Tag Archives: tooth replacement options

How Long Can I Wait for a Dental Implant?

I have a tooth where decay grew under the crown. My dentist doesn’t feel he can get it all out and recommended I see an oral surgeon to pull the tooth and then come back for a dental bridge. I’m not too keen on that so I’m thinking of seeing someone else about the decay. I’ve also been doing some research and it looks like a dental implant will be a better option for replacing a missing tooth. I’ve got fairly new dental insurance which has six more months of a waiting period before I can get any coverage for work done. If I pull this tooth, how long can I wait before there are problems?

Catherine

Dear Catherine,

illustraition of a dental implant next to natural teeth

I’m going to be blunt and tell you that you are not being well served by your dentist. Most skilled dentists will do everything possible to save a tooth. What does he mean he can’t get all the decay out? Has he tried and failed? Based on what you said, he didn’t even bother trying.

Next, he suggested a dental bridge instead of a dental implant. Your research is correct. Yes, it is a much better tooth replacement than a bridge. The one exception to that would be if the adjacent teeth already need dental crowns. If they don’t, then you are just grinding down healthy tooth structure.

I’m sorry, but this dentist seems too willing to get rid of teeth. You can do better. I’m going to highly recommend you get a second opinion on this tooth.

Don’t Wait before Getting a Dental Implant

If, after getting a second opinion, it turns out the tooth cannot be saved, I wouldn’t recommend waiting more than a week or two (at the most) with that space empty. The teeth around it will start to drift or tip into the space, making a replacement difficult.

In fact, it can lead to serious bite problems, which can cause TMJ Disorder. Just like cleaning out the tooth properly with a root canal treatment before getting your original dental crown would have saved you the problems you are facing now, making sure that space is kept open will save you a lot of pain down the road.

I’d recommend something simple and inexpensive, such as a dental flipper, to hold the space for you until your insurance will cover your dental implant. Truthfully, even if you received the implant today you’d need a temporary tooth anyway. The site where the implant is placed needs both time to heal and for the bone to integrate around the implant before it can support an implant crown anyway, so this isn’t an unnecessary step.

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

What If Dentures are my Only Option?

I’m in a pickle. I’ve had four pregnancies in six years which kept me vomiting every day, multiple times a day. Then, when I was done with that, I was diagnosed with cancer. My teeth are an absolute wreck as a result. Many of them are literally crumbling. I think the only thing I can afford is dentures. I’m about to completely lose it. I keep hearing dentists say dentures are the worst thing I can do but I’m not sure I have a choice. I’ve no money left and am still paying off tens of thousands of dollars for my treatments.

Emily

Dear Emily,

An illustration of both a denture and a dental implant

You have been through a lot and I don’t want you to beat yourself up. Sometimes, our health (even the health of our teeth) are beyond our control. In your case, I’m going to make a couple of suggestions to see if we can help you get the health you need for your jaw as well as a beautiful smile.

You mentioned dentists have warned you against dentures. The reason for that is the danger of facial collapse. Your jawbone slowly shrinks. Eventually, there is not enough money to even keep your dentures in place. The upper dentures are held in by suction, so those are a bit safer. The bottom ones just sit on the ridge of your jawbone.

If at all possible, I am going to suggest you get snap-on dentures on your bottom arch. This can place as few as two dental implants into your jawbone and keep your dentures from falling out. Plus, it will preserve the bone where ever you have an implant. From there, you can save up for other implants as you are able.

Getting Beautiful Dentures

Regardless of the type of your tooth replacement option, you want to make certain, the dentist who prepares them will create a beautiful smile for you. This is one of the few upsides for your particular situation. After years of damage to your teeth, you can now have the smile of your dreams.

Not all cosmetic dentists are equal in skill. It’s not a recognized specialty by the American Dental Association, so it is up to the dentist how much time and training he or she invests in learning how to make beautiful smile makeovers. There are two sources where you can find dentists capable of giving you a gorgeous smile.

The first is the American Academy of Cosmetic Dentistry website. They have a link where you can find a cosmetic dentist. When you list your area, make sure you check that you’re looking for an accredited dentist. These are the ones with expertise and artistry. The second source is mynewsmile.com. They also have a “Find a Cosmetic Dentist” link. Not all of them are accredited. However, each one of them has been screened for their technical and artistic skill.

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

Dentist Holding Teeth Hostage

I’m in a pickle. I’m losing my teeth. I know it’s my fault, but that doesn’t actually change my predicament. I need to replace them and asked for dentures because of cost. My dentist said he only placed dental implants and won’t give me dentures because of my age. I feel like my teeth are being held hostage by my dentist. Please tell me I’ll have alternatives.

Clarke R.

Dear Clarke,

An illustration of both a denture and a dental implant

While every dentist has the right to their practices treatment philosophy, I think this is unfair. Not everyone can afford the ideal. Instead, give patients their options. Tell them the pros and cons of their decision. Then, let them decide.

I will say one thing to your dentist’s credit, if you’re middle-aged or younger, he’s trying to save you from a devastating fate later. Once your teeth are removed, you body will begin reabsorbing the minerals in your jawbone to use elsewhere throughout your body. It does this because there are no longer any teeth roots and it perceives that as you not needing as much jawbone anymore.

The problem with this is your jaw begins to shrink. Your dentures just rest on the ridge of your jawbone, so after ten years or so there is no longer enough jawbone left to keep your dentures in. This is known as facial collapse and can derail your health. Without an ability to retain your dentures, you’ll be on a liquid diet.

Options to Complete Removable Dentures

Ideally, you’d get what’s known as implant overdentures. This allows you to anchor your dentures with about 4-6 dental implants per arch. There are quite a few benefits to this. No matter how well-fitted your dentures are, you lose about
50% of your chewing capacity. Having securely anchored dentures, gives you a normal chewing capacity again.

In addition to that, you no longer have to worry about them slipping or sliding. However, the biggest benefit is the prevention of the facial collapse I mentioned above. The implants serve as prosthetic tooth roots. This signals to your body that those minerals are still necessary.

However, I do realize not everyone can afford this option. In that case, my suggestion would be to get snap-on dentures. This allows you to get as few as two implants, which is much more affordable. It will keep your dentures from falling out and will preserve the bone near those two implants. As you can afford it, it will be incredibly beneficial for you to add implants.

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

Is it Too Late to Get a Pretty Smile?

I’ve had dentures for years. They have always looked fake but I knew they would be because they were dentures. Last week a friend of mine I hadn’t seen in a few years came to town and we had lunch together. Her smile was gorgeous. I couldn’t believe it. She said she got dental implants. I didn’t even know those existed. Is it too late for me to get them?

Mandy

Dear Mandy,

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

It’s never too late for a pretty smile. You should know that, with a great cosmetic dentist, you could have had a beautiful smile with dentures as well. It’s not the procedure in this case. It’s the dentist. However, you can’t change the past.

Dentures or Dental Implants

Truthfully, dental implants are by far the best choice when it comes to replacing their teeth. First, they’re permanently implanted so they’re completely secure. It’s like having healthy, natural teeth back in your mouth. You can eat whatever you want and brush and floss like you do with natural teeth.

They have a more important function, though. You’ve probably noticed your dentures don’t fit the same way they used to when you first received them. That’s because your jaw is shrinking. When your teeth were removed, your body recognized that and started resorbing the minerals in your jawbone to use elsewhere.

It won’t be long before you won’t be able to keep your dentures in place. This is known as facial collapse. Dental implants prevent that. The prosthetic roots placed into your jawbone tricks your body into thinking your natural teeth are still there and, as a result, leaves your jawbone intact.

If you decide to get dental implants, you’ll likely find you no longer have enough jawbone left to support them. However, that doesn’t mean you can’t get them. It means you’ll have to have an additional procedure first, called bone grafting.

Bone grafting is a simple, outpatient procedure. This will build up the bone structure so that your jawbone will be able to retain the implants.

Getting Beautiful Results No Matter What Procedure You Choose

As I mentioned above, the most important decision is to find a highly skilled and artistic cosmetic dentist. They can create something stunning that you’ll be proud to share with the world. You’ll never feel like you have an ugly smile again.

The easiest way to find one of those is to go to the website of the American Academy of Cosmetic Dentistry (aacd.com). They have a “find a cosmetic dentist” link. However, to get one with the expertise you need, you need to check that you want an accredited dentist, not just a member.

After you find a great cosmetic dentist, see which of them have experience with dental implants. You’ll want one with post-doctoral training in restorative dentistry.

Best of luck to you. 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.

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.

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.

Am I Doomed to Dentures?

My dentist said that my teeth aren’t worth saving and I should just get dental implants. When he showed me the price tag, I almost had a stroke. I told him there was no way I could afford to get those. He just shrugged and told me it’s that or dentures. I want to cry. Am I really doomed to dentures at 31?

Rebecca L.

Dear Rebecca,

Salem Snap on Denture

I’m a tad concerned that your dentist said that your teeth weren’t worth saving. Most dentists are of the opinion that every tooth is worth saving. You’ll find that saving natural teeth gives you a much better quality of life.

Sometimes teeth can’t be saved, even when you try your best. When that happens, then yes, dental implants are your best option. They’re the closest thing to having your own natural teeth. As you discovered, they are pretty pricey.

While dentures are a more affordable option, many patients hate them because they’re not anchored. At your age, dentures would be disastrous. There’s a condition known as facial collapse that will become an inevitability for you. When your teeth are removed, your body recognizes there is no longer a need for your jawbone to support the roots of your teeth. To that end, it removes the minerals in your jawbone to use elsewhere in your body where they may be more beneficial. Unfortunately, that means losing jawbone structure. Before long, you won’t have enough jawbone left to retain your dentures.

You may be feeling doomed right now, but there are options. The first one is the most important. I want you to get a second opinion. I can’t imagine, unless you just haven’t taken care of your teeth AT ALL, that at least some of your teeth cannot be saved. The more teeth you save, the better your outcome and the less money you’ll have to spend on replacements. It might be you won’t have to even worry about whether to get dental implants or dentures.

But, let’s plan for the worst. If you get a second opinion and the dentist said there wasn’t a way to save your teeth, don’t despair. It may be possible for you to set up a payment plan with your dentist in order to afford dental implants. Then you wouldn’t have to worry about being doomed to dentures. But, there’s always a possibility that even with the most generous payment plan, it would still be impossible for you.

If that’s the case, a decent option would be to get snap-on dentures. They use as few as two implants which enables you to snap the dentures. While you’re still getting dentures, these have a couple of benefits. First, they’re anchored. You won’t have to worry about them falling out the way traditional dentures do. Second, the areas that have the snaps will not lose jawbone.

You can do snap-on dentures with as few as two, but this allows you to save up until you can get a decent set of dental implants.

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

Dentist Humiliated Me about the Condition of My Teeth?

I’m beyond humiliated. I haven’t been to the dentist in years because of finances. Though, I do try hard to take care of my teeth. I brush twice a day and floss every night. Yet, when I went to the dentist there was a LOT wrong with my teeth. That was bad enough, but when I asked him how I could spread out the treatment because I couldn’t afford everything he suggested he started yelling at me and telling me how irresponsible I’ve been about my teeth. He said if I care that little about them why don’t I just have them all extracted and get dentures. Then I’d not have to do anything for them. Then he stormed out. The office has an open floor plan so everyone in the entire clinic heard him. I was absolutely horrified and left in tears, without even paying because I was too embarrassed to stop. What do I do? Are dentures my only option if I can’t afford to get the work done? I’m only 37. It sounds horrifying to wear dentures at my age.

MaryAnne E.

Dear MaryAnne,

You certainly don’t deserve to be treated the way that dentist treated you, even if you hadn’t been taking care of your teeth, which you’ve obviously tried to do. When you haven’t been to the dentist in a while, it’s normal for you to need a lot of work done. Your dentist should have been happy to list it out for you in staged treatment lists.

Result of dentures

Whatever you do, don’t remove all of your teeth and replace them with dentures, especially at your age. When all your teeth are removed, your body begins reabsorbing the minerals in your jawbone to use elsewhere throughout your body. It’s remarkably efficient the way our body works. The problem comes in about ten or twenty years. You’ll only be in your 40s and you’ll no longer have enough jawbone left to even support dentures. Not to mention your face will take on a squashed appearance making you look two decades older than you are, as you can see from the illustration above.

My suggestion would be to get a second opinion from another dentist; preferably one who’s known for their kind manner to their patients. You can often find that kindness from dentists who work with fearful patients. Many patients with dental anxiety avoid the dentist for years. When they finally come back they don’t want to be judged or lectured. Neither do you.

When you go, have the dentist list out everything that needs to be done in order of importance. It’s important you save as many teeth as possible. Those which can’t be saved, it would be better to replace them with dental implants instead of dentures. These help to retain your jawbone.

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