Dentist Won’t Give Me Dentures

I am 45 years old and losing my teeth due to extensive chemo treatments over a period of 15 years. I have no money. None. My husband left me two years ago and I just can’t afford anything but dentures. My dentist said I am too young and he can only give me dental implants. What do I do, go without teeth? How is that better for me?

Pamela

Dear Pamela,

Let me start by saying I am so sorry for all you have been through. That is so much hardship. I am equally sorry that your dentist isn’t willing to work with you at all. This is unfair of him. Though he has legitimate concerns with your age, you are in an untenable situation and there are ways of working around this.

Let me start with his concerns so you understand what you’ll have to confront at some point.

Dentures and Facial Collapse

before and after side images of a woman suffering from facial collapse
Years with Dentures will Lead to Facial Collapse.

When you lose or remove all your teeth, your body recognizes that and immediately begins to resorb the minerals in your jawbone to use elsewhere in your body. While it does this in an effort to be as efficient as possible with your body’s resources, it has the unfortunate side effect of shrinking your jawbone.

After about ten years or more, depending on your body’s response, you will no longer have enough jawbone left to retain your dentures. This is known as facial collapse.

Having Dental implants in your jawbone, signals to your brain that there are still teeth there so it leaves your jawbone intact, preventing facial collapse.

Affordable Dental Implants

Full-sized versus Mini Dental Implant

If you can’t afford traditional dental implants there are two other options for you. The first is to help stabilize your denture with mini dental implants. You’d only really need to do it on the bottom arch because that is the one with the more serious repercussions to facial collapse.

This won’t be as secure as using full sized implants, but it will cost significantly less and will preserve your jawbone. Additionally, you’ll never have to worry about your dentures slipping or falling out.

Another option in affordable dental implants is to get snap-on dentures. This uses just two dental implants, If your dentist isn’t willing to work with you, believe me, there are plenty of caring dentists who will!

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Does She Deserve a Refund?

I had four mini implants done to support a denture. It was time for the denture to be done, but I knew I’d be relocating. I asked my dentist how long it would take for the overdenture to be made and he told me three weeks. Nine and a half weeks later (and a week before I have to move), I finally get the denture and it doesn’t fit. Knowing I have to leave, he sort of forces it in. I thought I could make it work, but I could even eat soft food. I called back to see what we could do about it, but he wasn’t in. I ended up calling another dentist for an “emergency” second opinion. He said there are two problems. First, the holes around the attachment were not drilled out properly. Second, the denture teeth themselves are slanted the wrong way. He doesn’t think there is any way it can be fixed in the time I have left in this state. Is it appropriate for me to ask for a refund or will I have to travel back and forth to get this finished here?

Rebekah

Dear Rebekah,

dental implants anchoring dentures
Implant supported dentures

You definitely have the right to ask for a refund. When he told you he could do it in 3 weeks, that was the equivalent of a contract. He broke that contract by a large margin. Then, when he did provide your denture it didn’t fit. From a legal standpoint, you are in good shape.

There’s the dental standpoint as well. Dental implants aren’t a recognized specialty. Because of that, many dentists are doing a procedure they are not qualified to do. It is one of the leading areas of dental malpractice.

Three weeks was a right and reasonable time to get your dentures done. Because he couldn’t, nor could he get them done correctly in a much longer period of time, I have a high suspicion he is in over his head.

Getting Your Refund

You are in a good place here with the leverage you have. He’s messed up from a legal and dental standpoint. You’ve already done this. For those who haven’t, it is always helpful to make sure it is a blind second opinion. This means you don’t let the second dentist know who the first dentist is. Simply let him look at the work which was done and give his thoughts.

Once you have secured the second opinion, then you go to the dentist and simply ask for a refund. Hopefully, your dentist will recognize the flaw in his technique and have the integrity to make things right. But what if he doesn’t?

If he doesn’t, use your leverage.

Tell him you will write a bad review for him. Research shows that somewhere between 60 -65% of people rely on reviews to determine where to go to the dentist. He should care about the type of reviews he is getting. You could even tell him you’d be willing to do a good review about his willingness to cooperate with you when your denture didn’t work out.

If that doesn’t work, you could tell him you will have to speak with the dental board about the situation. I’m sure the second opinion dentist can help you show the level of incompetence that went into your case. That should sober him up a bit.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Collapsing Mouth

My dentist is suggesting I get porcelain veneers for an issue I’ve been having. My mouth seems to be collapsing. It is getting harder and harder to see my teeth when I smile and I’ve even been having trouble saying certain letters such as P and T. I want to make sure that porcelain veneers are the right solution before I move forward. It’s a rather expensive procedure.

Elizabeth

Dear Elizabeth,

If your dentist suggested that porcelain veneers would fix your problem, he is mistaken. The only thing it will improve is the appearance of your teeth. Even that will depend on his or her skill as a cosmetic dentist.

You have a bigger issue than just the appearance. Based on your description, it sounds like your teeth are worn down. It’s likely you are grinding your teeth without realizing it. Most patients who grind their teeth do so while they are sleeping.

This grinding wears the teeth down to little nubs and causes your mouth to over close. This can lead to TMJ disorder and will give you a lifetime of jawpain and migraines.

You’ll need a dentist with extensive treatment in TMJ disorder in order to fix this properly. This is especially true with a case like yours which will be more advanced than most.

In your place, I’d look for a dentist who received training in one of the following institutions, which are all highly reputable.

  • The Dawson Academy
  • The Spear Institute
  • The Las Vegas Institute for Advanced Dental Studies
  • The Pankey Institute

A dentist with this type of training will be qualified to provide you with the solution to fix your bite and your appearance.

This blog is brought to you by Salem, MA Cosmetic Dentist Dr. Randall Burba.

A SErious Case of TMJ Disorder

I need some advice. In my late 20s I had all my teeth crowned because of severe teeth grinding. I don’t think it was done properly because those ended up ground down as well. In addition, my teeth are now on a slant and I have massive jaw pain. I became desperate and sought out a neuromuscular dental specialist. I didn’t know that wasn’t a real specialty and now worry I’ve been duped.

He had me in an orthotic for 2 years that opened up my bite too much. I’m worse off than I was at the beginning. I need to get this fixed. Here’s my questions. First, if there isn’t a specialty, how do I know who to go to for treatment? Second, do I have to choose between form and function? By that I mean is it possible to get someone who can give me a properly functioning smile that also looks good?

Marcy

Dear Marcy,

woman holding her jaw in pain

You’ve already learned some hard lessons. I’m sorry about that for you. I wish your dentist in your twenties would have recognized your teeth grinding and been proactive instead of allowing them to be ground down so far that it required you to get a full-mouth reconstruction. He or she gave you very poor care.

Now onto your questions. I am actually going to answer the second one first. You absolutely do NOT have to choose between form and function. It will take finding the right dentist, but there are dentists who are qualified in both treating TMJ Disorder and skilled in creating beautiful smiles. How you go about that will answer your first question.

Who Should Treat Your TMJ Issues

You want a dentist who has done post-doctoral training. The training that is given in dental school isn’t enough. Here are some of the top post-doctoral training centers for TMJ Disorder:

  • Spear Institute
  • The Dawson Academy
  • The Las Vegas Institute of Advanced Dental Studies

Once you’ve found a list of qualified TMJ dentists, you’ll want to see what type of cosmetic dentistry training they have. Ideally, you want a dentist who has achieved accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of cosmetic dentists in the country.

It isn’t always easy to find a dentist with both of those qualifications in every area. If you’re having trouble finding a TMJ dentist who also is AACD accredited, you can also look on the mynewsmile.com website.

They have a “find a cosmetic dentist” link. This site is run by a retired cosmetic dentist and he pre-screens all the dentists who want to be listed for both their technical training as well as their artistry. They can’t just pay to be listed, they have to be qualified. On the list are many AACD accredited dentists as well as those who are on their way to accredidation, which takes years, and equally qualified.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.