Category Archives: Dental Implants

Dental Implants

Dental Implants are Falling Out

I had dentures for a while and just really hated them. After doing some research, I decided to get implant overdentures, with eight implants total. This has cost me about $12,000. Yet, in less than a week three of them have fallen out and today a fourth one came out. Should I get a refund for those? Is there a way to get them back in? I really hated the removable dentures.

Penny

Dear Penny,

Implant overdentures

You should absolutely get your money back on those failed implants. To be honest, I wouldn’t have too much confidence in the ones that are left either. The current estimated failure rate for dental implants is 5%. Your dentist’s failure rate is 10 times that in just a week.

Most dental implant failures come from poor surgical placement. However, you mentioned you have been in dentures for a bit. You didn’t mention how long. When your teeth are removed, your body begins to resorb the minerals in your jawbone. It is possible, depending on how long you were in dentures that you did not have enough bone to retain the dental implants. That is something your dentist should have caught with his diagnostics.

My first recommendation to you is to see a dentist with real dental implant training, such as with Dawson Academy or the Las Vegas Institute of Advanced Dental Studies. Have them look at your implants and see if they can tell you what went wrong. If you had adequate bone support and it was a problem with the dentist’s surgical placement, then don’t just ask for a refund. Instead, ask for him to pay to have the new implants replaced by a dentist of your choosing.

This is because it will cost more to repair this than it did originally. Losing or removing dental implants takes bone with it. The missing bone structure will have to be replaced in order to have a succesful outcome the second time around. That can be done with bone grafting, but your dentist should cover that if you had enough bone to begin with.

If you didn’t have enough bone to begin with, then you would only need a refund. You would have needed bone grafting to begin with in that case.

You should not have any trouble getting a refund on this, especially if you have a second dentist advocating for you.

Best of luck. You can still get the implant overdentures you want!

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

Dental Implants

cLEAR cHOICE OR cOSTA rICA FOR dENTAL iMPLANTS?

I am trying to choose between Clear Choice Dental Implant Centers for all-on-4 dental implants or going to Costa Rica for traditional implants. A dentist here said I am not a candidate for the traditional implants because of my bone structure. Clear Choice said they can work around that, but I’ve heard Costa Rica will place implants when dentists here won’t. Do you have any experience with these scenarios?

Ben

Dear Ben,

Implant Overdentures

You are asking me to choose between the lesser of two evils. Here are my problems with both of those options. Let’s start with Clear Choice. They pretty much do the all-on-4 dental implant procedure for most patients. However, while the procedure can be useful in certain situations, it is also risky. If one part of it fails, the whole thing has to be completely re-done. A second issue with Clear Choice is there is no significant follow-up care. This puts you at risk of post-procedural complications.

One of the problems with the dental implant procedure is it isn’t adequately taught in dental school. Dentists have to take post-doctoral training in order to develop the skills necessary. Too many dentists are delving into this for the income stream, but without adequate training. It is one of the leading causes of malpractice cases at the time I write this post.

Now, take the worst dentist in the United States and you will still be better off than if you went to Costa Rica for this procedure. You say they are willing to do cases that dentists here will not. Of course they are! They don’t have to worry about your dental implant failure. You will be back in the States with zero recourse, and they will be raking in their profits. It is a no-lose proposition for them and a total gamble for you.

And what will you be gambling? Here are just some of the complications you could deal with.

  • You could lose a large portion of your jawbone, leaving you a dental cripple.
  • They could place the implant on a nerve, leaving you either in constant pain, no feeling at all, or even paralysis in the area.
  • They could perforate your sinus cavity.
  • Infection could set in.
  • The implants could be too short or too thin to retain properly.
  • They could be loaded prematurely leading to dental implant failure.
  • They could come loose.
  • You could end up with peri-implantitis.

Your safest option is to go to a solo practice here in the United States where there are standards of care and patient recourse if something were to go wrong. Look for a dentist with post-doctoral training.

I know your dentist said your bone structure would preclude you from receiving the implant procedure you want. However, with a bone grafting procedure, you will build back up the lost bone structure and can get the best replacement possible. Instead of an all-on-4, I would look at getting implant overdentures.

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

Dental Implants

Dentist Pulled My Implant Out

I had a dental implant placed on a front tooth. I wasn’t thrilled with how it ended up looking. It was obviously fake next to the other teeth. However, it was better than having a gaping hole in the front of my mouth. A week after the crown was placed, the implant felt loose. I called the office and they told me to come on it. The dentist said the crown was likely loose and he would just rebond it. He had a little trouble getting it off until he got a tool, but when he did, the implant came out with it. Does this normally happen? He said they can re-implant it but I’m nervous.

DeeAnn

Dear DeeAnn,

No, this does not normally happen. However, in your case I am going to call this a blessing in disguise. I am having a hard time fathoming the level of incompetence this rises to. First, when a dental crown is loose, it is easily removed. He would not need a special tool at all.

It was obviously the dental implant that was loose the entire time. Because this implant was defective and unattractive, it is fortunate that your dentist accidentally pulled it out. Now you have the right to demand he pay to have it repaired properly.

Do not just ask for a refund. Instead, I want you to insist he pay to have it replaced by the dentist of your choice. This is because it will be more complicatted to replace the implant and dental crown. You lost bone when he ripped it out. That bone is necessary in order to retain your implant. In order to place it, you will need bone grafting done to build the area back up.

Finding the Right Implant Dentist

Dental implants aren’t really taught in dental school so you need a dentist who has invested in post-doctoral training. You also want to make sure that they have a high success rate with their dental implant procedures.

At the time I’m writing this dental implant failure and the consequences of poor placement is one of the leading dental malpractice suits. Ask about their success rate. I’d like you to see someone with a 95% or higher rate.

In addition to their implant training, you need to consider how skilled they are in cosmetic dentistry. You are replacing a front tooth. As you’ve discovered, getting a perfect match is essential for a beautiful, natural-looking smile. In your place, I would want an AACD accredited dentist to work on my implant crown.

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

Affordable Dental Implants

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.

Dental Implants

Dental Implants with Diabetes

I have type 1 diabetes and want to get a dental implant for a tooth I lost. I asked my dentist and he said I am not a candidate because of my diabetes. Is there any chance I can do some special extra procedure or something to make this possible?

Benny

Dear Benny,

Having diabetes doesn’t preclude you from getting dental implants. It does, however, make you high risk. My guess is your dentist told you that because he is not comfortable placing dental implants. Given your situation, he felt even less comfortable.

I would see a dentist with significant training in dental implants. Additionally, they’d need to have a great deal of experience with a success rate of at least 98%. No one will have a 100% success rate. Like any medical procedure, some times everything can be done perfectly but the body rejects it.

Your diagnostics will be especially important to give you the best chance of success. Don’t skimp on any of them or go to a dentist who tries to cut any corners for you.

Some dentists do the surgery and the implant. Others will refer you to an oral surgeon. If whoever you see refers you out for the surgery, make certain it is the dentist who decides on the placement of the implant, not the oral surgeon.

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

Dental Implants

Bone Grafting Didn’t Work

I have a dentist who has done many dental implant procedures in his career. When he went to do mine, he decided there wasn’t enough bone structure for it to be a viable case. He told me we’d need to do some bone grafting to be certain the case wouldn’t fail. I agreed because I wanted the best chance of a successful case. We did the bone grafting, waited for healing, then attempted to do the dental implants again. Again he felt that I didn’t have enough bone structure. Now I’m three procedures in and still have nothing. He’s now suggesting we just do a dental bridge. I will if I have to but is there any way I can still get a dental implant? Should I have gone to a dental implant specialist?

Melissa

Dear Melissa,

illustraition of a dental implant next to natural teeth

You’ve certainly been through the ringer with these procedures. While there isn’t actually a detnal implant specialty that is recognized by the American Dental Association . However, there are obviously going to be dentists who invested more in training (which all has to be done post-doctorally) and have more experience as well.

It sounds like your dentist may be experienced at the dental implant procedure but new at the bone grafting part. The good thing this tells me about your dentist is he is continuing to learn the new technology and add to his skill set in order to better help his patients.

Another thing I like about your dentist is his integrity. Some dentists, not wanting to embarrass themselves over a failed procedure would have just gone ahead and placed the implant without the ideal amount of bone in place. The dental implant would have lasted for a while and eventually failed, you would never have known it was because of the bone. Your dentist cared more about the quality of your care than his own pride.

Can you still have a dental implant? Yes. If you’ve got the stamina to try again, I certainly think you can. But, in all likelihood, you will need to have the bone grafting done with a different dentist. I don’t think your dentist will be at all offended about that given what I’ve learned of his character and ethics thus far.

If you decide you don’t want to go through all of that again, then getting a dental bridge is an acceptable option.

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

Dental Implants

Can I Get Dental Implants if I’m Allergic to Some Metals?

I have some metal allergies, but I am losing a couple of teeth, in different places. I could get a dental bridge, but that would mean crowning four healthy teeth. I’d really like to get dental implants for those two teeth but don’t know if that is possible with them being made of metal. What do you think?

Benny

Dear Benny,

The Type of Metal Allergy Makes a Difference.

illustraition of a dental implant next to natural teeth

When you said you had a metal allergy, you didn’t mention which metal or metals you are allergic to. That will make a difference in which way you go. Some metal allergies are common, like an allergy to nickel.

Dental implants are made from titanium unless otherwise specified. We’ll get to the non-titanium implants in a moment. Titanium is highly biocompatible and serving in various prosthetics for decades. Very few people are allergic to this particular metal. If your allergy is not specific to titanium, you can just get dental implants without any worries. But, what if your allergy is to titanium?

Zirconia Dental Implants

Metal-free Dental Implants

If it does turn out that you have a titanium allergy, boy do I have good news for you! There are now metal-free zirconia implants. Zirconia is dubbed ceramic steel. They are well witin the requirements to be strong enough to serve as a prosthetic tooth root.

It’s a little trickier to find a dentist who provides these, not because they are sub-par, but because they are newer. Many dentists like to wait until something has been around a LONG time to start incorporating them into their practice. However, it will be worth it to you to find a dentist who does provide them so you don’t have to get those dental bridges. It’s rarely a good idea to place porcelain crowns on healthy teeth. I always recommend keeping as much healthy tooth structure as possible.

Planning Ahead Saves You Money

Another thing I always recommend to someone needing dental work such as a dental crown, whether for an implant, stand-alone, or dental bridge, is they think long term.

If you are ever going to whiten your teeth, the time to do it is before your crown is made. Because the color you choose for your crown is permanent, if you choose to do teeth whitening later, your natural tooth struture will whiten but not the crown. The only way to get your teeth to match then is to replace the crown and have it made the newer color.

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

Dental Implants

Dental Implants After Ten Years?

I’ve had full removable dentures for a little over ten years. I really don’t like how they feel or look, plus I haven’t been able to eat normally since getting them. Is it too late for me to get dental implants? Will they look better than my dentures?

Andrea

Dear Andrea,

side by side comparison of dentures and a dental implant

You can get dental implants after any period of time, with one caveat, which we will talk about in a moment. In fact, it is actually important that you do. As you can see from the image above, your lower dentures just rest on the ridge of your jawbone.

You have already experienced that it makes it harder for you to eat. Even the best fitting dentures reduce your chewing capacity by 50%. However, there is an even bigger issue.

When you first removed your teeth, your body recognized that and began to resorb the minerals in your jawbone. Everntually, there isn’t enough of your jawbone left to retain your dentures. This is known as facial collapse. You are probably already starting to experience some of this.

Dental implants are different. They serve as prosthetic tooth roots, which signal to your body that you still have teeth. As a result, it leaves your jawbone completely intact.

Bone Grafting

Without enough bone, you won’t have a way to retain the implants. They’ll simply fail and fall out. Depending on how much jawbone you’ve already lost, you may need some bone grafting done first. This will add the missing bone and enable you to have the implants placed in a way that will be successful.

When you’ve lost all your teeth, it is more financially feasible to do implant overdentures. With these, you have 4 to 6 dental implants placed and anchor dentures to them. They will be completely secure.

Getting Beautiful Dental Implants

Whether or not they are beautiful will depend on the dentist who creates your new dentures. Creating beautiful smiles isn’t taught in dental school. Instead, a dentist has to invest in cosmetic dentistry training in a post-doctoral setting.

The best cosmetic dentists have reached accreditation with the American Academy of Cosmetic Dentistry. Any one of them will be able to create a stunning smile for you. You’ll be getting new teeth and a smile makeover at the same time.

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

Dental Implants

Dentist Feels I’m Too Picky

I had to get a dental implant on a front tooth. The implant itself has done fine but I’ve had the crown replaced three different times. My dentist hasn’t been able to get it to match the adjacent teeth. She said it’s because my teeth are between two shades and I’m being too picky. She also said if I keep having her remove it, I risk losing the implant itself. That scares me. Am I being too picky? Should I just accept that false teeth can’t match perfectly?

Lanie

Dear Lanie,

Woman covering her mouth
Your dental crowns can match

One thing I want to tell you right up front is that you are not being too picky and it is possible for your implant crown to match the adjacent teeth. That being said, it may be above the skill set of your current dentist.

Matching a single front tooth is challenging even for the most expert of cosmetic dentists. They often have to do several try-ins before they are satisfied it matches properly. Notice I said “try-ins”. There is a temporary try-in paste your dentist could have been using this entire time instead of permanently bonding it on and then having to pry it off.

Don’t buy into the fear your dentist hinted at. Your dental implant will be safe having the crown replaced. However, you may have to go somewhere else to have it done.

Matching Your Dental Implant Crown

It’s very possible the color of your teeth is between two standard shades. That happens a lot. However, the tooth can still be made to match. While using one of the standard shades is fine for a back tooth, front teeth need some artistry. Below is a color map a dentist would provide for a ceramist to show them what tints to place and where in order to shade the tooth properly and get it to match seamlessly with the teeth beside it.

color map for a cosmetic tooth
Color Map

Your best bet at this point is to ask for a refund on the crown portion of your dental implant procedure. Then, find an AACD accredited dentist. They’ll be able to provide you with a beautiful, natural-looking porcelain crown that matches perfectly.

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

Dental Implants

Will Metal Wings Be a Better Solution on a Maryland Bridge?

My daughter had orthodontic treatment to make room to replace a genetically missing tooth. We needed a temporary tooth replacement in order to keep the space open for a dental implant a few years from now. Her dentist provided a Maryland Bridge with zirconia wings to blend better. Unfortunately, that fell off. She decided to try again but when it fell off the second time, she has decided we are going to have to switch to the metal wings in order to get it to stay better. I have a couple of questions. Will the metal show? Will the metal damage her teeth?

Andrea

Dear Andrea,

First, I’m going to say I’m glad you have chosen a dental implant for your daughter’s permanent tooth replacement. Great job in picking the top of the line replacement for her. Unfortunately, your current dentist isn’t top of the line. I don’t know the name of your dentist so none of this is said out of malice. She doesn’t understand the bonding procedure for a Maryland Bridge. Nor does she understand what a temporary replacement means.

Let’s start with the problem with her bonding and then I will answer your questions. She tried her traditional bonding method and it didn’t work. Rather than question the method, she questioned the material. Maybe I need metal instead of zirconia. Nope. That’s not the problem.

example of preparation for a Maryland Bridge

Maryland Bridge’s require some tooth preparation in order to stay bonded properly. Without that, the bridge will fail regardless of the type of wings your dentist uses. Grooves will need to be cut into her adjacent teeth, like what you see in the picture I’ve posted directly above. My guess is she didn’t do this type of tooth preparation, which is why it keeps falling off.

Now, to answer your questions. Will the metal show? Yes. It will darken the tooth structure. This is one reason dentists who use a Maryland Bridge are moving to the zirconia wings, which will keep the color unaffected. Your second question is will it damage your tooth? Yes, if she makes the grooves to properly attach the wings.

You could have her go back and do the grooves, but I’m going to recommend you switch temporary replacements here. One of the many benefits of dental implants is that the adjacent teeth aren’t impacted. To me, when you have to remove any structure from a tooth to use the replacement, it is no longer considered temporary. Instead, I’d like you to get a dental flipper for your daughter. This is truly a temporary replacement that she can take in and out at will. Good news for you is it is significantly less expensive than any type of dental bridge.

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