Dental Implants Archives | Dr. Currie's Dentistry Blog

The root of my tooth is cracked, now what?

Posted on December 2, 2020

It has been several years ago now that I had a root canal placed on my upper, left molar. A gold crown was placed on it after the root canal was completed. A couple of years ago, I started noticing pain on that same tooth which is surprising since the root canal had been completed and the tooth was fine for years. So, I was referred to an endodontist.

A fourth canal was discovered and it was treated. Then, after another year or so I ended up getting an abscess on that same tooth. So, I went back in to see the same endodontist who originally took care of that fourth canal. In all fairness, at the time of the treatment of the fourth canal, he did prepare me that there was a chance that the treatment wouldn’t be successful if the root was cracked. So he referred me to a periodontist this time around to take a look at the abscess and to get another opinion. The periodontist confirmed that I had a cracked root. I really didn’t want to lose the tooth entirely, so I opted to have the cracked root amputated. Then, he did a bone graft. I have so much money invested in this tooth now, I felt like I needed to do everything possible to save it.

Now, it’s been about another eight or nine months. Unfortunately, I have yet another abscess and the tooth is very painful. The pain is different this time too, it feels like it’s deep in my gum. They have prescribed antibiotics for me to treat the infection. Then, I am supposed to go back in to see how things look. Ugh! They seem to think the the root canal needs to be redone. I honestly think both of these doctors are honest and doing their best to work through this situation. They seem as disappointed as I am. However, I am beginning to feel helpless at this point.

Is it possible to have another root canal or branch off of one of the roots that is causing the infection? I originally thought that a root canal would take care of the infection and that there shouldn’t be a reason for anymore pain. Is there some other cause for the reoccurring abscesses?

Please let me know if you have any other ideas or advice about what could be going on? I’m beginning to feel helpless at this point.

-Carl in Georgia

Carl,

It sounds like you are working with two dentists that you trust. That’s great. However, at this point I would be hesitant to go in for another root canal treated again. It seems that they have failed so far. So as much as you want to persevere, it may be time to explore other options. Tooth infections are serious and most dentists will do everything possible to save a teeth no matter what. But, based on what you have described about what you are experiencing, it sounds like it may be time to move on and consider other options for your overall health and to avoid another potentially painful and unhealthy situation.

It may be in your best interest to consider replacing the tooth with a dental implant. Sadly, you have been dealing with this for years and there has been a lot of effort invested in to trying to successfully treat it. The bottom line is that root canals are tricky. And when the pain occurred after the initial root canal treatment, it doesn’t sound like the source of the problem was ever discovered. Many times root canal treatments are essentially educated guesses. Endodontists use probability and there is a possibility that the treatment may not work in the end.

Cracked roots are difficult to diagnose properly and treat. They can’t even be seen on x-rays. Also, leaky canals aren’t anything that can be seen on an x-ray either. This is why the endodontist prepared you from the beginning when they gave you ‘odds’ for success. It sounds like you tried your best to beat the odds. But, it doesn’t sound like it’s paying off because they aren’t any closer to figuring out the cause. Honestly, it is entirely possible that several or all of the roots are cracked.

Again, only you can make the decision about what is best for you. As long as you fully understand that there is a chance you could go through another round of treatment and it still won’t solve the problem.

You should at least learn more about the dental implant process so you can make an educated decision. Most implant dentists will meet with you for a consultation so you can learn more about your options. A dental implant is a permanent solution to replace a tooth. It will look, function and feel just like your natural tooth. It would be wise to consider it, get more information and then make a decision.

Thank you for your question. I wish you all the best as you figure out what is right for you.

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

My tooth broke off, now what?

Posted on October 25, 2020

I had a crown done over 30 years ago done on my right lateral incisor. When I went in for my regular cleaning and exam, my dentist informed me that I needed a root canal. He said there was a lot of tooth decay located underneath the crown.

Don’t get me wrong, I believe him. I mean, it’s been decades. But, I haven’t had any issues with pain or any other sign of a tooth infection. So, I moved forward with the recommended treatment. The dentist started the procedure and had to give up after two hours. He said that the root canal had calcified and he couldn’t find it. So, he put a temporary filling in the crown and referred me to another dentist who specializes in root canals.

When I called the endodontist, he didn’t sound too concerned when I explained what was happening since I haven’t had any pain associated with it. So, my appointment was scheduled for several weeks away. Well, I still need to wait another two weeks for my appointment and my porcelain crown broke off. There was some of my tooth that came out with it too. I don’t know what I’m supposed to do at this point. I am an elderly person and I don’t have a big budget for dental care. I honestly think it should have been left alone because it wasn’t bothering me. Now, I’m wondering if I should move forward with a dental implant to replace the broken tooth?

I’m just not feeling really good about the endodontist doing a root canal that should have never been messed with. I have to wonder if there is even enough of my natural tooth left to put a new crown back on. I went to Walgreens and picked up some over-the-counter dental adhesive so I can reattach the crown until I’m able to get back in.

It sure seems like you are a reputable dentist in your area. What would you recommend for me at this point?

-Sylvia

Sylvia,

Well, it is difficult to provide specific recommendations without having seen your case in person. But, I can provide some general feedback based on what you have explained so far.

First off, was it the dentist’s fault that the tooth is broken? It is not common to have a dentist drilling for two hours and not having success locating the canal. You have to wonder if that compromised the health tooth structure underneath the crown. The dentist should provide you more options at this point and should have offered more information to the endodontist, instead of referring you and leaving it at that. Hopefully, he has learned from this experience. However, that doesn’t help you out at this point. If it was his fault, it seems he should help you with some of the cost to get it fixed. On the other hand, it sounds like he may be in over his head and it wouldn’t be wise to continue working with him at this point.

Since you mentioned that there is decay located underneath the crown, it would be wise to have the crown removed since you need to have it replaced anyway. Then, the decay can be removed and it should be a lot easier to locate the root canal. If there is any infection that took place under the crown (even if you don’t feel it) then the decay may have gone into the canal. With the old crown removed, there will be a higher chance of success for the endodontist if you go that route.

Another important issue that you have brought up is the fact that some of your natural tooth has come off with the crown. The remaining tooth structure may not be sufficient to re-cement a new crown. The best way to replace a missing tooth is with a dental implant. It will look, feel and function just like a natural tooth. However, it is more expensive than alternative treatments like a dental bridge. If you would like to learn more about if you are a dental implant candidate, be sure to find an excellent implant dentist in your area. Not just any family dentist will have success in placing dental implants. The surgical posts need to be placed in the proper positions in order to hold up to rotational forces. It requires extensive training beyond dental school to get it right. Find a dentist with strong credentials, ask to see cases similar to yours and see if there are reviews or testimonials so that you can hear from others who have had similar treatment plans.

The biggest takeaway here for you is that it sounds like it may be time to seek a second opinion on your case. Your current dentist doesn’t sound equipped to successfully treat your tooth.

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

How long can I wait to get a dental implant for a missing tooth?

Posted on September 19, 2020

It has been a couple years since I’ve been in for my regular dental cleaning and exam. While I was there, the dentist informed me that I have a molar underneath a crown that is broken. When he took a closer look, he didn’t feel that he would be able to get out all the decay if he did a root canal treatment. So, he recommended that I get the tooth pulled. After a few months, I am supposed to go back and get a dental bridge.

I decided to go to the endodontist anyway to see if he would be able to complete the root canal because I really want to save the tooth if there is a chance it could be saved. When I talked with my dental insurance, they told me that a crown wouldn’t be covered for a year. I am starting to wonder if the insurance will cover any part of a dental implant, but it’s worth asking. I don’t want a bridge. So, I’m trying to figure out how long I can wait if I have the tooth extracted right away. Will I start to have problems if I put it off for awhile and save up for the next treatment? If I have to wait a year to do anything for insurance, then I might as well get the dental implant if it’s covered.

I’m in my 50s so I want to get a treatment that will serve me well for years to come. I realize I should have had a root canal years ago. The dentist put a crown on and didn’t want to drill through it to do a root canal. The pain stopped eventually so I didn’t worry about it. But, apparently I should have because now it is dead I guess.

Thank you in advance for your time.

-Patricia in North Carolina

Patricia,

Dentists have varying philosophies when it comes to saving teeth. Some tend to be a bit eager to pull one. But, it is always better to save a tooth if at all possible. It seems odd that the dentist doesn’t feel confident that he can get all of the decay taken care of under the crown. It may be in your best interest to get a second opinion. It will be telling what the endodontist says.

As for a more permanent solution, a dental implant is a far superior solution to replace a missing tooth. That said, you don’t want to wait longer than a couple weeks to move forward with the dental implant process. The reason is that even though you are only in your 50s, the teeth can begin to shift around. A dental implant will stimulate the bone in the area of the missing tooth and prevent any bone loss at the site.

It is worth asking why the dentist is wanting to pull the tooth so quickly if it is not causing you any pain.

Also, a dental implant takes time to heal before it is able to complete the process with a dental crown. A temporary fixture can be placed in order to fill the empty space.

Also, you need to be prepared that a dental implant may not be covered by your dental insurance. It is possible you may get a discount, depending on what kind of coverage you have. So you may need to cover that expense out of pocket. So be prepared for that.

Generally speaking, you want to work with a dentist who prioritizes saving teeth. It may require greater skill and also may indicate a higher level of empathy and integrity by the dentist. However, there are cases where a tooth truly cannot be saved. It really would be in your best interest to get another opinion by a reputable implant dentist to see what your options are.

Lastly, it is confusing that you mentioned that you should have had a root canal treatment done years ago. If what you have explained is accurate about the the dentist not wanting to drill through the crown, then that dentist may not have done the right thing. Whenever you have decay or an infected tooth, that is when you need to take action to save the tooth. Drilling through a crown may not be ideal, but it is not a reason to leave the tooth alone. The infection or decay wasn’t going to improve once it started. It is not uncommon to drill through a crown.

I hope I’m not leaving you with more questions than answers. But hopefully this gives you a more in depth explanation as to what is going on. Getting another opinion is the best course of action at this point.

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

Can I get dental implants to replace my canines?

Posted on August 20, 2020

I still have several baby teeth and I’m 16 years old. So, I’d like to figure out what my options are. I have always been self conscious about the way my teeth look. I end up hiding my smile all the time.

Here is what is going on. I had the canines on the bottom removed but I still have two baby teeth left on top. The permanent right canine came in after the baby tooth was pulled. It has gradually moved into a normal spot and looks OK. The one on the bottom left was pulled and the permanent tooth is coming in too far behind my other teeth and is crowding my lateral incisor.

Like I said earlier, I feel very embarrassed of my smile, and I don’t know what can be done. I still have the ones on top and the last thing I want to deal with is more gaps in my smile. I’m nervous that once they are pulled the other underlying teeth won’t come in properly. Do you think dental implants are an option for me?

-Jenny in Nevada

Jenny,

Thank you for reaching out. Do you get in regularly for routine dental exams and checkups? If so, it is odd that your regular dentist hasn’t recommended a treatment plan for your situation. The situation you are describing isn’t all that uncommon. Most dentists should know how to address this type of issue, as long as they get a detailed x-ray of your jaw.

The main reason people end up still having their baby canine teeth in place at your age is likely due to the fact that your permanent canine teeth are impacted. So, in order to make the correct determination of care for the baby teeth, it is important to have all the information about how the permanent teeth are positioned below and what is going on with them.

The dentist needs to know if they are indeed impacted and if so, where they are at. If they are impacted, an orthodontist can help you get them to erupt in the proper position for your teeth and jaw.

Sometimes, an individual’s permanent teeth never form. However, it is quite rare for canine teeth to not be formed. It is more common for lateral incisors and lower premolars to form. It is also not uncommon for wisdom teeth to not form properly.

If the canines are still in place at your age, it is quite possible that their eruption is blocked for one reason or another. In order to help them erupt properly typically requires a surgical opening in the gum tissue to help expose the tooth. Then, a bracket can be attached to the tooth to help it erupt using braces. In some cases, the braces aren’t required because simply exposing the permanent canine with the opening is all that will be required.

Now, if you don’t have enough room for the canine teeth to come up into their normal position, then an orthodontist may need to recommend further treatment.

The canine tooth is an important part of the look of your overall smile. So, it may be best to remove the first premolar to give the underlying canine space to come in, and then you may need to have your teeth straightened.

Unfortunately, replacing them with dental implants isn’t the best option if your permanent canine teeth are impacted. This is because the dental implant post is surgically implanted in your jaw, which means they will likely come into contact with the underlying teeth. So, in this case dental implants would not be the recommended treatment.

It sounds like your best course of action will be to work with an orthodontist to make a plan, and don’t be afraid to get multiple opinions. However, your case shouldn’t be too difficult to diagnose and make recommendations based on what you have shared .

Thank you for sharing your story. Hopefully, this helps point you in the right direction.

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

Is it best to save my final two top teeth?

Posted on June 29, 2020

I have sadly lost almost all my teeth on my top arch. I only have two of my natural teeth left. However, I do still have most of my teeth left on the bottom.

I’m trying to figure out what the best option is to replace my two front teeth? If they are removed, I could probably get a complete denture on top. Or if I keep them, the dentist will have to work around them.

It is also worth adding that my two front teeth appear to be healthy and they should last for awhile longer I would assume. I do have a bit of an underbite. So, right now I have an upper partial denture. I don’t like it. It feels big and bulky. And that’s probably due to the cheap material it’s made from.

The last dentist I saw said I would probably be happier having the two teeth extracted and getting an upper denture. Then, the next dentist I met with basically said it’s up to me. I don’t know what I’m supposed to do. I manage eating OK at the moment with just the front two teeth and my lower teeth. And I use the upper removable partial denture for more difficult things to eat like meat or nuts. I do have difficulty speaking normally when the appliance is in too.

I realize that there is no turning back if I decide to have the front teeth removed. So, I’m looking for any feedback you can provide on functionality and comfort. I want it to look natural too. But, I am on a limited budget and cannot exceed $5,000. I’m in my mid-50’s so I will likely have to deal with this for a long time. I’m not sure if that’s a good thing or bad thing. Please let me know your thoughts and recommendations.

-Michael in Texas

Michael,

It is important that you realize that anything that is said right now is based on generalities. It is difficult to provide specific, individualized recommendations about your case when we haven’t seen you in person. So, please keep that in mind since we are not working from an examination or any x-rays. But, hopefully we can provide you some principles that may help guide you along the way.

First off, it is almost always the best to save your natural teeth whenever possible. If you were to replace the missing front teeth with dental implants, that would be the most natural-looking, functional treatment. But if your teeth are in good health like you have described, there is no reason to have them extracted. The fact of the matter is that replacing natural teeth with any type of appliance comes with a lot of disadvantages. If the appliance isn’t secured in place, it will move around and present issues with eating and in some cases talking, like you have explained.

You’ve mentioned that you are using those two front teeth to accomplish a majority of eating, which is placing a lot of extra strain on those teeth. So, when you are saying that they are strong and in good health, that may not actually be the case. It would be good to have them evaluated. Those teeth are not ideal to manage a lot of chewing day in and day out. It cannot be good for them to continue functioning in this way in the long term.

In regard to a removable upper denture, it is known to be more comfortable and easier to chew normally when compared to a lower denture. The upper uses suction to stay in place and typically doesn’t move around as much. On the bottom, there is no suction since your tongue is in the middle. So it is gravity that is keeping it in place, along with your tongue and cheek muscles. Therefore, many people aren’t happy with lower denture appliances.

Something else to think about is that you will experience bone resorption when you are missing your natural teeth. This means that the body uses the minerals elsewhere in the body since they are no longer needed to support the teeth. So, after a longer period of time, around 10 to 20 years or so, you will begin to see signs of a condition called facial collapse. This means that the jawbone appears sunken and it makes it increasingly difficult to keep a denture in place. The situation is usually more exaggerated on the bottom jaw for facial collapse. But since you mention that you are in your 50’s, than this is something you should factor in when making your final decision. The bone will reabsorb and the suction will be lessened as time goes by. You are likely already experiencing the bone deterioration if you are missing the majority of your upper teeth.

Also, you mentioned that you have an underbite, which may also be stressing the lower teeth from the way you are chewing. So, the upper denture would be more gentle on the lower teeth. So, that is something to think about.

If budget weren’t a large consideration, dental implants would be the ideal treatment plan to replace your top two teeth. They are a permanent solution and function just like natural teeth.

All things considered for your case, if the x-rays and/or further examination show that the two upper teeth aren’t in as good as shape as you may think, then it sounds like the most affordable and functional solution in your case may be to move forward with the upper removable denture. It would also look nicer than using a partial denture along with your two natural teeth. But, if those natural teeth are healthy, than you have other options.

It is always good to get multiple opinions from implant dentists in your area that can see you in person. So, hopefully between what we have shared here and those exams, you will be able to determine the right treatment plan for your needs.

Thank you for reaching out. Hopefully, this information will be helpful.

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

Do I need to delay my dental implants appointment due to COVID-19?

Posted on May 8, 2020

I have heard of many dentists that were closed during the COVID-19 pandemic. Now that things are starting to open back up again, do I need to have my dental implant procedure postponed for safety reasons? I am in decent health but I am over 65 years old, which theoretically means I am considered a high-risk person. I have already started the initial processes, so the surgical components have been completed. That was all probably a year ago and I have had many follow-up appointments since then. Bone grafting was done and the implant posts are in. I guess I’m ready to get this all over with because the next appointment is the one where they will finally place the restorative crowns onto the implants.

As much as I have been counting down the days to put this all behind me, my family is concerned about me going in to get things completed. They say, I’ve waited this long, why don’t I just wait a little longer. I guess from what I can tell is that all non-essential appointments are supposed to be rescheduled or canceled for now. I am trying to figure out if dental implants are considered an essential procedure. I guess the reality is I have had these teeth missing for years, so in that way it’s not urgent. But, I do hear about people returning for things like getting haircuts and salons are opening too.

Any insight you could give me would be much appreciated. It seems like the timing is confusing too since things are beginning to reopen. Thank you!

-Gerald in Illinois

Gerald,

Thank you for reaching out. We definitely find ourselves in unprecedented times with the COVID-19 pandemic. Things seem to be continually changing, week by week and in some cases day by day. As more “non-essential” businesses are beginning to open up, each dental practice is trying to determine what they are comfortable with in their offices and how they can adapt their procedures to meet federal guidelines and make sure every precaution is implemented to keep patients safe.

Generally speaking, most states were encouraging you to reschedule or cancel non-essential services when stay-at-home orders were in effect. Now, that businesses are reopening, your best bet will be to call your implant dentist and talk through your concerns and learn more about what services they are considering essential or non-essential.

If anyone has a dental emergency like a tooth infection, broken tooth or some other painful issue, dentists would address those on a case by case basis. They have been seeing emergency cases throughout the pandemic. The truth of the matter is that you have been in the healing phase for quite some time now, so there is likely no issue with waiting a few more weeks. That said, it may be difficult to reschedule certain dental appointments since so many patients had to cancel routine care during stay-at-home orders. So, as businesses and people are more comfortable going out in public safely, you may have to wait longer to reschedule an appointment.

Unfortunately, there is no clear cut answer and it likely comes down to your personal comfort level and your dentist’s philosophy. Dental implants do restore function, which is essential for chewing efficiency and they also do make your smile look nice too. So, technically you could see both sides and make the argument for it to be both essential and non-essential since it’s the final phase.

Some other things to consider. Are you able to eat normally and keep a healthy diet? Are you uncomfortable and is it affecting your quality of life? Only you can answer those questions honestly and it is difficult to give a blanket response without knowing your specific case.

The bottom line is that every case is different. The best thing to do is have an honest conversation with your implant dentist. What one person considers necessary, the next may view as an inconvenience or have no issue with putting it off. It’s likely an argument could be made for either scenario in your instance.

Good luck in your decision-making process. Stay safe!

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

Is it a good idea to switch implant dentists once I’ve started?

Posted on March 10, 2020

Hello,

I have a cracked tooth on my upper, right premolar. The implant dentist gave me a quote for nearly $5,000. That included the tooth extraction and bone grafting, as well as a Lava crown with an abutment. The fee was supposed to cover the implant dentist too.

Also, I have an upper, right lateral incisor, which has been capped for nearly 30 years. The quote came back nearly identical, another $5,000 for similar work. It was a lot to swallow financially, but I decided to go ahead with it because all the work could be done at the same time. So, both of these teeth have now been extracted and the bone grafting procedure was done. They put in a Maryland Bridge for a temporary solution for about three months while the surgical sites heal. Then, once the healing is complete, they plan to place the Lava crowns and dental implants.

If everything went according to plan, I would be fine. But, it’s been a nightmare. It’s been three weeks since the Maryland Bridge was placed and sadly I’ve had to have it replaced three times. I’m beginning to think this is not the norm. Is it possible that my dentist isn’t an implant specialist? Do I need to find an implant dentist or a cosmetic dentist to complete what is left of the work? Or is it better to stick with the same dentist that I started with since he is familiar with what has been done to date. I’m starting to seriously doubt the bridge will stay in place for more than a couple days, which makes me pretty concerned for him to complete the work on my missing teeth.

For the price tag of nearly $10,000, I would expect the dentist to know what he is going. Any insight or recommendations you have would be appreciated.

Thank you for your time.

-Diana in Florida

Diana,

Well, you are right to start questioning your original dentist’s abilities when it comes to dental implants. What you have laid out is more than concerning, frankly it’s frightening. If the dentist cannot get a Maryland Bridge to stay in place, that is a big indicator of their lack of experience or training. It sounds like it would be wise to find a more experienced implant dentist in your area.

A Maryland Bridge is made of a false tooth that is suspended between two wings, and the wings are etched. The backs of the teeth that secure the bridge are where the etching is. Then, composite dental bonding is used to sandwich the wings to the backside of the supporting teeth. If the bridge doesn’t stay in place, there is an issue with the design of the appliance or the technique used to place it. Or it could be a problem with both. Until the issue is resolved with the bridge, you will continue to have issues keeping the bridge secure. It may be time to send the appliance back to the lab so the metal can be redone, and it can adhere properly. However, your dentist may very well be in over his head at this point. He may not truly understand the bonding technologies required for success or not even know where the flaw is occurring.

The aesthetics of your case are also very important. After spending so much money, you not only want your teeth to function correctly, you deserve to have them look lifelike and natural. I would have serious doubts that your dentist understands the cosmetic techniques to give you the smile you deserve.

There are dentists that do both implant dentistry and cosmetic dentistry. Your dentist sounds like he is in unfamiliar territory based on the temporary solution he offered you.

It is likely time to start looking for a reputable dentist in your area that has a lot of experience doing dental implants. In order to be successful with dental implants requires extensive training beyond dental school. Not just any family or general dentist has the skills required, as you are finding out. The problem for patients is that implant dentistry is not a designated specialty area in dentistry. This means any dentist can claim to do dental implants. And the same holds true for cosmetic dentistry. So, be sure to do your research moving forward. Meet the dentist for a consultation, research their credentials and ask to see cases of patients that they have treated successfully that have similar issues as you.

The dentist is ethically obligated to coordinate with the new dentist if you decide to switch dentists in the middle of treatment. And from the sounds of it, it’s time for you to begin your search. Your original dentist should provide the new dentist with all the information required for them to properly treat you and complete the procedure. You are actually in a good transition spot since you are waiting to heal. And you shouldn’t need to have anything redone at this point, assuming the implant posts were properly placed. The new dentist may recommend a different temporary solution, like a dental flipper instead of the Maryland bridge.

Thank you for sharing your story and I’m sorry you are in this spot. Hopefully, you are able to get back on track with a new dentist who is more experienced and by sharing your story, you may also help others considering dental implant treatment.

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

Is a dental implant a good idea for a hockey player?

Posted on November 20, 2019

I just found out that my son lost his front tooth. I realize it sounds cliché, but it was from getting a hockey puck to the face. He has made it all the way to playing college before it happened to him. After meeting with our dentist, it was recommended that he get a dental implant to replace the missing front tooth. So, we started the process. The tooth was extracted and a plug was put in. But, he talked with several of his teammates who raise a good point. Since he will continue to play hockey through college, they said it would be good to wait since the risk is high that it could happen again.

Do you know if there are any other options to avoid going through the entire dental implant process and then having it knocked out again? Would some sort of dental bridge work? Also, it is worth mentioning that he will be getting married in six months so we would like a solution in place before then.

-Paula in Washington

Paula,

You have made a good point and it’s probably coming from a good source. I’m sure your son’s teammates have lost their fair share of teeth over the years. Dental injuries are far too common for hockey players, so it is definitely a legitimate concern to explore other options regarding your son’s front tooth. If the tooth was replaced with a dental implant and than suffered another trauma, the implant would likely damage the bone and cause other complications. If the dental implant came out, there would be a strong possibility that your son would also require bone grafting.

It sounds like you have moved forward with the implant dentist placing the root fixture. And there is nothing to be concerned about with that in place. However, it would be wise to postpone getting the porcelain crown placed until after college hockey is done. You mentioned the possibility of a dental bridge as a temporary solution. Even thought a dental bridge is another solution to replace a missing tooth, it requires the surrounding teeth to be shaved done in order to support the bridge between them. Since it sounds like your son’s other front teeth are healthy, this would not be the recommended option. That would mean he would have three teeth treated instead of one. Ultimately, it would endanger all three of those teeth if he were to suffer another dental hockey injury.

You should talk with your dentist about a removable flipper partial. This will work just fine as a temporary solution and it will also meet your need to have a solution in place for his upcoming wedding. When this type of restoration is done by a dentist that values aesthetics, it can be made to look natural. From a conversational distance, no one will know that he has a false tooth.

Then, when the time comes, he will be ready for a dental implant and this temporary solution will offer the least risk as he continues playing hockey.

Thank you for your question. Hopefully, this gives you some information to work with and determine what is best for his unique situation.

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

Is a dental implant best for my front tooth?

Posted on October 21, 2019

One of my two front teeth was extracted. The oral surgeon was concerned about me replacing it with a dental implant since I have been on Fosamax for over a decade. So, I have a dental flipper in now. I hate it because I seem to always have this nasty taste in my mouth. I was wondering if you agree about the caution with the dental implant? If it’s not an option, I started looking at some other options. I found information on an Encore or Maryland bridge. The tooth next to the empty tooth already has a crown on it. So, does that mean I can get a bridge? When I mentioned this to my dentist he advised against it because he said the other one would need to get a crown too and that he didn’t recommend it.

I would love to hear your feedback.

-Janet in Nevada

Janet,

Thank you for your questions. The first thing that is worth mentioning is that taking Fosamax shouldn’t be a deal breaker regarding the possibility of a dental implant. There may be a small increase of bone issues since you are on Fosamax. This is mainly because the oral surgery does involve placing the surgical post in the bone. The risk is small but it does have rather serious consequences. So without seeing your case in person and knowing your history, it is difficult to give you specific recommendations. But, it is possible to stop taking the medication for a short time to work with the oral surgeon on the placement of the implant. So, it isn’t out of question.

Now, if you agree that the risk isn’t worth it or it is determined that is the case after continued conversations with your oral surgeon, a dental bridge is the next best solution. As far as the type of dental bridge (Maryland or Encore) that isn’t something you need to decide on your own. You should yield to the experience and recommendation of your dentist. For example, it would be a bad idea to walk in and insist on a Maryland bridge if your dentist has never done that type before. Stick to whatever treatment is within your dentist’s skills and experience. You never want to push a dentist out of their comfort zone.

A regular, conventional dental bridge will work just fine. And he is correct that it will require placing another crown on the neighboring tooth in order to anchor the bridge in place. His hesitation probably revolves around placing a bridge on an otherwise healthy tooth.

So, if a dental implant is not an option, it sounds like a traditional dental bridge would work best, unless your dentist has a liking toward a certain type of bridge. Don’t hesitate to discuss your concerns and preferences with your dentist. Together, you should come up with a treatment plan that is best for you.

Thank you for reaching out.

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

What started with Lumineers has ended with dental implants.

Posted on September 11, 2019

Last year, I went to the dentist to improve my smile and got six Lumineers. Imagine my surprise when I went in for a recent exam and cleaning and was told that in four of the teeth with Lumineers I had lost over 50% of bone density. Then, he informed me that I would need to replace them with dental implants, with a price tag around $2,700 for each dental implant. I was shocked!

I asked him about crediting me the fees from the Lumineers, since he did them in the first place. He agreed to credit me $1,500 total and that was only if I had him do the implant work. This whole situation is maddening. I had no idea that I was at risk for needing dental implants, and in such a short time after getting the Lumineers, which were $720 each. The way I see it, he is going to make a huge profit off of this whole thing. And I’m beginning to wonder if I should trust him with doing the dental implants.

Shouldn’t I have had x-rays done before he moved forward with the Lumineeers? I asked the office staff and they said my last set was over 10 years ago. Something just doesn’t feel right and I’m wondering if this sounds negligent. I am in every three months for periodontal care, so how on earth could they have not considered taking an x-ray!

-Bethany in North Carolina

Bethany,

First off, I’m sorry you are in this situation. It does sound like the dentist was negligent because he didn’t diagnose you properly and failed to take x-rays. Most excellent dentists will do their due diligence and perform x-rays, to make sure there aren’t any immediate concerns that need to be addressed. It is also interesting that he is offering you a credit of $1,500, which in an indirect way means he is admitting fault.

At this point, it does not sound like it is in your best interest to have him place your dental implants. You need to get a second opinion to get a better read on the situation. Based on what you have shared, it sounds like you have a pretty solid case. It isn’t right that you should have the teeth extracted after such a short time when the Lumineers were done. Go ahead and demand a full refund and if he doesn’t cooperate, tell him you are going to be getting a lawyer. If for some reason he still doesn’t cooperate, you absolutely have a strong case to pursue legal action.

You are wise to question this dentist. You should avoid any further treatment from him. In fact, in getting a second opinion, don’t tell the next dentist that you were told that you need dental implants. See what their independent recommendations are because it doesn’t sound like your original dentist should be trusted. It could be that you may not need extractions after all and may be a candidate for a less invasive treatment plan. Maybe you will need dental implants, maybe not. Just don’t make that assumption.

This is frustrating and degrades dentists that are out there trying to build trust. Hopefully, this will all be resolved quickly because most dentists genuinely love helping people and will do whatever they can to make sure you are satisfied. It’s true, everyone makes mistakes. But, the way this dentist handled the situation sounds unethical. The right thing to do would have been to offer you a full refund and then to fix the problem that he missed.

Thank you for sharing you story. This post is sponsored by York PA dentist, Donald H. Currie, DMD.