Category Archives: Dental Implants

Dental Implants

Will I Lose My Tooth If I Decline a Post and Core?

I had a root canal on my tooth. My dentist told me that I need a crown and a post and core. I thought a crown protects a tooth after the root canal and do not understand why I might need the extra step. My dentist’s explanation does not make sense. Why would I need a post and core, and what could happen if I decline it? My insurance doesn’t want to pay for it. – Thank you. Federico from Trenton, NJ

Federico,

Thank you for your question.

Your dentist recommends a post and core to preserve your tooth. As far as your dental insurance, you need to understand that their object is to save money.

What Are a Dental Post and Core?

A dental post is a small rod that helps your tooth support a core. A core is a dental filling material for building your tooth to support a dental crown. Dentists use a post and core to strengthen a weak tooth after root canal treatment.

Why Would a Dentist Recommend a Post and Core?

A dentist may recommend a post and core if you lack enough healthy tooth structure to support a dental crown. Sometimes, a dentist must remove so much tooth decay or damage that little structure remains for cementing on a dental crown. A dentist will complete these steps:

  • Perform root canal therapy to remove tooth decay and infection
  • Insert one or two posts into the tooth
  • Fill in the tooth with dental material
  • Use dental bonding to shape the crown of the tooth
  • Bond the dental crown to the rebuilt tooth

Will You Use a Your Tooth If You Decline a Post and Core?

If you decline a post and core, you may lose your tooth for these reasons:

  • Without a post and core, your weak tooth may not be able to support a dental crown in the long term.
  • If your tooth further weakens, your dentist must remove it.
  • Replacing a missing tooth is expensive. You can expect to pay $3,000 to $5,000 for a dental implant and crown.

If you are unsure about your dentist’s treatment recommendation for a post and core, you may get a second opinion from an advanced cosmetic dentist. Delaying a post and core can create more concerns with your tooth and result in costly treatment.

The Salem, Massachusetts, dentists at Burba Dental Partners sponsor this post. Read about what our dentists do to provide their patients with some of the best dental care in Boston.

Dental Implants

What Can a Dentist Do for Teeth Broken Near Edge of My Gums?

I am wondering if dental implants are my only option. I have 3 teeth that are about 2/3 broken off. The break almost hit my gumline. I was biking on an unfamiliar trail that wasn’t in good condition. It’s a scenic trail, but I didn’t get enough information about its condition. I hit a huge hole that sent me flying off the bike. There was more damage to my lips and teeth than to the bike. I always wear a helmet and am fortunate not to have a concussion.

I do not know anyone who bikes and wears a mouth guard, but I am seriously considering it now. The teeth that broke are my left front and center tooth and the 2 behind it. Amazingly, the teeth do not hurt unless I mistakenly chew on them. I have a dentist, but he is only two years out of dental school, so before I let him do anything to my mouth or refer me out, I wonder if there are options other than dental implants. Thank you. Rick from St. Paul, MN

Rick –

Thank you for your question.

You didn’t mention when you had the accident, but it is best not to delay getting treatment. Although you do not feel any pain, the trauma to your teeth and their continued exposure put you at risk for infection.

What Are Your Options for Teeth Broken Near the Gumline?

If your teeth break near the gumline, your dentist needs to examine and x-ray to determine the damage’s extent. Tooth replacement options may include a dental implant or a dental bridge.

Dental implants

Dental implants are the best form of tooth replacement. They limit the bone loss when teeth are missing, and they will look and function like your natural teeth. Implants take longer than other tooth replacement options because they require surgery that places the artificial roots in your jawbone. In three to four months, your jawbone and implants will fuse. Afterward, you can get your final dental crowns. Still, the results can last a lifetime.

Dental bridge

A dental bridge can restore multiple missing teeth in a row. The teeth on either side of the damaged ones will anchor the bridge. A dentist must reduce the size of the anchor fit to allow the ends of the bridge to fit over them.

Look for a dentist with advanced cosmetic dentistry training and accreditation if possible. After your exam and x-rays, the dentist will explain your options and their pros and cons.

Dr. Randy Burba, a Salem, Massachusetts, accredited cosmetic dentist, sponsors this post.

Dental Implants

Is There an Age Limit for Dental Implants?

I’ve worn dentures for 20 years and have never been happy with them, so I’m considering getting dental implants to support a new denture. Unfortunate circumstances in my family have left me emotionally devastated but have given me some unexpected income. I feel bad that things have turned out this way, but I want to do a few things for myself that are not excessive.

Dental implants would make me feel better in so many ways. I’m just worried about the condition of my jaw and my age. I’m almost 65 years old. Will you please tell me the age limit for getting dental implants? – Jackson from Austin, TX

Jackson,

Is There an Age Limit for Dental Implants?

Your medical history, not your age, will determine whether you are a dental implant candidate. You can qualify for dental implants if you are well enough for oral procedures and in generally good health. Dental implants will erase much of the frustration commonly experienced with dentures. Your dentures will look better and feel more like your natural teeth.

Can You Get Implants If You’ve Worn Dentures for Years?

Although wearing dentures for many years will not prevent you from getting dental implants, there are some factors to consider.

  • Since you have worn dentures for more than 20 years, you probably have significant jawbone shrinkage.
  • Implants require enough bone volume for support, so you may need bone grafting before implants if you have bone shrinkage.
  • After bone grafting procedures, the grafting sites need three to four months to heal.
  • After the bone heals and an implant dentist places the implants, it takes three to four months for your jawbone to fuse with the implants. Meanwhile, you can wear temporary dentures.
  • When your jawbone and implants fuse, your dentist will attach your final denture to the implant abutments, or connectors.

What to Expect If You Receive Implant Dentures

The benefits of implant-supported dentures are many:

  • Your denture will be stable and no longer slip around. The more implants you have, the more stable your denture will be.
  • It will be easier to eat and speak with dentures.
  • If you have already started to experience facial sagging, bone grafting will help support your facial muscles. You will look years younger.
  • Dental implants stimulate your jawbone like tooth roots and prevent jawbone shrinkage and further facial sagging.

We recommend scheduling appointments with at least two implant dentists to learn about their qualifications and training and discuss your options.

The Salem, Massachusetts, dentists at Burba Dental Partners sponsor this post.

Dental Implants

Will My Dentist Need to Replace My Crowns with Implants?

I’ve had six upper dental crowns on my front teeth since 2020. The crowns for my left front tooth and the one behind it irritate my gums. I have slight gum swelling and some peeling. Also, when I floss between the crowns, my gums bleed. Although I asked the dental office for an alloy certificate, the only thing listed on it is GC LiSi Press, which I looked up online. The crowns are lithium disilicate, so I guess that the problem may not be a metal allergy. I have not had metal allergies in the past anyway.

My concern is that the crowns are new. Something about them is unhealthy if my gums are irritated. What can I anticipate with my dentist? His treatment options seem a little pushy, so this time, I am expecting him to recommend dental implants to avoid future problems. – Thank you. Bethany from Virginia Beach, VA

Bethany,

Although one of our doctors would need to examine your gums and crowns, we will provide information on lithium disilicate and sensitivities.

What Are GC LiSi Press Crowns?

GC LiSi Press crowns are metal-free, high-density lithium disilicate. We have not heard of lithium disilicate allergies, but neither can we say that someone cannot be allergic to the material. Still, if you were allergic to lithium disilicate, you would react to all the crowns, not just two.

What Causes Irritation and Bleeding Around Dental Crowns?

Bleeding and irritation around non-metal dental crowns may be related to food particles caught between your gums or a functional problem with the crowns that prevents flossing from removing food particles.

Illustration of a dental implant
Replacing teeth with implants is only necessary if a dentist cannot save the teeth

The next time you floss your teeth, notice whether anything seems to catch the floss or prevent it from moving freely. If you feel a ledge snagging the floss, your dentist needs to correct the overhang on the crowns.

It is unlikely that the concerns you describe are problems with your tooth structure or dental health that would require removing your teeth and replacing them with dental implants.

Schedule an appointment with your dentist for a thorough examination.

Dr. Randy Burba, a Salem, Massachusetts, accredited cosmetic dentist, sponsors this post.

Dental Implants

Do I Need to Switch Dentists to Get My Implant Crown Color Right?

Although my dentist replaced the first mismatched implant crown he gave me, the second crown is no better. Twice I went to the lab my dentist uses for color assessment. But my dentist attached the crown without assessing the color. He did not even ask my opinion. I thought he was putting the crown on for me to check—not cementing it on. On top of that, I felt like my jawbone would break because my dentist had trouble attaching the crown to the implant. Well, now the crown is the wrong color, and it hurts. Should I ask for a refund and find a better dentist? Am I wrong for thinking this is ridiculous? Thank you. Scott from Kansas

Scott,

Your frustration is understandable. Unfortunately, you are the victim, but your case shows the difference between dentists who understand aesthetics—creating beautiful dental work—versus those who want to fix it and get it done.

It seems that your dentist has little or no interest in aesthetics, so your crown does not match. And your description makes it seem that your dentist is not interested in your satisfaction with the work either. A cosmetic dentist would ensure the color is right before cementing it. And if the color is off, they would return your crown to the lab to correct it.

When a dentist sends you to the lab for a color check, it is a clue that the dentist is not skilled in matching restorations (e.g., a crown) to your tooth color. Your dentist should be more qualified than the technician and instruct the technician with notes on what to do to color match the implant crown to your natural teeth. A cosmetic dentist also sends a shade guide and pictures of your smile to help the lab tech craft an accurate match.

We think that you realize that you cannot rely on your dentist. If you want your implant crown to match your natural teeth, you need to find a dentist trained in aesthetics and having artistic inclination. A skilled cosmetic dentist is your best option for getting predictable results.

How to Find a Reliable Cosmetic Dentist

We recommend that you look for a dentist with advanced cosmetic dentistry training. How can you find a trustworthy cosmetic dentist?

  • Look for a dentist with accreditation from the American Academy of Cosmetic Dentistry or extensive post-graduate training in cosmetic dentistry.
  • Look at a few dentists’ websites and their smile galleries to see the quality of their work.
  • Then, schedule consultations with two of them, discuss your concerns, and decide who you can trust to finish the work.

Best wishes for a beautiful new implant crown.

Salem Massachusetts dentist Dr. Randy Burba sponsors this post.

Dental Implants, Uncategorized

Do I Need Root Canal or an Extraction and Implant?

Three years ago, my wife and I got in an accident that released the airbags in our van. I took a hard blow to my face, and since that time, my front left tooth has been sensitive on and off. My dentist said she would watch the tooth, but it began to turn dark last fall.

I saw my dentist last week for the first time since Covid, and she referred me to an endodontist for a root canal. The endodontist will complete the root canal next week. Will the root canal improve the tooth color, or will I need to see a cosmetic dentist? If I need a root canal and a cosmetic dentist, who will probably recommend a porcelain veneer? Should I get an extraction and dental implant anyway? – Thank you. Gordon from Tampa, FL

Gordon,

Thank you for your question.

Will Root Canal Treatment Lighten a Dark Tooth?

Root canal treatment will not lighten a dark tooth. It often makes a tooth darker. Why would root canal treatment darken a tooth? When a dentist leaves root canal filling material and cement in the portion of the tooth above the gumline, the tooth darkens.

Preventing a Tooth from Darkening After Root Canal Treatment

Your dentist can minimize the darkening effects of root canal treatment with these steps:

  • Remove root canal filling and cement from the tooth crown
  • Bleach the tooth internally
  • Seal the bleaching solution inside the tooth
  • Insert a flexible fiberglass post in the tooth and fill the tooth with composite, or correct the color with a porcelain veneer

When you have most of the structure left on a front tooth, preparing it for a crown can weaken it and increase the risk of it breaking. A cosmetic dentist can correct the color with a porcelain veneer after root canal treatment if your front tooth is intact.

illustration of a dental implant in three stages
Saving your tooth with root canal treatment is better than a dental implant

Unless your tooth is severely damaged and the endodontist (a root canal specialist) cannot save it, it is best to preserve it and avoid extraction and a dental implant. We recommend scheduling a second opinion with an advanced cosmetic dentist to examine your tooth and discuss your treatment options.

The Salem, Massachusetts dentists at Burba Dental Partners sponsor this post. Please read why our patients say we offer some of the best dental care in the Boston area.

Dental Implants

Repeat Root Canal Failed But My Dentist Still Ordered a Crown

My dentist did a repeat root canal on a bottom left molar. After the root canal, an infection lingered for almost two months. An oral surgeon helped me get rid of the infection and said that my dentist should wait before putting a crown on. The tooth hurts again, so I think the infection returned, but my dentist already had the crown made without my permission.

I prefer an extraction and implant because the tooth is problematic and has interfered with my routine so much. Besides, if the tooth still hurts after a repeat root canal, I think putting a crown on it is a waste of money. Why would my dentist order a crown for a tooth that won’t heal? – Aspen from Illinois

Aspen,

You are correct. Your dentist should not have ordered the crown without your permission and without ensuring that your tooth healed. And you can refuse the crown because the tooth has not recovered.

When Should You Get a Crown on a Root Canal Tooth?

You can feel comfortable getting a crown on a root canal tooth when your dentist is sure that the treatment is successful. Preparing the tooth for a crown will further aggravate the tooth. And covering the tooth with a crown wastes your time and money.

Sometimes, root canal treatment can fail despite a dentist’s best efforts. But your dentist’s judgment was flawed in ordering a crown for a tooth that did not heal. Your dentist took a risk and is responsible for it. We recommend asking for a refund for lab fees or other fees that you paid toward the crown.

Should You Try to Save Your Tooth?

If your tooth is savable, perhaps a root canal specialist (endodontist) can save it. But as the number of root canal treatments increases, the likelihood of saving the tooth decreases. If you prefer an extraction, you can schedule an appointment for a second opinion from a cosmetic and implant dentist.

Diagram with five states of root canal treatment
Repeat root canal failure may require an extraction and dental implant

Burba Dental Partners of Salem, Massachusetts, sponsors this post. Read about what our dentists do to offer some of the best dental care in the Boston area.

Dental Implants

How Long After Tooth Infection and Removal Before I Can Get an Implant?

How do I know that the infection is gone from a tooth that I had extracted? Is there a waiting period before I can receive a dental implant? I want to be sure that the infection is gone before putting an implant there to avoid having an infection with the implant. The dentist is ready to place the implant, but I just finished antibiotics. Is it safe to move forward? Thank you. Geoff from CT

Geoff,

When you have an infection in a tooth, other than a wisdom tooth, the tissue in the tooth dies. The infection exits through the bottom tip of the tooth root and goes into the bone.

Does Tooth Infection Remain After Extraction?

Extracting the tooth removes the source of the infection. Your body quickly eliminates the condition in the bone. Additionally, the extracted tooth leaves a drainage opening that inhibits the infection from lingering there.

Dental implant

It is rare to have a lingering infection after a basic extraction. Also, if you have finished antibiotics, your dentist prescribed them to ensure the infection is gone.

Infected wisdom teeth are different. In this case, the infection exists between the tooth and the gum. A dentist must remove both tissue and bone while removing an impacted wisdom tooth, and infection can spread to the surgical site. After the surgery, the wound is sutured closed. It is more likely to have an infection after the impacted wisdom tooth is removed, so dentists prescribe antibiotics to prevent it. But wisdom teeth do not get replaced with dental implants, so it is not an issue.

Although you are likely safe to get an implant, you can explain to your dentist that you want to wait a few weeks to ensure you have no symptoms. If your dentist is concerned about your comfort, they will wait.

Burba Dental Partners of Salem, Massachusetts, sponsors this post. We strive to offer some of the best dental care in the Boston area.

Dental Implants

My dentist wants to remove my new implant

After three consultations with implant dentists, I chose the wrong one. After implant surgery, he told me that the bone was shallower than he thought. But he still placed the implants.

A month later, my dentist took an x-ray and said the implant was not healing correctly, so he wanted to remove it. He said that we could talk about other options, but a dental bridge is one of them.

The implant is not hurting, and I am very careful not to disturb it, so I asked my dentist for time to think about it. That was two weeks ago. I still do not know what to do, but I know that I want an implant. What are my options? – Thank you. Malcom from NJ

Malcom,

Thank your question. We are sorry to hear about your experience with your implant dentist. We are sure that it is frustrating. However, you can get the care you need.

If Your Dentist Places an Implant in Low Bone Volume

Illustration of a dental implant
A dental implant needs enough bone to fuse

If your dentist places an implant in low volume, it probably means that they did not take three-dimensional x-rays before your surgery. The x-rays would reveal that your bone is too shallow for implants and prevent healing. Still, your dentist should not have proceeded with the surgery.

Your dentist is responsible in several ways:

  • Breached the standard of care
  • Put you at risk for infection and trauma
  • Performed faulty surgery
  • Inconvenienced you because you must seek additional care

What to Do If Your Implant Failed Due to Dentist’s Negligence

If your dental implant failed due to your dentist’s negligence, you should demand a refund. If your dentist resists, you can do several things:

  • Report the issue to the state dental board
  • Hire a malpractice attorney
  • Get a second opinion from an advanced implant dentist and use the evaluation and proof of your dentist’s negligence.

Is It Too Late for a Dental Implant?

If your dental implant failed because your dentist placed it in low bone volume, it is not too late to replace it. However, a skilled implant will need to remove your loose implant, perform bone grafting surgery, and wait for three to four months for it to heal. Afterward, you can get an implant.

Best wishes for a smooth resolution.

Burba Dental Partners of Salem, MA, sponsors this post. Please read how our doctors strive to be among the best dentists in the Boston area.

Dental Implants

Sinus Perforation During Dental Implant Procedure

I need to ask about something that happened with my dental implant procedure. First, some minor backstory. When my dental implant was placed the oral surgeon perforated the sinus by a few millimeters. He said this is fairly common. The problems started six months later when the gum would not heal and he suspected there was some bone loss. He removed the implant which went pretty smoothly because there was no bone integration with the implant. He stitched the gums and asked me to wait a year to see if the area fills back up. Here’s one thing I am frustrated with. He did not give me any antibiotics, just Flonase and some instructions on things like not blowing my nose for a while, etc. Five days later I went in for a follow up. I’d had pressure and felt yucky since the procedure. While he thought everything looked great, I didn’t feel that way and insisted he give me an antibiotic. He did and I started feeling better. Did he put me in danger by not prescribing one to begin with?

Margie

Illustration of a dental implant

First, I will answer your question, but there is a much bigger concern here that I want to address after. As to your question, no, he did not put you in danger by not prescribing antibiotics as a preventative measure. It is better for your body’s health in the long run if there is not already an infection, to try and allow the body’s natural defences to keep one away. It helps to strengthen your system. Having some medication jump in and do your body’s job when it doesn’t need help ends up weakening its ability to fight infection over the long haul. Think of it like a parent who always steps in to help their child climb the monkey bars by lifting them when it is hard. Sure, they get up the monkey bars, but it did nothing to develop their muscles. Waiting until your body needed the boost was the right course of action.

Two Problems with your Dental Implant Procedure

I see two really big problems with your situation. First, is the sinus perforation itself. Yes, it does happen. I certainly would not call it normal. Plus, the amount of the perforation is a big deal. A few millimeters is HUGE in dentistry. I am really concerned that he blew this off. This could only happen if he did not do adequate diagnostics. He should have done quite a few x-rays and preferable a CT scan also. The dental implant procedure is a 3-dimensional procedure and does require a 3-dimensional map.

The second real concern I have is that your bone never integrated with the dental implant. This leads to dental implant failure. This also indicates to me (again) that he may not have done adequate pre-surgery diagnostics. It’s possible you would have needed a bone grafting procedure to make this work.

My opinion– get a different dentist or surgeon to do this when you’re ready.

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