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Is It Too Late For Me to Get Dental Implants

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I have had dentures for about ten years and I finally have dental insurance. Is it possible for me to get dental implants at this time? I do have some periodontal disease which did cost me my teeth to begin with.  What do I do?

Luke

Dear Luke,

Implant Overdentures

Dental implants are always a good idea. They are far superior to dentures. Even the best fitting dentures will reduce your chewing capacity by 50%, but the worst side-effect is the facial collapse that will result the longer you live with dentures. Once your teeth were removed, your body recognizes that and immediately starts to resorb the minerals in your jawbone. It does this in an effort to be as efficient as possible with your body’s resources.

Realizing you don’t need the bone to support teeth, it wants to use those minerals somewhere they will be more useful to you.  It is a wonderful way of using your body’s resources. The downside, though, is after a number of years you have lost so much bone that you are not even able to keep your dentures in any more. Having dental implants placed signals to your body that there are still teeth there and because of that it will leave the minerals of your jawbone in place. This protects you from facial collapse.

Generally, if you are in good general health you are a candidate for dental implants. In your case, there are two things you will need to deal with before moving forward. The first is your gum disease. If it was severe enough that you were losing teeth. You don’t want to lose your new dental implants. So, step one to getting dental implants is to have your gum disease treated.

Second, the gum disease combined with the length of time you were in dentures means you probably have a significant amount of bone loss. Once your gums are healed, the second fix will be to get bone grafting done. This will build back up the bone you need in order to secure the dental implants.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Temporary Tooth Replacements Before Dental Implants

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My daughter has a congenitally missing tooth and we are working to get her a smile she can be proud of. We started with orthodontics to get all the teeth she has in their correct position. Our dentist has been working on a Maryland Bridge as a temporary tooth replacement but we’ve been having some problems with it staying on. She was using the ones with ceramic wings. The reason she did that is because we thought the ceramic would blend in better with her teeth. Because we can’t keep it on, she’s thinking we need to switch to a one with the metal wings.

Here are some things I am wondering. Will metal stick better than the ceramic? Will the metal show? These are some tough years for girls and I don’t want her embarrassed if it can be helped.

Laurie

Dear Laurie,

Maryland Bridge Diagram

It sounds like you are working hard to make certain your daughter gets all the care she needs. You are also wise to wait until her jaw has fully developed to get her the dental implant. You mentioned wanting to get her a good temporary replacement.

The problem you are facing with this Maryland Bridge is two-fold. First, your dentist doesn’t know how they work. When the tooth is properly prepared, it will not fall off. One thing she may not realize is that there needs to be a groove in the tooth in order to retain it better.

tooth preparation for a maryland bridge As you can see from the picture on the left, a groove will be cut into the tooth in order to help retain the wings.

Before I go into the second issue, I wanted to answer your questions. Will the metal bond any better? No. In fact, they will have a weaker bond than the ceramic will. Your second question had to do with appearance. To answer that one, yes, the metal will be more visible than ceramic. Switching from ceramic to metal is not your best solution.

All that being said, I wouldn’t go back to ceramic either. This brings up the second issue. You mentioned wanting a good temporary replacement for her. A Maryland Bridge is not one that I would consider a temporary replacement because it permanently changes the structure of the tooth. Instead, I would get her a dental flipper. It won’t affect her tooth structure and will actually cost you less money to boot.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Danger of Dental Tourism

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I want to get dental implants for a few missing teeth I have but for the cost my dentist quoted me, I could literally fly to Costa Rica, have the procedure done there, stay for a couple of weeks during recuperation, get a little sight seeing done and STILL have money left over. If you can’t give me some seriously good reasons not to, that is where I’m headed.

Brad

Dear Brad,

illustration of a dental implant

I’m very glad you wrote before finalizing any plans. You are not the first person to consider dental tourism. When there is a happy ending, you can save some money. When there is not a happy ending, the results vary from expensive to devastating.

One of the reasons dental care is more expensive here is because of the standards we hold both the practitioners and the materials to. The fewer the regulations, the cost will go down. Unfortunately, with rare exceptions, so does the quality of the care you receive.

This is even more dangerous with an advanced procedure, such as dental implants.  Even in the United States, this is one of the leading areas for malpractice cases. But, take the most negligent dentist in the United States and you are still likely to get better care than you will in Costa Rica. Plus, in the U. S. you have recourse if things go poorly.

There aren’t the same standards in places such as Costa Rica. Many of these spots that are popular for dental tourism because of their low prices do not even have laws that require their dentists to sterilize equipment between patients. If you were to go there to get a dental crown, that might be okay. Though, depending on the sanitary measures the dentist adheres to you may end up with an infection.

With a dental implant, the risks are much greater. The fixtures could corrode or not be placed precisely opening the door to a serious infection in your jawbone. They could place the fixture on a nerve which will leave you with numbness, facial paralysis, or serious pain. There have even been cases where patients lost a portion of their jaw because a serious infection set in. What will you do if you have an emergency situation? It’s not like you can call the dentist and have him meet you at the office in 30 minutes.

Another consideration is follow-up. How many times are you willing to travel to Costa Rica for follow-up appointments? At the very least, you would have to go once for the surgery, then several times to check how osseointegration is fairing, then again to have the dental crowns placed on the implant fixtures.

If I were you, I would do it the safest way possible. It may cost you a little more, but it is worth the peace of mind to know you are getting the best care possible.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Dental Implants and Hockey Players

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My son is playing hockey in college and recently had a tooth knocked out.  We’d made all the arrangements for a dental implant and he had the implant placed. Now, some of his teammates are telling him not to finish the procedure because there will probably be more trauma to the area. They all use temporary tooth replacements until they’re done with the sport. Do you agree with this?

Madison

Dear Madison,

Hockey player with tooth knocked out

We never stop worrying about our children, do we?  Under normal circumstances, we want to get the best replacement possible, and that would be a dental implant. You had the right idea.  This is a unique situation, though.

His teammates are correct. A second trauma would be a huge deal with a dental implant because it would take out some bone with it. The damage would be extensive.

I’m glad you had the surgery. It’s okay to have the implant itself placed. You just don’t want to place the dental crown on. That will attach to the crown and rip the implant out if his tooth is damaged again.

Even if you hadn’t already placed the implant, I would have suggested you go forward with that portion. This is so his bone will be preserved while his tooth root is missing. When teeth are removed, the bone where that root was implanted begins to resorb into your body. Your body does that because it realizes that you no longer have a tooth there and it wants to use those resources elsewhere.

Having an implant tells your body you need that bone. The good news is he’s already done the surgical portion. Having the implant in place means his bone will be preserved. That is huge.

In the meantime, you can do a dental flipper or a removable partial denture for his temporary replacement. That would take the implant with it.

I’m glad to hear his teammates are looking after him.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Dental Implants after Ten Years in Dentures

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I have had dentures for the last ten years and have hated them the whole time. I have money for dental implants but my dentist thinks the length of time I’ve been in the dentures may keep me from getting the implants. Is it too late for me?

Bonnie

Dear Bonnie,

Implant Overdentures

 

You are not alone in hating your dentures. While some patients adjust to them, many find them a pain to deal with. Technically, if you are otherwise healthy, it is never too late to get dental implants. However, depending on the bone density in your jawbone, you may need an additional procedure.

before and after facial collapseWhen your teeth were first removed, your body began to resorb the minerals in your jawbone to use elsewhere in your body where they will be more useful. Unfortunately, this has the unfortunate side-effect of slowly shrinking your jawbone. After ten years, it starts to get harder to properly fix your dentures. In twenty to thirty years you won’t have enough jawbone left to keep your dentures in. This is known as facial collapse.

In order for dental implants to stay securely, you need enough bone to integrate with them. It’s possible if you’ve lost enough bone that you will need to have some bone grafting done to ensure there is enough for the bone there for osseointegration.  Once that is done and healed, it will be time to get your dental implants.

Your dentist can place four to six dental implants in your jaw and then anchor your dentures to them. These are known as implant overdentures. You will find this life-changing compared to your dentures. The first thing you’ll notice is your chewing capacity goes up dramatically. Even the best fitting dentures will reduce your chewing capacity by 50%. In addition to that, there will be no more slipping and sliding. Plus, you’ll never have to worry about them falling out.  The biggest benefit, however, is that having prosthetic tooth roots in your jaw prevents facial collapse.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Should I Save the Two Last Upper Teeth?

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I have a removable partial denture on my upper arch. The only teeth left there are the two front teeth and (knock on wood) they are healthy so far. The partial isn’t the least bit comfortable. I don’t know if that is because of my overbite or because it is a partial. Right now I can eat with the two front teeth and my bottoms. I only put the partials in when I have to chew beef or am going to socialize.  My dentist thinks I might be more comfortable if I get rid of those two top teeth.  I thought it was better to keep natural teeth. What do you think?

Paul

Dear Paul,

implant overdentures

I need to qualify this with the fact that I have not examined your bite or even seen x-rays. The best I can do for you is to give you some general guidelines. You are correct that under normal circumstances it is best to keep any natural teeth possible. There are some unique circumstances in your case.

First, there are high stresses on those two teeth, even though they are healthy now, I wouldn’t have full confidence that they would remain that way. A second factor is your underbite. This will put stress on your bottom arch. A well-made denture will be much easier on those teeth than your natural teeth will.

In your case, I think removing the remaining two upper teeth will not be as disastrous as most often would be the case. A full denture is much more comfortable than a partial.

You didn’t tell me your age, but bone absorption is a big problem when you have missing teeth. If possible, the best treatment option would be for you to get some dental implants placed in order to secure your denture to them. It’s not as urgent to have implants on the top arch where your denture is held in by suction. Even then, however, there is always movement. Securing them with implants will make them even more comfortable as well as prevent any further bone resorption.

On your bottom arch, if you were to lose those teeth, then dental implants would be even more urgent. On your bottom arch, your denture just rests on the ridge of your jaw. The longer you wear dentures the more of your jawbone shrinks away until you are dealing with facial collapse. Placing the implants, prevents that from happening.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

 

My Dental Implants Keep Falling Out

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I’ve had six dental implants and so far four have fallen out. Is this normal? Should I have to keep paying for them?

Lauren

Dear Lauren,

illustration of a dental implant

You are in serious need of a new implant dentist. The failure rate of dental implants should be between 2-5%. Your dentist has a failure rate of 67%. That is inexcusable. My guess is the remaining dental implants you have won’t last long either.

The first thing I want you to do is get with an experienced and qualified implant dentist and have them examine your dental implants in order to tell you where the problem lies. here.

Reasons for Dental Implant Failure

  • Inadequate bone support. This can happen if your dentist did not do adequate diagnostics to ensure you had enough bone to begin. This should include 3-dimensional images, such as you’d get with a CT scan.
  • Premature loading. This means putting stress on the implant by placing the dental crown before it has adequately integrated with the bone.
  • Incorrect placement of the dental implant.
  • Infection.
  • Poorly fitting fixtures.

There are other reasons, but these are some of the most common.  Once you know the reason for your multiple dental implant failure, you can make a plan for moving forward.

At this point, I would ask for a full refund. When I say that, I don’t just mean on the fixtures that have already fallen out. I mean all of them.

Unfortunately, you won’t be able to just get new implants. You will first need to have a bone grafting procedure. This is necessary to build back up the bone you lost when the implants failed.

Then, after that has had time to heal, you can move forward. Please make sure you see a dentist with extensive post-doctoral training in dental implants. This is an advanced procedure and not adequately taught in dental school.

Right now, it is one of the leading procedures leading to malpractice lawsuits.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Dental Insurance and Dental Implants

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I am a candidate for dental implants. However, they are pretty pricey. Are there dental insurance plans that will help cover this cost?

Kevin

Dear Kevin,

dental implant diagram

Dental Implant Diagram

If you already have dental insurance, they are likely to help some, but not a ton. In general, insurance companies are willing to pay for the least expensive procedure. For a tooth replacement, this will mean a removable partial denture or, if you are losing all of your teeth a complete denture. Neither of those is the most comfortable solution. There are some plans which will pay a small percentage of the fee of a better treatment option, such as dental implants.

If you don’t already have a dental insurance plan, then before you purchase one, do your research. Many of them will have a waiting period for up to a year before paying out benefits for larger procedures. You will not want to wait a year to replace your tooth.

If that is the case, you may be better off looking into something like Care Credit, which is a medical credit card of sorts. If you qualify, they will pay for your dental implant and you will pay them out over a period of time.

Your dentist may have an in-house payment plan as well.  In all honesty, the best person to talk you through insurance issues and what is covered will be your dentist’s business office.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

How Long Do I Need to Wait After a Crown Before Getting a Root Canal?

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Hi,

In late April, an endodontist did a root canal treatment on one of my bottom right molars. I had delayed the appointment, but the pain and inflammation were so bad that I couldn’t wait for COVID-19 restrictions to relax. The first appointment was okay, but the endodontist scheduled a second appointment because she thought there might be a fourth canal in the tooth that she didn’t clean. She found the fourth canal and spent what felt like an hour digging in it. It was so uncomfortable. She also found a crack in the fourth canal. After the procedure, I had pain and swelling for four days, but most of it is better.

I’m concerned because sometimes I feel dull pain at the bottom of the tooth near my jaw, along with a dull ache that radiates to my ear. It feels like a dull headache. I take ibuprofen every 6 hours. Is the dull pain normal? I’ve returned to a soft diet because I’m afraid that there is still infection, and I’ll need an extraction and a dental implant.

My next appointment is in two weeks to get a crown on the tooth. Should I postpone it, or is the pain normal? I had a Zoom meeting with my dentist, and he had me come to the office for an x-ray, but he didn’t see anything abnormal. My dentist said that it might be a good idea to delay the appointment another week or so for the crown, but he still seemed somewhat hesitant to disagree with the endodontist’s recommendation. Is it okay to get the crown, or should I wait?

Thank you,

Dahlia from Augusta, GA

 

Dahlia,

Your dentist’s advice to wait for the crown was good. But it may take more than a month to determine if the tooth is healthy enough to survive.

Reasons to Wait Before Getting a Dental Crown

  1. A cracked canal might not heal – Root canal treatment isn’t always successful. A crack in the canal increases the risk of losing the tooth. In that case, your endodontist would recommend a dental implant instead of placing a crown on a tooth that can’t be saved.
  2. It takes time for an infection to become evident – Some dental schools teach dentist to wait six months after root canal treatment before crowning a tooth. But a dentist doesn’t always wait that long because each patient’s case is different. Waiting to place the crown allows time for problems to surface. For example, a tooth infection is seen on an x-ray after it’s settled in. Before that, a dentist might recognize any subtle signs of infection on the x-ray.
  3. An endodontist can re-evaluate your case – You can schedule an appointment with your endodontist or ask your dentist to send her the x-ray. Describe your symptoms, tell her about your concerns, and ask her to review your x-ray.

After your endodontist takes a second look at the tooth roots, they’ll give you a recommendation. You’ll have to decide if you want to wait for the crown or receive it as scheduled.

 

This post is sponsored by Hoffman Estates dental implant provider, Dr. William Becker, of Poplar Crossing Dental.

Should I Replace My Bridge with a Dental Implant?

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I’m starting to regret not getting a dental implant. I had a top, right molar extracted, and my dentist placed the bridge o immediately. I thought the extraction hole might need some time to clot, but my doctor said that the bridge on top of the extraction would help the blood clot set. I’m afraid that my gums and bone beneath the bridge won’t heal and that I should have gone with the other dentist who wanted to do dental implants. – Thanks much. Vaughn

 

Vaughn,

Although a dentist, such as Dr. William Becker of Poplar Crossing Dental, would need to examine your extraction site, it sounds as if your dentist did the right thing.

You didn’t mention if your dentist placed a temporary or a permanent bridge. A bridge could put some pressure on the site, but often it isn’t necessary. It usually only takes about five minutes for the bleeding to stop.

Other ways to stop bleeding after a tooth extraction include:

  • Gel foam
  • Astringent
  • Electrocautery

Dental Bridge vs. Implant

A dentist can replace a missing tooth with a dental bridge or an implant. Either solution will prevent the teeth on the other side of the missing one from moving.

Dental bridge

  • Purpose – It will fill the space of a missing tooth and prevent the teeth on either side from drifting in the space.
  • Function – It’s much more comfortable to eat and speak with it than a removable partial denture. But it’s not as comfortable as a dental bridge.
  • Jawbone shrinkage – Without stimulation from tooth roots, the jawbone at the extraction site will shrink.
  • Longevity – A dental bridge can last up to 15 years before your dentist replaces it.
  • Cost – It’s less expensive than a dental implant

Implant

  • Purpose – An implant is an artificial tooth that replaces a natural tooth from the root up.
  • Function – It functions like a natural tooth.
  • Jawbone shrinkage – The “root” fixture stimulates bone and prevents shrinkage.
  • Longevity – Dental implants can last a lifetime, but the dental crown will need to be replaced every 15 to 20 years.
  • Cost – It’s the most expensive form of tooth replacement.

If you received a quality dental bridge, it should last for years. Keep your regular dental cleaning and exam appointments to protect your oral health and ensure the bridge is functioning well. Whenever your dental bridge needs replacement, you can consider a dental implant.

 

This post is sponsored by Hoffman Estates, IL dental implant provider, Dr. William Becker.