Katrina D.- Miami

Katrina,

Though your daughter is too young for dental implants, there are options for her. I recommend taking her to an orthodontist who can fit her for an appliance to hold those spaces open for when she is old enough for implants. They can put acrylic teeth on the appliance so she won’t be self conscious. Once she turns about 15 or 16, you can take her to an implant dentist to see if she is a good dental implant candidate.

This blog is sponsored by Los Angeles implant dentist Dr. Robert Thein.

Janet- Connecticut

Janet,

Though smoking is very bad for you, I do not think it is the cause of your bleeding. The dental implant is new and sensitive. You may have just been brushing too hard. Some symptoms of dental implant failure are pain, mobility, and loose bone around the implant.  Whether you quit smoking or not is up to you, though it would be a good decision.

This blog is sponsored by California Implant Dentist Dr. Robert Thein.

Tiffany R.- San Antonio, TX

Tiffany,

Actually, dental implants will prevent  your bone from eroding.  When you extract teeth, your body senses you no longer need to support a tooth root and begins reabsorbing the minerals in your jawbone throughout your body. This is known as facial collapse. When you have implants placed, your body interprets in implants as tooth roots and none of  your jaw will be reabsorbed.

This blog is brought to you by Los Angelos implant dentist Dr. Robert Thein.

Lance Q.- Santa Clarita, CA

Lance,

Based on what you’ve said, I think a fixed dental bridge would be a good option for you. You won’t have to worry about placing another implant and it possibly failing again. It is helpful that you already have crowns in the area, so you won’t have to affect any healthy teeth.

It would be difficult to give you a decisive reason for why your dental implant failed. It could by anything from a problem during the procedure installation to just the fact that your body doesn’t respond biologically to an implant. That’s not much help now, is it? You can click here to learn more about dental implant failure, but it won’t tell you the exact reason yours failed.

If you’re concerned about shrinkage or your appearance in the area of your missing tooth, you could look into bone grafting or a soft tissue graft.

This blog is brought to you by Los Angelos Implant dentist Dr. Robert Thein.

Vinny S.- New Jersey

Vinny,

You are experiencing what is known as facial collapse. When your teeth are removed, the roots are no longer implanted in your jawbone. This signals to your body that your jawbone is no longer necessary and it starts reabsorbing the minerals to use elsewhere throughout your body. Our bodies are very efficient systems. Unfortunately, this sinks your face in and make dentures impossible to wear. All is not lost, though. You can get a procedure done called bone grafting, which will help build back bone in your jawbone.

Once that happens you can get new dentures, but that will start a cycle of bone loss all over again. My recommendation is for you to get dental implants. These insert a root form into your jawbone, and a crown is placed on top to function as your tooth. They are the closest thing to having your own natural teeth in your mouth. Plus, you’ll never have to worry about facial collapse again.

This blog is brought to you by Los Angeles implant dentist Dr. Robert Thein.

Terry,
The main disadvantage in using cadaver bone for bone grafting in the placing of dental implants is how it sounds. It sounds yucky, but it actually works just fine. It is processed and sterilized so that it is safe. While some have raised fears of contracting a disease from the graft, there has never been a reported case of that in the professional literature, to my knowledge.

There are about four different sources of bone for grafting, when you have a case, say, of facial collapse or any situation where there isn’t enough bone at the implant site to support the implant. The first is the patient’s own body. This is called “autogenous bone.” If there is bone somewhere else in the mouth, that can be used. But often that isn’t an option. Some surgeons go to the hip and take bone from there. That works well, but produces a second surgical site and is another source of pain during recovery. One reason many oral surgeons don’t go to the hip for bone is that they are ORAL surgeons and simply don’t do hips.

Another source is human cadaver bone, which is what you are asking about. These are called allografts, and they work quite well.

Another is called bovine bone, or in plain English that would be cow bone.

And another would be synthetic bone products. While these are the most convenient and least expensive, some dentists say they have a poor track record of success.

I hope this is helpful.

This blog is sponsored by Los Angeles implant dentist Dr. Robert Thein
Link: Read more about dental implant failure.

Lucille- Texas

Lucille,

You are in a difficult position. What you are experiencing is called facial collapse. It is inevitable with dentures worn over a long period of time. What happens is that, once all your teeth are removed, your body begins to re-absorb all the minerals in your jawbone. This is what is causing the loss of your ridge. And, you are right, at some point you won’t be able to wear your dentures any more.

When it gets to that point, you will need bone grafting, which builds back the bone. Not all dentists, or even oral surgeons, will perform this procedure because it is quite complicated. You will have to hunt around for an implant dentist who is qualified to do that. Dr. Thein is, but would be quite a distance for you to travel. Check around your area for implant dentists who are experienced in bone grafting.

Once that procedure is done, you have several options:

1. You could just get removable dentures again. Bear in mind that in 10-20 years, you will have the same problem with facial collapse and have to do the procedure all over again.

2. The ideal treatment is to get dental implants. These place titanium posts, that take the place of your tooth roots, in your jawbone and prosthetic teeth are attached. The implants signal to your body that the jawbone is still needed and no minerals are reabsorbed. You’ll have no problems with facial collapse.

3. The more implants you have the better, because it helps you retain more bone. But, implants are pricey, and out of reach for some people. If that is your case, you can get something called snap-on dentures (also called overdentures). These have just two implants and your dentures will snap on to them.

I hope this helps, and I sure wish your dentist had warned you about this 20 years ago.

This blog is brought to you by Los Angeles implant dentist Dr. Robert Thein.

Everything was fine, crowns were put on and 6 months later the front crown came loose and there was a slight infection. The dentist gave me antibiotics and replaced the crown. Things were fine for another 4 months, then the gum on the outside of the front implant got very sensitive, pale and mushy. He had me take antibiotics and told me to wait and see.

It got worse and I went back to the oral surgeon. He had my dentist take the crown off, then the oral surgeon cleaned out the area. The implant was able to be saved, but needed a bone graft. It took 7 months to heal. My dentist decided to change to one crown that would go on both implants, hoping to avoid the issue of looseness. He put the crown on and things were fine for about 8 months. Now the same implant is getting infected again. There is pus coming out from under it and there are white “spots” on the outside of the gum that are also pockets of pus. The dentist blames me – says I must be doing something wrong, the oral surgeon blames the dentist. Believe me – I floss; then water pick, sometimes with Peridex; then brush; then antibacterial mouth wash and finish with an proxy brush dipped in Peridex in the area. The surgeries cost me thousands. I’m tired of the blame-game. I’m looking for a solution, an idea, some action to take. The oral surgeon is reluctant to take the implant out – he is the only oral surgeon in the area (I live on the island of Kauai). I don’t know of any good surgeons in Honolulu – they all claim to be expert. I don’t know if you know of anyone out this way or have any suggestions…..

Thanks for your time.
- Nicole from Hawaii

Nicole,
I don’t know what exactly to make of your situation – I can’t tell what is wrong – but I can be helpful.
Implant dentistry is a very unregulated field, and there are dentists doing implant work who quite frankly don’t know what they are doing well enough.

You had a dental implant failure. The implants became loose and were infected. Generally, when that happens, the implant needs to be removed, the area needs to heal, and possibly the bone needs to be bulked up with a bone graft. But only after it heals should a new implant be placed. The idea that your dentist would prescribe antibiotics for a failing, infected dental implant suggests to me that he doesn’t know what he is doing. Maybe I’m missing something, so forgive me, but at least from what you are telling me, something is very wrong here.

After this team has failed twice on this same project, I would definitely say it is time to try someone else.

What I would do to find an excellent implant dentist would be to go to the website of the International Congress of Oral Implantologists, or the website of the American Academy of Implant Dentistry. They award fellowship and diplomate status to dentists with strong expertise in implant dentistry. You can search their websites to find these dentists with these credentials, and they should be able to help you. Dr. Thein has achieved the highest level credential in both organizations as a way to assure his patients that he knows the field of implant dentistry.

This blog sponsored by La Crescenta implant dentist Dr. Robert Thein

Chad,
If you’re missing a tooth, there are two good ways to replace it and another way that is not as good. One is with a fixed bridge. A bridge involves placing crowns on the two adjacent teeth and suspending a false tooth between them. It is cemented as one solid unit, and it can last for years.

Another good way is with a dental implant. A root form is implanted in your jawbone, allowed to heal, and a false tooth is placed on this root form. This most nearly simulates a real tooth because it has both a root and a crown. It also helps keep the bone from sinking in. When a tooth is extracted, the bone that was supporting that tooth gradually resorbs and your body uses those minerals elsewhere.

Another method that isn’t as good but is usually quite a bit less expensive is with a removable partial denture. It clips onto the other teeth and it can be taken out to clean your teeth and at night. It is not as comfortable and can be annoying.

If you’re missing just one tooth, it’s kind of an even call, as far as which method is better – a dental implant or a fixed dental bridge. When you add more teeth, it tips the scales in favor of the dental implant. The more teeth that are missing, the more strain it puts on the adjacent teeth. If you are missing four teeth in a row, to be done properly the bridge should rest on four good teeth. So you are ending up with an eight-unit bridge. This is complicated to engineer, and if anything ever goes wrong with any one of the four teeth it rests on, you will likely need to replace the entire restoration. It addition, the way your missing teeth are configured, they go around a curve at the side of your mouth. The canine tooth, which when present is in the middle of that curve, is the tooth in your mouth with the longest root. The reason for that is that, because of its position, it has to take a lot of sideways stress. With a bridge, that tremendous stress will be taken by the teeth the bridge rests on, which could shorten their lives.

The ideal treatment for you would be to have the teeth replaced with dental implants. There may be reasons that your dentist hasn’t suggested that. She may not be that proficient with dental implants. Doing them well usually requires continuing education after graduating from dental school. It is only in the past few years that some dental schools have begun to include regular training in placing and restoring dental implants, so older dentists and even many young dentists may not be adequately trained in this area. And, if these teeth have been missing for some time, the bone could have shrunk where the teeth were. Some bone grafting may be required to provide enough bone support for the implant root forms.

This blog sponsored by California implant dentist Dr. Robert Thein.

Also, my teeth were corrected with braces and therefore are aligned, however he stated that my bite was “off”. He offered to correct my bite with full restoration. I do not want to cap every tooth in my mouth. Granted I do have fillings in many of the teeth the bands for braces were placed on.

I’m a 40 year old professional and want the best option for my appearance within financial reason. I’ve been researching my options. Wouldn’t a flipper be okay for the time being, especially since it’s so similar to a retainer, that I’m used to wearing anyway? Or a Nesbit? If they make 2 teeth Nesbits. Any input would be greatly appreciated. Thank you very much.
- Suzanne from New York

Suzanne,
This treatment plan makes me very suspicious of your dentist. A full mouth restoration based on a statement by the dentist that your bite is “off”? Such a radical treatment would be called for if there were major functional problems, but the complaint would originate from the patient, not by a simple statement of the bite being “off.” Almost everyone’s bite is “off” to one degree or another. It’s not clear what problem this dentist is proposing to solve.

A full-mouth reconstruction (putting a dental crown on every tooth) is called for in some situations when there is serious TMJ disorder accompanied, say, by debilitating headaches, or you have worn down all your teeth. But not just for your bite being off.

And as far as the dental implants, there are some cases where a single tooth is extracted and there really isn’t enough horizontal space to accommodate a dental implant. But when two teeth are extracted, you should be able to get a dental implant in there.

I would think a flipper would certainly work for now, and that would be a common temporary restoration as you are waiting for implants to osseointegrate. A nesbit is another possibility – this is a small removable clip-in tooth, and it could be fitted with two teeth. I would lean toward the flipper, because nesbits, being as small as they are and removable, have been known to be swallowed, or easily misplaced.

I’d recommend a second opinion. Find a reputable dentist who seems to have your best interests at heart. When dealing with dental implants, a dentist with credentials from the American Academy of Implant Dentistry, or from the International Congress of Oral Implantologists is a good bet.

This blog is sponsored by California implant dentist Dr. Robert Thein.