjusting the crown
• Remaking the crown
• Extraction, replacing the tooth with a dental implant, a new implant crown

After retreatment, your tooth and bite should be comfortable.

 

Thomas J. Goebel, DDS, of Moline, IL, sponsors this post.

I want to replace my twice-broken flipper with a dental implant

Although I thought it was best to get a partial denture instead of a dental implant, I am disappointed with my dentist. I paid my dentist to extract my tooth and give me a partial denture. After I went for the appointment, he said he changed his mind and wanted to try a root canal instead. But that did not work, so I needed an extraction anyway. I wore a temporary flipper partial, and it broke twice. My dentist is charging me for the root canal, extraction, and temporary flippers. He claims that I am at fault for breaking the flippers, but I know they were cheap. I want a refund and dental implants. But I do not understand the strategy for getting my lying dentist to cooperate. Before I ask for my dental records and switch to a new dentist, can you help? – Thank you. Kraig from PA

Kraig,

We are sorry to hear about the nightmare with your dentist. We recommend that you speak candidly with your dentist and list your concerns about what your dentist said he would do versus what happened.

Your dentist cannot charge you for two broken dental flippers and falsely claim that you are at fault, so don’t worry about that.

When you speak to your dentist, explain what action you will take if you do not get a refund:

• Contact your insurance company (if applicable) – Your dental insurance company wants to know if a dentist charges them for work the dentist did not complete. But they also want to know if an in-network provider is dishonest.
• Report the issue to the state dental board – Although the state dental board might not penalize your dentist, they will contact him to investigate the matter. Your dentist does not want to build a negative reputation with the state dental board.
• Hire an attorney – A dental malpractice attorney will be happy to contact your dentist, request a refund, and explain the what will happen if your dentist fails to cooperate.
• Leave negative online reviews – Particularly, dentists who have positive online reviews are concerned about their reputation. Many patients read reviews before choosing a new dentist. So your dentist might respond to your promise to write detailed negative reviews.

Finding a Dentist for Implants

Look for a dentist who is skilled in implant placement, restoration, or both. And ensure the dentist has advanced cosmetic dentistry training. Some dentists refer patients to an oral surgeon or periodontist for implant surgery. After a healing period, the dentist will restore your implant with a natural-looking crown. But the dentist must be skilled in cosmetic dentistry to match the crown to your natural teeth. Schedule a consultation with two dentists before you choose a provider so you can discuss your options.

Best wishes for a speedy resolution.

Thomas J. Goebel, DDS of Moline, IL, sponsors this post.

Can I Remove a Loose Dental Implant at Home?

I have a new implant and crown that I received almost three months ago. The implant is loose and irritating. I will see the dentist next week. Can I pull out the implant myself? – Thank you. Lyle from PA

Lyle,

Thank you for your inquiry.

If you have a loose implant, we do not advise you to remove it yourself. Instead, only allow a skilled implant dentist or specialist to remove the implant.

What Happens If You Remove a Loose Implant at Home?

If you remove the implant at home, you might harm these areas:

• Mistakenly damage surrounding tissue
• Disrupt the surrounding bone
• Cause the space to fill in with tissue prematurely

What Causes Dental Implant to Loosen?

Some factors that can cause a dental implant to loosen:

• Placement – Without a 3-D CT scan, the implant location may not be ideal for healing. If the implant and your jawbone do not fuse, the implant can loosen and fail.
• Infection – Infection in your bone or gum tissue creates inflammation and prevents osseointegration (bone and tissue fusing).
• Implant overload – Too much pressure on the implant abutment (connector) or crown can cause overload. Clenching or grinding your teeth can add stress to an implant.

Symptoms of a Loose Dental Implant

Symptoms of a loose dental implant include the following:

• Implant crown movement
• Pain when you chew
• Bleeding around the implant
• Gum discoloration
• Changes in gum structure

Loose Dental Implant Treatment

An implant dentist must remove a loose dental implant. But your implant dentist will take an x-ray to identify which dental implant components are loose or damaged. Then, your implant dentist will determine and treat any of these factors before replacing the implant.

• Infection – A dentist must treat and remove the infection to promote healing.
• Bone loss – You may need grafting to support the implant. And three to four months of healing will follow. Otherwise, your dentist may replace the failed implant with a larger one.
• Teeth grinding – You will need to wear a mouthguard to avoid pressure around the implant site.

You Can Get a Second Opinion

If your dentist does not give you satisfying answers about why your implant is loose, schedule an appointment for a second opinion. Look for a skilled dentist with advanced implant training or who works with a specialist for implant surgery.

Thomas J. Goebel, DDS of Moline, IL, sponsors this post.

Dentist placed my implant in shallow bone, and it failed

After implant surgery, my dentist said that he placed the implant, but my bone was shallower than he expected. After three months, he now says that the implant will not heal, so he wants to remove it. My dentist offers a dental bridge instead. I spent $3200 on dental implant failure. I told my dentist that I am not interested in a bridge. Will you please give me suggestions on how to get my money back and get a new implant? Should I let my dentist remove the implant? – Thank you. Marlon from Iowa

Marlon,

Your dentist failed you legally and in the care he provided. Your implant will not function, so he owes you a refund. So you can promptly ask for one, and it should not take much explanation. We will offer suggestions later in this post.

Placing a Dental Implant in Shallow Bone

A dentist can avoid placing a dental implant in the shallow bone. Before implant placement, a skilled dentist plans for it. Three-dimensional x-rays are a must to reveal your bone volume and orofacial anatomy. While using 3-D guided navigation, a dentist can precisely place your implant for maximum support and a dental crown that fits well.

It seems that your dentist failed to do adequate x-rays. And during surgery, he placed the implant knowing your bone level is shallow.

Dental Bridge vs. Implant

• Dental implant – If you want a dental implant and you have low bone volume, a skilled dentist or oral surgeon can build your bone with grafting. After the graft heals, your dentist can place the implant. But a dentist must extract your current implant first and allow the area to heal.
• Dental bridge – A dental bridge requires grinding down the healthy teeth on either side of the missing one. After the teeth are shaved down, the ends of a dental bridge will fit over them. And those teeth will anchor the bridge.

Getting a Refund for a Dental Implant

You can get a refund for a failed dental implant with these steps:

• Ask your new implant dentist to help you get a refund
• Tell your current dentist that you are willing to report the issue to the state dental board
• If your insurance company partially paid for any of your implant services, report the issue to them
• Hire an attorney
• Demand that your dentist pays for the cost of your new treatment.

Although your dentist gets credit for not continuing with the process and attaching a crown to your implant, he still owes you a refund. And an apology would help, too.

It Is Time to Switch Dentists

Look for dentists with post-graduate implantology (dental implant) training. Schedule at least two consultations to discuss and compare your options.

 

Thomas J. Goebel, DDS of Moline, IL, sponsors this post.