Category Archives: Dental Implants

should I have to pay for a dental implant again after two years?

I had a dental implant placed a couple of years ago. It’s feeling loose and I’m kind of worried I’ll have to pay for another one. I heard these were supposed to last a long time. Will I have to pay all over again?

Tracy

Dear Tracy,

You’re right that it shouldn’t be loose after this short a period of time. However, there can be a lot of reasons for this to happen. Some of them are easy fixes. Before you give up, contact the dentist who placed your dental implant and let him know what is going on.

Why a Dental Implant Can Be Loose

Three parts of a dental implant
The three parts of a dental implant

Not every loose dental implant is a disastrous fix. Sometimes it is something simple. There are actually three parts of a dental implant which can struggle for one reason or another.

The Implant Crown

Sometimes it can just be the porcelain crown, which your dentist placed over the implant which has come loose. Repairing that is just a simple matter of re-bonding it on again. Many dentists will even fix this without charge.

The Abutment

This is a piece which fits between the implant and the crown. Maybe it has come loose . If it turns out the abutment was faulty, the dentist can contact the manufacturer and get a replacement at no cost to you.

The Implant Fixture

If it is the dental implant fixture which is loose, that can be more serious. Sometimes it is coming loose because of an infection. There is a chance that can be saved, but you need to get to your dentist right away. Even when a dental implant isn’t a factor an infection is considered a dental emergency.

If it is loose because it hasn’t integrated with the bone, there isn’t much that can be done. Even when everything is done perfectly, a dental implant procedure can fail. When done by an experienced, skilled cosmetic dentist it’s a rare occurrence, but they can still fail through no fault of either you or the dentist.

This blog is brought to you by Salem Dentist Dr. Ruandall Burba

snap on dentures: a middle ground

I have been struggling with my dentures. Really struggling. I talked to my dentist about it and he suggested dental implants, but the price was way over anything I can afford. I don’t really want to continue with the dentures, but I just don’t like how they move around. I do use adhesive. It helps some. Not a lot. Unfortunately, it also feels kind of gross. Is this just something I’ll have to adjust to or is there another treatment option I’m overlooking?

Diana

Dear Diana,

Salem Snap on Denture
Snap-on Dentures

I hate to hear that patients are left grappling for answers when their dentists should be giving them all their options. And, you do have some options here.

While some people adjust to dentures, others never do. You didn’t mention how long you’ve had your dentures. If they’re fairly new, they shouldn’t be sliding. Your dentist needs to adjust them. Free of charge.

However, if you’ve had them for several years, you could be at the early stages of facial collapse. The longer you wear dentures, the more your jawbone shrinks. Eventually, you won’t have enough jawbone left to even keep dentures in.

This is why your dentist mentioned dental implants. The implants provide prosthetic tooth roots which your body interprets as you still needing your jawbone, leaving it intact.

Alternatives to 1 to 1 Dental Implants

I don’t know if the price quoted to you for dental implants was a single implant for every missing tooth or for implant overdentures. However, implant overdentures are significantly more affordable.

This uses four to six dental implants on each arch and anchors your dentures to them. They are completely secure and will also prevent facial collapse.

In some cases, even implant overdentures are still out of reach. That’s okay. Everyone has a different budget to work with and dentists should never pressure patients to extend themselves beyond their means.

In those cases, we often recommend snap-on dentures. They are a good starting place. There is a picture of them at the top of this post. It uses just two dental implants. While there is some movement, they will not fall out. The snaps keep them in place.

This also allows you to save up to get more implants at a later date if that is what you desire. It will also protect against bone loss, but just in the areas there are implants.

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

traveling for dental Implants

I know the dangers of dental tourism when you’re talking about leaving the country. I’ve read the horror stories. But, what if you’re not traveling to save money, but to find a really good implant dentist? I need to replace two teeth in the upper right part of my mouth. The dentists in my area aren’t that great when it comes to dental implants. However, my best friend from college lives near one of the top dental implant dentists in the country. She said I could stay with her. In that case, is it a safe option?

Pepper

Dear Pepper,

Illustration of a dental implant

Dental implants are a fantastic option for replacing teeth. It also sounds like you’ve done some great research as far as what dentist to use. That is the number one factor in a successful outcome.

When you are talking about this type of travel for dental care, it is a totally different story than the dental tourism horror stories you’ve read about.

However, there are some things which need to be handled differently for this to go smoothly for you.

Considerations When Traveling for Dental Implants

One of these you’ve already done, but I’m listing it for the benefit of others.

Research the Dentist

As I said above, the dentist is a very important factor in the success of your case. You’ll want to know:

  • The type of implant training he or she has had
  • How many cases they’ve done
  • Percentage of successful cases
  • Always check reviews

Budget Carefully

You’ll need to be prepared for six or more visits spread out throughout the year. Some of these include:

  • Consultation
  • Implant surgery
  • Post-op checks
  • Impression appointment
  • Crown placement

Accommodations for after surgery is important too. You have this arranged, but others may not have your support. They’ll need to have someone travel with them and plan on staying somewhere comfortable at least overnight.

Discuss Emergency Protocols

Even when everything is done right, something can go wrong. You’ll want emergency protocol information up front. Will he insist you come in or will a Skype visit be fine for a triage of sorts?

Do all this and you should have a positive experience.

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

Blade Implant Not Healing?

I don’t know what’s going on. I had a blade implant placed over 12 months ago and it still isn’t healed. Is something wrong or is this normal? Do I just wait it out?

Catherine

Dear Catherine,

Illustration of a dental implant

I’m curious as to why your dentist decided on a blade implant. While they have been in use for many years, there are better options in current practice. It’s generally used for people who don’t have a thick enough jawbone to retain a traditional screw implant but don’t want to do bone grafting.

Unfortunately, while traditional dental implants (pictured above) have a 98% success rate, blade implants only have around a 50% success rate. This should have healed within twelve months. At this point, something is wrong. You need to return to your implant surgeon and have them look and advice you.

Dental Implant Options

A woman's profile twice, one with facial collapse, one after
Wearing Dentures Leads to Facial Collapse

Bone loss in your jaw is usually the result of having missing teeth with no replaced root. For instance, if you removed your teeth but didn’t replace them or replaced them with removable dentures, the minerals in your bone start to resorb into your body. The result not only ages your appearance years, but it will also make you a denture cripple, forced onto a liquid diet the remainder of your days. This is known as facial collapse.

If you want to replace those teeth with an option which provides a prosthetic root, thereby preventing facial collapse, you need to have enough jaw bone. If you don’t, you have two great alternatives to blade implants.

Bone Grafting

This is a simple outpatient procedure which adds bone structure back into your jaw. The biggest benefit to this is it allows you to get screw implants which have a significantly higher success rate to the blade option.

All-on-4 Dental Implants

This doesn’t require grafting. Instead, the all-on-4 implant procedure places the implants at an angle helping them retain with less bone structure.

Cosmetic Considerations with Dental Implants

While it is wonderful to have a full mouth of teeth. If they’re not attractive teeth, you might not smile nearly as much as you would if you were provided with a stunning smile. Whether you are getting all new “teeth” or just a couple of implants, you’ll want a dentist who can make them match your teeth. You don’t want natural teeth next to obviously fake teeth.

One or Two Implants

I recommend before your implant crowns are made, you whiten the rest of your teeth. It’s an inexpensive way to drastically improve the aesthetics of your smile. But, the real reason for doing it before getting your crowns is the permanence of your crown color. Even professional teeth whitening only works on natural tooth structure. That means if you get the crowns first and then decide to whiten your teeth, your natural teeth will whiten. Your tooth replacements will not. Doing the whitening first means your implant crowns can be made to match the beautiful new color of your teeth.

A New Smile with Implant Overdentures

If you are getting a new smile with your implants, you want an expert cosmetic dentist to do the work. You are talking about a complete smile makeover made from dental crowns. Finding an expert cosmetic dentist is a lot easier than it used to be. The American Academy of Cosmetic Dentistry has an accreditation program which helps patients to know who can give them a stunning smile.

Just go to aacd.com and click on find a dentist. Just make sure you put a check by “accredited dentist”. This way you get a list of those who are experts in their field.

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

Considerations Before Getting Dental Implants

illustration of a dental implant
Dental Implant Diagram

You’ve lost a few teeth and need to replace them. While all the buzz is about dental implants when it comes to tooth replacement options, there are some things to ask yourself before deciding. Here are some questions to consider:

Have All My Options Been Explained?

Yes, dental implants are a fantastic way to replace missing teeth, but it’s important you know your options so you can be sure you chose the correct option for you. For instance, if you’re only replacing one tooth, but one or more of the two adjacent teeth need crowns, then a dental bridge would make more sense. If you’re missing all your teeth, getting a dental implant on every tooth would cost up to $84,000. Getting implant overdentures addresses all the same needs with significant cost savings. Be sure to ask your dentist to explain all your options along with their pros and cons when you book your consultation.

Are You Committed to Proper Oral and Health Care?

If you’ve lost your teeth because you have gum disease, that will have to be addressed before getting dental implants. Gum disease will cause the implant to fall out just the way your teeth did. Once your gums are healthy, it’s fine to go ahead and get the implants. However, if you’re not willing to care for your teeth with regular brushing and flossing, along with visits to the dentist, you’ll end up right back where you are now. In that case, you’d be better off not investing in something you won’t care for. Removable partial dentures may be a better option for you.

If you’re a smoker, this is a larger contributor to both gum disease and dental implant failure. The reason behind that is smoking causes a reduction of blood flow in your gums. This slows healing time, which often leads to infections. You’ll want to consider quitting or at least severly cutting back if you’re serious about dental implants.

Think About Your Long-Term Goals

These are meant to be a permanent replacement. That’s great, but if you’ve been unhappy with a dingy smile, you’ll want to take care of that before getting your implants done. Get your teeth whitened. This way when your dentist creates your implant crowns, they can be made to match your beautiful new fresher, whiter color. It’s a great way to come away with not just a full set of chompers, but one you’re proud to share as well. Make sure you discuss with your dentist any long-term goals you have for your smile at your consultation. This way the two of you can work out a logical plan that will save you money in the end.

Make Sure You Book with an Experienced Implant Dentist

This is an advanced procedure which requires extensive post-doctoral training. Don’t hesitate to ask the dentist where they received their dental implant training as well as the number of cases they have performed, as well as their success rate. It should be around 98%.

While not everyone is a dental implant candidate. They are the closest option to having healthy natural teeth in your mouth.

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

Dental Implants Turned My Gums Gray

I’m worried something is seriously wrong. I had two dental implants placed on my front teeth. They’ve been on for a few months now. While I sort of like how the implant crowns look, the surrounding gums have turned gray. Are the implants causing an infection? Will I lose the implants?

Melissa

Dear Melissa,

illustration of a dental implant

The good news is that you’re probably not dealing with an infection. If you were, there would be a fever and pain involved, neither of which did you mention. More likely, the titanium from your dental implants is showing through your gums. This could be from one of two reasons or a combination of both.

You probably have thin gum tissue which contributes to it. The placement of the implants is also a big factor. If your dentist isn’t experienced in placing dental implants, he may have placed them without factoring in the depth of your gum tissue. I suspect that’s the issue. Another reason I’m wondering about the skill of your implant dentist is your disappointment with the look of the crowns. But, first, let’s talk about your options for your gray gums.

Obviously, your first option is to live with it. If it’s not visible when you smile, that may be acceptable to you. If the gums are visible, then you won’t want to leave them. In that case, you’ll need to have them re-done. If it turns out they weren’t properly placed for the thinness of your gums, you could get at least a partial refund. A second opinion by an expert implant dentist can tell you that.

When you have them replaced, you can either get titanium implants again or you can get Zirconia Implants. These are white and more easily masked. These are also great for people who have severe metal allergies because they are metal-free.

Can Dental Implant Crowns be Beautiful?

When you’re talking about getting restorations on your front teeth, it especially important you find a skilled and artistic cosmetic dentist. Ideally, you’d want an AACD accredited dentist. They’re the cream of the crop when it comes to cosmetic dentistry. But, very few dentists are accredited so you may not find one at a reasonable distance from you. In that case, look on the mynewsmile.com website.

They only recommend the best cosmetic dentists. Many of them are on their way to accreditation, which is a lengthy process. If a dentist is on their list, they’ll give you a beautiful smile.

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

Can a Diabetic Get All-on-4 Dental Implants

After my husband died I really struggled. I stopped taking care of myself. I gained 100 pounds, developed diabetes, and even developed gum disease which led to losing several teeth. I didn’t care. Then, one day I was at a park and smiled at a little girl and she asked if I was homeless. I realized then, things had to change. I have a full life ahead of me. I started eating right. I joined a gym. I’ve almost completely lost all the weight I gained and I no longer have gum disease. I asked my dentist about what he recommended for my missing teeth and he suggested all-on-4 dental implants. I was super thrilled about the idea of having a full mouth of teeth again. But, I went home to do some research and learned that diabetics shouldn’t get them. I don’t want to pay all that money if it’s not going to work. What should I do? I really want teeth again.

Carra

Dear Carra,

illustration of a dental implant

First, let me add my condolences. Don’t be too hard on yourself regarding how you dealt with your grief in the beginning. It’s almost suffocating to lose a loved one and we all seem to lose ourselves at first too. You should be really thrilled with the incredible progress you’ve made since then. I think the healthy changes you’ve made are remarkable.

For the most part, dental implants have a 98% success rate when done by an experienced implant dentist. There are some factors which make patients more at risk for implant failure. The biggest of these are:

  • Gum Disease
  • Smoking
  • Uncontrolled Diabetes

You’ve already taken care of your gum disease, which is huge. A responsible dentist will NEVER give a patient who has gum disease dental implants. There’s no way for your body to retain them well, just like when you suffered from gum disease, they couldn’t retain your natural teeth. They will fail. Because you’ve already turned that around it’s not a worry for you.

You didn’t mention anything about smoking, which I hope means you’re not a smoker. Smoking lowers your blood flow in your gums which increases your risk of infection, a leading cause of dental implant failure. You also increase your risk of redeveloping gum disease.

Your diabetes is under control, so again, Yay! not a problem for you. I think you’re likely a good candidate for dental implants.

Are All-on-4 Dental Implants the Right Choice for You?

The only real reason to do the All-on-4 procedure rather than traditional implants is bone loss. Sometimes, with gum disease and tooth loss, you lose so much jawbone structure you don’t have enough to retain dental implants. All-on-4 is one way to get around that. However, there is a better, more reliable option.

If you don’t have enough bone to support traditional dental implants, I’d consider getting bone grafting done. It will build back up your bone structure. Then you’re free to get whatever procedure you want. I hope this helps you make your decision.

Best of luck and congratulations on all your hard work!
This blog is brought to you by AACD Accredited dentist Dr. Randall Burba.

My Dentist is Gouging Me

I have full snap-on dental implants. I have four posts. I fairly regularly need the locator male retention caps. I’ve looked online, but they only seem to allow dentists to purchase them. Unfortunately, my dentist charges me $30 for one! I can tell they come in sets of four for $20. That’s a huge markup and one I just can’t afford to keep paying. Do I have other options?

Brandon

Dear Brandon,

dental implants anchoring dentures

Ouch! I’m guessing your dentist has high overhead and is using that markup to cover some of that. However, that’s quite a markup. You do want to keep up with your maintenance, especially after investing so much money in your dental implants. I have a couple of options for you that may help.

First, most dentists are very generous people and understand how expensive life can be. You could call around to a different dental office explaining your situation. It’s usually the dental assistant not the dentist who orders those materials using the dentist’s code. You could see if one of them would be willing to order for you and allow you to pay much less than your current dentist, making it affordable for you. You might even find someone who’d be willing to sell it to you at cost.

Another option is ebay. There are dental implant locator caps available there from overseas which don’t require any documentation that you’re a dental professional. They sell for about $20 per set. There is a catch though, it’s important you know EXACTLY what you need, including the resistance. They vary and you don’t want to end up with the wrong ones. Because of that, I’d try other dentists in your area first.

This blog is brought to you by Dr. Randall Burba.

Dental Implants for Stuntman?

Hoping you can point me in the right direction. I’m a stuntman and normally have no problems. But, in the last six months, I’ve lost two teeth. That’s quite a spate of bad luck for me. I need to replace those teeth but wondered if dental implants are stronger or a dental bridge. I don’t want anything removable because I’d think that would be a choking hazard.

Carlton

Dear Carlton,

Illustration of a dental implant

I’m glad you’re taking the time to research this ahead of time. You’re in a unique situation and have to be certain you’re getting the absolute best tooth replacement. Before we discuss your options, I want to make sure you’re wearing a mouthguard during your stunts. If you’re worried about appearance, your dentist can fashion one that will look like teeth.

Another thing to consider is whether you’re losing more teeth because of accidents at work or if they’re a little looser than normal because of some gum disease. If that’s the case, you’ll want to have your dentist start treatments right away or you’ll continue to lose teeth.

I’m not saying that’s the issue, just that you want to try to pinpoint why you’re losing teeth to see if you can eliminate the issue. Though, you can’t very well do anything about a run of bad luck.

Dental Implant versus Dental Bridge

As you can see from the illustration above a dental implant places a prosthetic root into your jawbone, making it the most stable replacement option. The implant mimics your tooth root. After the healing time and the bone has reformed around your dental implant, it will be as strong as your natural teeth were. But, just like you’ve broken your natural teeth, you can break your dental implant if enough force is applied.

An illustration of a dental bridge

The other option you asked about was a dental bridge. While a dental bridge will be bonded on (see image directly above), it’s not implanted into your jaw. They’re still stable, but not quite as stable as an implant.

Because of that dental implants are generally the better choice. However, if the adjacent teeth already need crowns, then a bridge may make more sense, though, you can certainly get more than one dental implant if you wanted.

Hopefully, your spate of bad luck will change soon.

This blog is brought to you by Dr. Randall Burba.

Dentist Said I’m Too Old for Dental Implants?

I’m a little distressed and hoping my dentist is mistaken. He’s been my dentist for years, but sometimes I get the impression he doesn’t exactly “keep up” with the developments in his field. I’ve had dentures for 25 years. Back then I’d never even heard about dental implants. My dentures never really looked natural, but it’s getting impossible to keep them in even though I completely replaced them a few years ago. To top it off, now my face is smushing around them. I asked my dentist about dental implants and all he said was, “Not at your age.” I’m sick of dentures. Is there any way for a mature woman to get implants?

Sarah L.

Dear Sarah,

dental implants anchoring dentures

I’m sorry your dentist gave you the impression that your age would preclude you from getting dental implants. If you’re in good health otherwise, there isn’t really a reason why you can’t have them. Though, the length of time you’ve had dentures will require you to have another procedure done ahead of time in order to make them viable.

When your teeth were removed, your body started reabsorbing the minerals in your jawbone to use elsewhere throughout your body. While great for other aspects of your body, it’s a horror for your jawbone. This is why your dentures no longer fit and why your face has scrunched up around them. This is known as facial collapse.

Dental Implants are a Great Solution

Fortunately, there’s an easy solution to that bone loss. Bone grafting can now be done as a one-day procedure. Once you have enough jawbone again, you’ll be good to go to get dental implants. The best part is, with implants in your jaw, you won’t have to worry about losing any more jawbone.

Now, I want you to know your dentures could have been made to look beautiful and natural, though you’d still have the same problem with the bone loss. What the dentures look like is really down to the cosmetic abilities of the dentist. It sounds like your dentist isn’t very artistic.

Unfortunately, you won’t get any better results from him next time, unless he’s done extensive training since then. If you want a beautiful smile, you need to find a different dentist to do these implants.

Who Should Do Your Dental Implants?

There are two things which need to factor into who you go to for this procedure.

1. Technical skill. They’ll need extensive training in the implant procedure. You want to make sure they’ve done post-graduate training.

2. Cosmetic Ability. If they get the implants right, that’s great, but you won’t like your smile much if he doesn’t make the implant crowns beautiful. The most artistic dentists are AACD accredited. In fact, many of them have a beautiful smile guarantee.

This blog is brought to you by Dr. Randall Burba.