Tag Archives: facial collapse

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.

Do Dentures Really Make Your Face Shrink?

My mother is losing her teeth. I’ve tried for years to get her to brush but she doesn’t like “how it feels”. Now she needs dentures. Of course, she doesn’t have dental insurance or money so I’m having to pay for her new teeth. I can barely afford these dentures and now the dentist tells me if I get them her face will shrink and instead I should get dental implants. They’re massively more expensive. However, I don’t want to damage my mother’s face. Is he right about the shrinking thing?

Annabelle C.

Dear Annabelle,

An illustration of both a denture and a dental implant

It is truly fantastic how you are looking out for your mother’s best interest, especially given she doesn’t seem to care about taking care of herself. What your dentist referred to with the dentures is known as facial collapse.

How it works is once your mother’s teeth are removed, her body will begin to resorb the minerals in her jawbone to use elsewhere. This is because her brain senses she no longer has teeth and assumes she doesn’t need the jawbone. It’s remarkably efficient. If only our government knew how to distribute resources where they’re actually needed.

The problem is after ten to twenty years, there’s very little jawbone left, which gives her face a squashed, older appearance. Additionally, it makes it impossible for her to keep her dentures in. He’s suggesting dental implants because the implants serve as teeth roots, which lets your brain know that jawbone is still a necessity. This prevents facial collapse.

Should Your Mother Get Dentures?

While dental implants are the better treatment, it doesn’t necessarily mean it’s the right treatment for your mother. I’m not just talking about the expense. My guess is your mother lost her teeth because of gum disease. If that’s the case, she’s not yet a candidate for implants. Gum disease causes tooth loss. It will also do the same to her dental implants.

Right now, dentures are the best thing for her. If you can convince her to take care of her oral health and get her gum disease thoroughly healed, then you can re-evaluate. However, there’s no point it getting an expensive procedure that will be guaranteed to fail.

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

Is There a Dentures Support Group?

Please help me. I feel so foolish. It’s bad enough losing your teeth. But, being poor and losing your teeth is the absolute worst. I couldn’t afford to get dental implants, and yes, I know they’re better. I’m just stuck with dentures. I absolutely hate them. I don’t know if there’s a group or something which talks about how they deal with dentures, but I really need one.

Carolyn

Dear Carolyn,

An image of a snap-on denture
Snap-on Dentures will keep them secure

I’m not aware of a denture support group, but it sounds like a good idea. You might even be able to start one at your local dentist’s practice. I say that with confidence because you’re not alone in your feelings. Many people struggle with dentures.

Common Struggles with Dentures

One of the biggest complaints is it’s much more difficult to eat food. Many times that can be improved with a better fit of your dentures. However, there are limitations. Even the best fitting dentures still reduce your chewing capacity by 50%. Cutting your chewing capacity in half is a huge drop in quality of life.

Another problem is they slip and slide. Removable dentures are, by their very title, removable. Because there’s nothing anchoring them there, they will move. This will happen more and more as your jawbone shrinks, which is a devastating side effect of dentures known as facial collapse. Eventually, you won’t be able to keep them in at all.

I realize I’m not telling you anything you didn’t already know and you want solutions, so let’s move on.

A Snap-on Dentures Solution

Without having the money for dental implants, most patients feel hopeless, like they’re trapped. However, there is a sort of “part way” procedure that will help a little.

Generally, when you’re talking about implant supported dentures, you’ll need about six for each arch. However, with snap-on dentures, you can get as few as two. This can make a world of difference.

Benefits of Snap-on Dentures

The most obvious benefit is they cannot fall out. The implants anchor the dentures to your mouth securing them so you’ll never have to worry about embarrassing public slips.

They’ll help you retain your jawbone where the implants were placed.

They give you a stop gap while you work toward more implants. Obviously, the more implants you have the better, but starting with two gives you hope, a bit of relief, and a place to start.

Our life circumstances change all the time, and there may come a time you can afford to get more implants. This also allows you to save up a bit at a time and you can add two implants in stages as you’re able, until you have the security and chewing capacity you want.

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

What Can Keep My Dentures In?

I’ve had my dentures for a long time. Don’t ask my age. It’s rude. However, I do need advice. Regardless of how old I am, I don’t enjoy being humiliated by having my dentures fall out when I’m in public. So, be a nice young man and tell me how to fix this disaster. I’m almost scared to open my mouth. If you knew how much I loved talking you’d feel very sorry for me right now.

Eleanor

Dear Eleanor,

An image of a snap-on denture
Snap-on Dentures will keep them secure

What’s happening to you is a result of how long you’ve had your dentures. I certainly hope your dentist warned you about the problems with long-term dentures, but based on your question I don’t think he did.

When your teeth were removed, your body began reabsorbing the minerals in your jawbone to use elsewhere. After 10-20 years, there’s not enough jawbone to keep your dentures secure. This is known as facial collapse and the reason yours keep falling out.

Snap-On Dentures Could Be Your Solution

To solve this will take a couple of steps. The first thing you need is to build back up that lost jawbone. A simple outpatient bone grafting procedure can do that for you. Once you’re healed from that you have a few choices. I would never dare ask your age, but it will have an effect on which you choose.

The cheapest solution is to have new dentures made, but remember in a period of time, you’ll face the same issue of a shrunken jaw.

If you want the top-of-the-line tooth replacement option, then I’d get implant supported dentures. These attach your newly made dentures to dental implants. They will last a lifetime and prevent you from any further bone loss. The only drawback is the expense. They come with a hefty price tag.

In between those two treatments, is something called snap-on dentures. I’ve posted a picture of them right after your question. These use just two implants that will snap on to your dentures. They’re not as secure as a full set of implants would be, but they will keep your dentures in.

If you want to, you can add more implants as you’re able.

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

Can Dentures Be Attractive?

Everyone I know who have dentures have an ugly smile. I’m losing my teeth and need to replace them. I am going to save up for dental implants, but in the meantime I need dentures. I don’t want an ugly smile. Is there a way to get attractive, normal looking dentures?

Kevin

Dear Kevin,

Mature couple smiling
You can have a gorgeous smile no matter what your age!

Yes, you can certainly have an attractive smile with dentures. It’s not the procedure which makes the difference in appearance, but the dentist. In order to have a natural and attractive smile, you need to see a cosmetic dentist with a lot of expertise.

There are different levels of artistry in cosmetic dentists, just like there are better and worse painters and sculptors. Any art is a skill which takes both technical skill, natural talent, and lots of practice. So, how do you find such a dentist?

I suggest you look for a dentist who has reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of expert cosmetic dentists in the world.

Transitioning from Dentures to Dental Implants

I’m sure your dentist has explained the dangers of dentures to you and that’s why you’re saving up for dental implants. One thing you could do starting out is to get snap-on dentures. This can be done with as few as two dental implants and will at least get you started.

Make sure that whoever you go to for your dentures also has some expertise in dental implants as well, especially because you’re going to be transitioning. They can do your snap-on dentures or even complete removable dentures in a way that will make the process easier.

The Danger of Dentures

In case your dentist didn’t explain why implants are the better option I’m going to put it here for you and for the benefit of others. Once you remove your teeth, your body will begin reabsorbing the minerals in your jawbone to use elsewhere throughout your body. This causes your jawbone to begin shrinking. Eventually, you won’t have enough jawbone left to even retain your dentures, making it nearly impossible for you to eat. This process is known as facial collapse.

Dental implants prevent facial collapse because the root form tricks your body into thinking you still have natural teeth there and it leaves the mineral in place, saving your jaw bone structure.

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

Will I Have to Have Surgery for Dentures?

I’m trying to figure out whether or not to get dentures or dental implants. I hate the idea of surgery so was leaning toward dentures. But, wonder if they require surgery too.

Jack B.

Dear Jack,

An illustration of both a denture and a dental implant

I think when it comes to deciding between two procedures, I’d first look at the long-term effects. Once you know how they’ll affect your quality of life, then you can weigh that against placement procedures.

Dentures Versus Dental Implants

Dentures are a removable tooth replacement option. The top arch stays in by suction. The bottom arch sits on the ridge of your jawbone. They have several “downsides” but I’ll just give the biggest. Once your teeth are removed, your body will reabsorb the minerals once used by your jawbone to help you keep the roots of your teeth in place. Without those minerals, your jawbone will begin to shrink. After a while, you’ll lose so much bone that you won’t have enough to keep in your dentures. This is known as facial collapse because of the way it makes your face look shrunken and prune-like.

Dental Implants are permanent. Prosthetic root forms, either titanium or zirconia, will be surgically implanted into your jawbone. After a period of healing you’ll have dental crowns placed on top. Aside from the obvious benefits of being just like having your natural, healthy teeth back, implants preserve your jawbone. No matter how many years you have them, they’ll protect you from facial collapse.

Surgery for Dentures

While dentures don’t require the same surgery as dental implants, you are talking about a major extraction. You have to extract all your teeth. This, like dental implants, also requires a healing period of 8 weeks or so.

There are two types of dentures you can get that affect the surgery.

Immediate dentures These are placed right after the teeth are extracted, having two benefits. First, you can walk out the office with your new smile intact. Second, it helps reduce the swelling and bleeding that occurs after having a major teeth extraction. The downside is they’re usually more expensive than conventional dentures because they take more time to make. You’re also required to have more follow-up visits, which are necessary to make adjustments.

Conventional Dentures These require you wait for about eight weeks after the extraction procedure for placement. However, they do tend to fit better than immediate dentures. During the healing process, your tissue will shrink and the immediate dentures will become loose. To aid with that, a soft temporary reline material is placed on the denture for refitting. It takes about six months for your month to completely heal after the extractions and at this time a more permanent reline or new denture is needed.

As you can see, either procedure requires extensive work. So, as I mentioned earlier, ask yourself which one has the best quality of life experience after they’re placed. The answer to that is definitely dental implants.

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

Are Pretty Dentures Possible After 20 Years?

I’ve had dentures for 20 years. I’ve never liked them and have been quite embarrassed about my smile ever since. I now mostly smile with my lips closed. But, things have been getting quite worse. Lately, they’ve been painful and difficult to keep in. They’ve even fallen out once while I was in public. Talk about humiliating. This likely means I need a new pair of dentures. Since there have been 20 years of developments in dentistry, I’m hoping that means dentures can be made pretty now? Pretty please tell me that’s the case.

Alexandra M.

Dear Alexandra,

Mature couple smiling
You can have a gorgeous smile no matter what your age!

I hate hearing stories like yours. It saddens me to know you’ve spent this much time ashamed of your smile. You’re right that there have been improvements in the dental field. In fact, there’ve been remarkable improvements. I’ll share several of them in a moment. First, I want you to know that you can definitely have a gorgeous smile, even with dentures. You could have when you first received dentures, too, had your dentist been skilled in the cosmetic end of dental care.

Let’s start with the beauty of dentures. Even back when you received your dentures, a skilled, artistic cosmetic dentist could have prepared a stunning set of dentures for you where you’d be thrilled to share your smile with the world. However, now you have a second chance to get that gorgeous smile.

Fixing Your Denture Problems

The reason your dentures no longer fit properly and are falling out is a condition known as facial collapse. It’s a result of the length of time your teeth have been removed. You can learn more about this on our problems with dentures page. The end result, however, is you no longer have enough jawbone to support any form of tooth replacement, including dentures.

All is not lost, though. The first thing you’ll need to do is have some bone grafting done. This is a relatively simple procedure (if the dentist knows what they’re doing) which can build back up the jawbone that you’ve lost. It can be done in one appointment, but you will need some healing time afterward for the bone to be secure.

After that, you have several options:

  • Get New Dentures Made

DenturesObviously, the first solution is to just have new dentures made. If you want them to be beautiful, though, you’ll need to go to a skilled cosmetic dentist. There isn’t really a cosmetic dentist specialty, so any general dentist can perform cosmetic procedures. The problem with that is their results vary. So, you need to do some research to determine if this is a skilled artistic dentist or not.

The absolute easiest way to do that is to simply go to an AACD accredited dentist. The AACD is the American Academy of Cosmetic Dentistry. Their accreditation program is designed to weed out the pretenders from the truly artistic cosmetic dentists. If a dentist has reached accreditation level with the AACD, you can be assured you’ll get a beautiful smile.

You do need to be aware, though, is if all you do is get dentures again, you’ll still face your jawbone shrinking and have to go through this whole procedure all over again in about 10 to 20 years.

  • Get Dental Implants

Illustration of a dental implantThe best way to prevent dealing with facial collapse after you’ve had your bone structure repaired is to get dental implants instead of dentures. These implant prosthetic roots into your jawbone causing your body to realize there is still a need to support your teeth, which leaves your jawbone completely intact. However, some people find dental implants out of their budget. Fortunately, there is a middle ground.

  • Get Snap-on Dentures

Salem Snap on DentureThese are dentures which are supported by dental implants. They’re considerably more affordable than a full set of implants and can help your dentures stay in place. Obviously, the more implants the better the support, but you can get them with as few as two. Then, as you’re able, you can add more implants to secure them further and protect additional bone.

I hope this helps with your situation.

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

What Would Getting Dentures Entail?

I’m losing my teeth and making some decisions about what to do next. What would it entail to get dentures? Do they put you out and then take out all your teeth at once? Do you get the dentures right away?

Carla

Dear Carla,

Dentures

I’m sorry you’re facing this decision. I know how heartbreaking it can be. I’ll answer your question about dentures, but before you make a decision I want to be certain you know your options other than full dentures.

Options to Full Removable Dentures

Dental Implants

illustration of a dental implantIf you’re removing all your teeth, ideally you’d get dental implants. As you can see from the illustration at the left, it implants a prosthetic root into your jawbone. This is why dental implants are so useful. They’re much more stable than other options. You can eat and brush/floss as you normally would with your normal, healthy teeth.

However, their biggest benefit is the prevention of facial collapse. When your teeth are removed, your body immediately begins to reabsorb the minerals in your jawbone to distribute elsewhere throughout your body where they’re more needed. It’s efficient, but the result will be you won’t have enough jawbone left to retain a denture. Dental implants prevent that.

Implant Retained Dentures

dental implants anchoring denturesVery few people can afford to get an implant placed on every tooth. However, implant supported dentures are another option which is more do-able financially. With these, your dentist will place an implant in even distribution throughout your bite. When that’s completed, he can anchor your dentures to them. You get the benefit of preserving a good deal of bone along with having your dentures secure in your mouth.

Obviously, the more implants you can afford to place the better, but this can be done with as few as two implants, which are called snap-on dentures.

How Are Removable Dentures Placed?

First, the teeth are extracted. Some people prefer to have dental sedation for this part of the procedure. This way they can sleep through the procedure if they’d like. Others prefer just to use a local anesthetic. It’s completely up to the patient. Once that is completed, the next step depends on the type of dentures you decide on.

Immediate Dentures

These can be placed as soon as your teeth are removed. The benefit is you can walk out with a full set of “teeth”. They tend to end up being a bit more expensive because they require more follow-up visits and adjustments.

Conventional Dentures

These are placed about eight weeks after extraction. The benefit is they tend to fit better, requiring less adjustment. The obvious drawback is the wait to have a smile.

Discuss these options with your dentist. I’m sure the two of you can come up with what works best for your lifestyle and budget.

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

Options to Dentures or Dental Implants?

I’m having every tooth extracted. It’s a long story I won’t go into as to how this happened. I’m looking for options now. My dentist wants me to get a dental implant on every tooth. Even if I owned a house (which I don’t). I’d have to sell it to pay the cost of something like that. He said if I didn’t do that I’d have to get dentures. I don’t want that either. Isn’t there a middle ground?

Darren L.

Dear Darren,

An image of a snap-on denture
Snap-on Denture

Absolutely there’s a middle ground. There’s also varying degrees of ground. I’m personally appalled that your dentist gave you only those two options. That’s like telling a potential homebuyer they either purchase the multi-million dollar mansion or they’ll have to like in a decrepit shack with no power. Ethically, he’s supposed to inform you of all your options.

First of all, you can get dental implants without having an implant placed at every tooth. In fact, only the richest of clients could afford something like that. When all your teeth are missing, patients normally get implant supported dentures. It utilizes a dental implant, but they’re anchored to your jaw with implants. Obviously, the more dental implants you have placed, the more secure they’ll be. However, you can get them with as few as two.

These are generally called snap-on dentures. They help keep the denture from slipping out. It also preserves your bone where the two implants are placed. That’s very important. In fact, the more implants you have placed, the more you’ll prevent the facial collapse that comes with jawbone shrinkage, one of the biggest problems with dentures.

How Dental Implants Prevent Facial Collapse

When you remove your teeth, your body begins reabsorbing the minerals in your jawbone to use elsewhere throughout your body. It’s remarkably efficient, but devastating to the use of dentures. Eventually, your jawbone shrinks to the point where there’s no way to keep the dentures in.

Every implant placed, including those from snap-on dentures, retain the minerals in each place there are implants. That’s because your body recognizes the implant as a tooth root and knows you need the jawbone intact in that area.

This is one of the reasons I’m frustrated with your dentist. Just telling you about dentures without giving you the dangers and how to prevent them is irresponsible.

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

What Are Implant Dentures?

I wanted to get dental implants but couldn’t afford it. My sister told me there’s something called implant dentures that don’t cost as much. Is that true?

Luke M.

Dear Luke,

dental implants anchoring dentures

What your sister is referring to is using dental implants to anchor your dentures. It’s very useful in allowing you to build up to the number of implants you’d like but can’t afford in the beginning. You can get this with as few as two implants, using snap-on dentures.

There are important benefits to this above just using straight dentures. When your teeth are removed your body begins to reabsorb the minerals to use elsewhere where they’re more needed. While very efficient, it does mean you’ll be losing most of your jawbone. Not only does this make you look years older, but eventually you won’t even have enough jawbone left to retain your denture. This process is known as facial collapse.

Advantages of Implant Supported Dentures

  • Prevents facial collapse
  • Keeps your dentures from slipping
  • Gives you time to save up for more implants

I’m concerned you’re having to get alternative treatment advice from your sister. A good dentist doesn’t just tell you the ideal treatment. He also tells you about all the alternative treatments along with their pros and cons. For instance, below I’ve pasted a screenshot of Dr. Burba’s submenu for dental implants. You’ll notice he would go through quite a few options with patients and not just expect them to go for the high-end treatment.

list of tooth replacement options

If you need to replace teeth, which is a huge and advanced undertaking, I’d like you to get a second opinion with someone who will tell you what your options are.

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