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Why do dentists push dental implants and not dental bridges?

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I have been told over and over by my dentist it’s time to replace my missing teeth. I have a couple out on top and one on the side, all on top. I have seen a couple different dentists because the first one wouldn’t stop nagging me about dental implants. But the new one is pushing dental implants over a dental bridge too. Why? What makes them so special other than the ridiculous price tag? They must be getting a kick back from the implant manufacturers or something.

– Rich in Washington

Rich,

Dental implants are superior to a dental bridge for many reasons. It sounds like you may have a misguided opinion. It’s not about kick backs or anything of the sort. Your implant dentist should have given you a thorough explanation as to why dental implants are an excellent choice. Just speculating here, but you may have been turned off by the fees. Then, you probably didn’t hear any of the explanation. It’s true, they are expensive. Especially when compared to a dental bridge.

Dental implants are a permanent solution. Also, they do not require preparation of the surrounding teeth. They prevent facial collapse (a bone loss condition) that occurs when you don’t have any teeth left. And they look, feel, and function just like your natural teeth.

Now, there are instances where a dental bridge makes more sense. If budget is a major determining factor, then a bridge may be right for you. Or if the teeth that surround the missing teeth need crowns anyway, then a dental bridge would work well.

So try meeting with your dentist again and listen to why he or she is recommending dental implants vs dental bridges. Most dentists want to find the right treatment for their patient and aren’t pushing a particular option. But feel free to seek multiple opinions. Just take an attitude of listening and be committed to open communication. You will be glad you did!

This post is sponsored by York PA dentist Dr. Donald H. Currie, DMD

 

How does Meth affect teeth?

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My son is a drug addict. You don’t know how long it took me to be able to say that, even when I’ve known it for quite some time. He has finally hit rock bottom, but with a lot of help and prayer, we think he’s turning his life around. Aside from the physical problems and damage he has probably done to his general health, I’m curious about the affects to his dental health? A lot of his teeth look terrible because of decay, I’m guessing. Can you tell me what to expect when we get him into the dentist so we can all move past this stage of his life?

– Carol in Georgia

Carol,

Your son is very fortunate to have loving, supporting parents that want to help him overcome this terrible addiction. In regard to his dental health, you are correct that he likely has severe tooth decay if he has been using for an extended period of time. You may or may not have heard of the coined term “meth mouth” which describes common problems meth users encounter with their dental health. Even in a year or less, meth users can expect severe tooth decay and in some cases eventual tooth loss.

Contrary to what many believe, it isn’t the chemicals or substances in the drug that does the damage. It is the effects of the drug on the body that are the culprit. Saliva is decreased for meth users and sometimes the salivary glands stop producing saliva altogether for periods of time. So when the body is dehydrated and the individual is experiencing an extremely dry mouth, the natural response is for the individual to be thirsty. Unfortunately, they are not selective in their choice to relieve thirst and grab very sugary soda or other acidic drinks to quench their thirst. This creates a perfect storm for tooth decay because dry mouth means the mouth is already more acidic than normal, and this combined with the sugary drinks means that it is easier for plaque to attach to the teeth. Additionally, all of this is compounded by the fact that many meth users do not brush or floss their teeth regularly while they are using.

It is not uncommon for Methamphetamine users to have teeth that break, crack, and crumble. This is also attributed to the grinding affect that meth users experience during a high.

All of these factors mean it is likely that the teeth will need to be restored and in some cases removed and replaced. Restoration options include porcelain crowns if the teeth are salvageable, but the best replacement for teeth that need to be extracted or for teeth that have fallen out is dental implants. Dental implants truly are the best replacement option, but a dental bridge, partial, or full denture tends to be more economical. When the time is right, look for a dentist you can trust to help you explain the pros and cons of your options, particularly for a dental implant vs bridge.

This post is sponsored by York PA dentist Donald H. Currie, DMD General & Cosmetic Dentistry.

Should I save my tooth or have it extracted?

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I have been in pain for far too long. I finally went into the dentist and was told that the cavity is down to the bone and in order to save the tooth he would have to do surgery on one of my canines. This freaks me out, because I already hate going to the dentist for regular care, let alone surgery. To be more specific, he wants to do a bone lengthening surgery, a root canal, and a crown. I’m trying to decide if it would just be easier to have the tooth extracted and then get it replaced with a bridge? Thoughts?

– Mark in Virginia

Mark,

From what you have described about the cavity, it sounds like the decay has reached down to the bone. This means the cavity is now under the gum tissue. The surgery that your dentist is referencing to is likely a crown lengthening procedure. What happens is that your gum tissue is reduced in the area around the tooth and the bone is re-contoured. This will enable the dentist to properly remove the decay so there is enough space between the bone for proper placement of the dental crown. If this step is skipped than the new crown will be placed improperly and cause irritation to the gums. If your gum tissue is indeed compromised, then a whole set of other risks like bone loss around the tooth may occur. With bone loss comes an increased risk for the tooth to be lost. Almost all dentists will do whatever possible to save a tooth. There are many procedures and options to replace a missing tooth, like a dental bridge or dental implant. But in dentistry we want to salvage a natural tooth if at all possible.

Ultimately the decision is yours and the cost of a dental bridge compared to the surgery your dentist is suggesting is probably about the same. It is worth mentioning that if the surrounding teeth are healthy, than a dental bridge will require them to be drilled away and capped with porcelain crowns. This puts additional stress on those otherwise healthy teeth. But if the surrounding teeth are already damaged, than a bridge may not be a bad option. Replacing the tooth in question with a dental implant will not affect the surrounding teeth, so it could be another decent option.

Be open with your dentist about your concerns. If you are still unsure, you could always seek a second opinion. Hopefully this helped to clarify some information for you.

This post is sponsored by York PA dentist Donald H. Currie, D.M.D.

Related link: dental implant vs bridge

Ugly Bridge

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I’ve had a bridge since I was in my 20s. I never was happy with it. It looked cloudy and too bulky.  I have had it re-done by a cosmetic dentist. It was better, but still looked a little fake. The bigger problem was it kept coming out. My dentist glued it back in a few times, but said that the real problem was my overbite. He felt as long as my teeth were out of place that the bridge would not stay on.

I went to an orthodontist in order to get my overbite fixed. He worked on my teeth and straightened them. The made my bridge worse. He offered to make it look less bulky and filed it down. He filed it down so much that now you can see the metal.

I was planning on getting the bridge re-done at some point, but now I have to get it done right away, which I’m not sure I can afford. Is there a way to get the orthodontist to cover part of the expense?  Also, my “cosmetic” dentist didn’t seem to do that great of a job. Are my expectations unreasonable? I just want them to look like my other teeth. When I told him I didn’t like the bridge and how it looked next to my teeth, he suggested I get all my front teeth crowned with a bridge so they will look uniform. I just don’t think I want to grind all my healthy teeth down. What do you recommend?

Alicia B.- Staten Island, NY

Alicia,

First let me say you do not have unrealistic expectations. Not only should your bridge look natural, but it can look beautiful as well. You’ve been through a lot with this bridge, so lets see if we can give you a good experience.

One of the problems I’ve seen is that you are assuming anyone who calls themselves a cosmetic dentist actually is.  There is not a recognized specialty in cosmetic dentistry. That means any general dentist who learns a few cosmetic procedures can call themselves a cosmetic dentist. What you’re really looking for is someone who has gotten a lot of post-graduate cosmetic training. Of course that is hard for you to find out on your own. I recommend you go to the mynewsmile.com website and see who they recommend for your area. This site screens cosmetic dentists for their training and artistry. You’ll be safe with anyone recommended on that list. I peaked at their list and their isn’t anyone listed from Staten Island. There is several listed in Manhattan, which is just a short ferry ride away. It would be worth some short travel to have it done properly.

I don’t think your dentist is a good fit. First, your overbite wasn’t the bonding problem. He should have been able to fit it to your bite. Secondly, a good cosmetic dentist should not have to do all your teeth to get them to match. In fact, that is a bad plan for you. Anytime something goes wrong with just one of your teeth you’ll have to replace the whole bridge unit. If you’re wanting to re-do more of your teeth, then you should replace the bridge unit (make sure it is all-porcelain), and put porcelain veneers on the remainder of the teeth you’re wanting to change.

I do think you can get some compensation from your orthodontist. If he has a conscious, he is feeling a little guilty for what happened. I would start by asking nicely and explaining that you didn’t have the funds to replace it right now, but based on what happened you’re kind of stuck needing to. Ask him to pay for half of the bridge replacement cost.

This blog is brought to you by York PA Dentist Dr. Donald Currie.

If Novocain doesn’t work, what are my options?

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I hope you can help me with some good information. I really need reliable advice, and just can’t seem to find a dentist that I can really talk to about this.

I have always had a real problem with Novocain. Specifically, it doesn’t work for me. Not at ALL. I’ve been to no less than five different dentists in my life, and have not found one single one that believes me when I tell them this. I swear, I am not just being wimpy. Every single time I have to have Novocain, it doesn’t work to make my mouth numb. I can ALWAYS feel whatever the dentist is doing.

I’ve been avoiding going to the dentist for a couple of years now, and I have a pretty good idea that I need some significant work done. I have a dental bridge that is loose, and am pretty sure I have at least two cavities. I would like to have those white fillings, but my last dentist didn’t do them.

I really need a forward thinking, sympathetic dentist. How can I find one?

Thanks,

Toby in Orlando

Dear Toby,

Though it it not a well understood phenomenon, some patients have to be sedated before numbing drugs work for them. Increased anxiety decreases the effectiveness of drugs like Novocain, so sedatives are necessary to reduce the anxiety so the numbing drugs work.

You need to seek the services of a sedation dentist, to find someone who is sympathetic to the complex issues of pain and anxiety. You may also want to search for a “mercury free dentist“, to find a dentist who is trained and skilled in placing the white fillings you refer to.

Post courtesy of Dr. Currie, York PA cosmetic dentist.

If I am taking Fosamax, what are my options to replace a front tooth?

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I had to have one of my front teeth extracted. I’ve been wearing a flipper, but that has to go, and soon.

The dental surgeon who did the extraction said I might not be able to get a dental implant to replace the tooth, because I have been taking the medication Fosamax for years. If I had my choice, I’d like to go with a dental implant, but what are my other options?

I’ve seen some information about dental bridges that looks interesting. One kind that looked good was an Encore bridge, and another kind was a Maryland bridge. When I mentioned a dental bridge, though, my dentist said he is reluctant to file down one of my front teeth to place it.

I guess I feel like he is not really offering many options. Can you help?

Darius in Jacksonville

Dear Darius,

A dental implant might actually be an option for you. There is a slightly elevated risk of serious problems involving the bone at the site of the implant associated with Fosamax usage. Percentage-wise, the risk is small, but the consequences can be quite serious, so talk this option over carefully with your oral surgeon and your primary care physician. Perhaps it would be possible to discontinue Fosamax use on a temporary basis while you get the procedure completed.

If you decide that a dental implant is not worth the risk, a dental bridge would be a viable option. It is a little concerning that your dentist does not seem confident about this procedure when it involves the front tooth. You may want to seek the services of an experienced cosmetic dentist for this procedure, so you can be more confident of a positive outcome.

This post produced courtesy of York PA cosmetic dentist Dr. Currie.

I need dental implants – am I a bone grafting candidate?

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My dentist said I need three dental implants, and that I may need bone grafting before we can do the implants. The thing is, my dentist is really young, and I don’t think he has much experience with dental implants. My previous dentist retired, and recommended this dentist. I really like him, and he is very personable and seems competent, but I am just not sure how much experience or education he has in dental implants.

How do dentists generally determine if a person is a good candidate for the bone grafting procedure? Because of a boating accident, I had a dental bridge put in 17 years ago, when I was 16. You can really see the bone loss (three missing teeth) when you know what to look for.

Thanks for the information–I really like your blog.

Melody from Austin, TX

Dear Melody,

We’re glad you like the blog! We enjoy writing about dentistry issues that are of interest to people.

To determine whether or not someone is a good candidate for a bone graft procedure, your dentist will first and foremost look at your general health. If you are in good general health, he will further examine your x-rays and scans before making any kind of decisions about your treatment.

You are right to be wary about your dentist’s perceived lack of experience. We would certainly suggest that you question your dentist thoroughly about his education and experience with dental implants. If you are not comfortable with his answers, be honest with him and ask him to recommend you to someone who has experience with complicated cases like yours. Placing dental implants is not considered a separate specialty, but doing it well does require extensive training above and beyond the standard coursework in dental school.

If your dentist does not know who to recommend you to, you’ll have to do some of the legwork yourself. Look for a dentist with a website that lists strong credentials, including specifics about his or her experience and training in placing dental implants. Check his biography page and look for memberships in groups like the Academy of Osseointegration, or the International Congress of Oral Implantology, or the American Academy of Implant Dentistry. Affiliation with any of those groups or evidence of coursework done through one of them is a good indication that the dentist is well educated and experienced.

This blog produced on behalf of York PA dentist Dr. Currie.