Archives for October 2020

He Yanked Out Her Dental Implant

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I had a dental implant placed and the crown came loose. I called the dentist who placed it and he did an x-ray. He felt the implant was fine and thought the crown was loose so he decided to remove it and rebond it. Unfortunately, when he went to remove it, it stuck so he needed a special tool. When he used that he had to pull pretty hard and the implant came out with it. Is it possible the dentist messed up here? I don’t know how to fix this.

Cammie

Dear Cammie,

Illustration of a dental implant surrounded by natural teeth

Yes, your dentist definitely messed up. I am actually having a hard time figuring out how he could have been so clueless as to pull out your dental implant. If a crown is loose, it would practically fall off. You certainly aren’t going to need a special tool for it. It should have been obvious to him that it was the implant that was loose the whole time.

Reasons for a Loose Dental Implant

There are a few reasons your dental implant could have been loose. One of the main reasons is because an infection developed. However, you didn’t mention any pain, nor did you have a fever. I’d expect one of those to be present if that was the issue. Another reason for a loose implant is premature loading. That could mean that the dental crown was bonded on before the implant was ready. A third reason could be there was never enough bone support to even place a dental implant.

Your dentist should have done diagnostic x-rays, including 3-dimensional ones, to determine that. I am a tad concerned about his diagnostic abilities as he did an x-ray when you mentioned it was loose and he couldn’t tell the implant was the problem.

Getting this fixed will require you to re-do the procedure. However, it will take more than just doing it again. Before another implant can be placed, you’ll need bone grafting done in order for there to be enough bone to retain the implant. Without that, you will end up with another dental implant failure.

In your place, I would demand your dentist pay to have this done correctly. Don’t let him re-do it himself and don’t just agree to a refund, because it will cost more to fix than you paid him. He needs to pay the new dentist and YOU need to be the one who picks the new dentist. You want someone who has done significant post-doctoral training in dental implants. If they need to refer you to an oral surgeon, make sure it is the dentist who determines the placement of your implant.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Full Mouth Reconstruction for White Teeth

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I have one dental crown and 3 porcelain veneers. The tooth with the crown had a root canal treatment, so it was already there. The gumline by this crown is showing a black/gray line. The veneers are starting to show their age as well. I asked my dentist about replacing these. He wants to do crowns on all my teeth because they’re not very white and this will take care of both issues at once. My concern is the choice. Why crowns instead of porcelain veneers?

Patty

Dear Patty,

tooth bleaching trays

I just want to make sure I’m understanding you correctly. Your dentist wants to crown all your teeth because they aren’t very white? Really? I have so many concerns about this. First, the solution for teeth that aren’t very white is to do teeth whitening. Not only does that preserve all of your tooth structure, but it is also significantly less expensive.

You brought up one of my second concerns. Why crowns instead of porcelain veneers? I can tell you why. Dentists who aren’t comfortable doing porcelain veneers, will steer their patients toward dental crowns. Here is the problem with that. Smile makeovers are not taught in dental school. Porcelain veneers should be a basic skill for any cosmetic dentist. However, there are plenty of cosmetic dentists who do them, but do them badly. You don’t want that either.

When you have a dentist already letting you know he can’t do porcelain veneers, run away from that dentist doing any cosmetic work on your teeth.

Crowning all your teeth is known as a full mouth reconstruction. This is one of the most advanced procedures a dentist will have to do. Not only is there the cosmetic aspect of it, which your dentist has already hinted he’s not qualified to do, but getting the proper occlusion of your teeth also takes significant post-doctoral training, which I doubt he has. If it is done wrong, you could end up with TMJ Disorder and a lifetime of pain and migraines.

My suggestion is you let him do the teeth whitening and then find a cosmetic dentist to replace the crown and veneers. Look at their smile gallery to see what type of results they get in order to get an idea of their skill level. Though, make sure it is their own work and not just stock photos. If they don’t have a smile gallery, they are not a cosmetic dentist at all.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

Dentist Placed My Implant Knowing it Would Fail

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I wanted to replace a tooth. My dentist told me I could get a dental implant, which was the procedure I was hoping for. Apparently, when he went in to place the implant he realized there wasn’t enough bone. He placed the implant anyway. When the surgery was over he told about it and said he doesn’t expect it to last and he thinks it should be removed and then he can give me a dental bridge. I really wanted a dental implant though. Also, I don’t think it is right I should be charged for a surgery he knew was going to fail. Am I overreacting?

Callie

Dear Callie,

dental implant diagram

No, you are not overreacting. In fact, your dentist could be in some trouble here. Let’s talk about the legal implications. He said he’d provide a service, which in any reasonable contract would be expected to actually not fall apart. If it does, you’d get a refund. In legal terms, this is called an implied warranty. In a dental implant, this would mean that the implant would be expected to support the crown. He placed the implant knowing it wouldn’t. So, yeah…he owes you a refund.

There are malpractice issues here too. How did he not know there wasn’t enough bone before doing the procedure? There are diagnostics that should have been performed, such as x-rays in order to make certain you are a good candidate. Either he didn’t do proper diagnostics or he didn’t know how to read the diagnostics he did. Then, when he saw the true “landscape”, he still went ahead and placed an implant he knew would fail. That is malpractice.

That isn’t the only problem here. You’re not bound to getting a dental bridge just because he blew the procedure. There is the option of getting some bone grafting done to build up the bone structure you are missing. Then, your jaw will be ready for that dental implant you wanted.

Bottom line. Yes, ask for a refund. If he gives you a hard time, tell him you are happy to speak to the dental board and an attorney about his malpractice. That should change his tune.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.