Archives for June 2021

Should I Switch Dentists in the Middle of My Implant Procedure?

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I’ve paid my dentist almost $10,000 dollars already and I am worried he is not up for the remainder of the procedure. The price was to cover extractions of teeth #5 and #7, bone grafting, Maryland Bridges as temporary replacements, dental implants, and crowns for each tooth. Thus far, we’ve done the extractions and bone grafting. He’s provided me with the Maryland Bridges but they keep falling off. This worries me not only because it is super inconvenient to have to constantly have to return to the dentist to have my work or repairs done, but also because I’m concerned he just isn’t up for the remainder of this procedure. What do you think? Am I overreacting and fretting over nothing or is there cause for concern?

DeeDee

Dear DeeDee,

Illustration of a dental implant

There is nothing wrong with you switching dentists in the middle of your dental implant procedure. In fact, your dentist is ethically obligated to provide all the labs and diagnostics to the new dentist. Given what you have said, I am actually going to recommend that you do switch for a couple of reasons.

First, he is using a Maryland bridge as a “temporary” tooth replacement. This is not a temporary replacement because in order for it to stay in properly there is a need to make a small groove in your tooth. Anything that changes the structure of your tooth is not temporary. Instead, he should have suggested something like a dental flipper. These are less expensive and don’t necessitate any changes to the teeth.

Second, he wasn’t able to properly bond the Maryland bridge. That is much less of an advanced procedure than the dental implants you need. You need to look for a dentist with dental implant training and experience. That training needs to be post-doctoral.

One other note, the dental implant crowns can be made any color necessary to match your teeth. You should be aware that whatever color is made is permanent. Once it is bonded on, no changes can be made. If you are considering teeth whitening at some point, then I suggest you do it before having your dental implant crown made. This way it will be the right color for the permanent smile you’d like. If you decide to wait until after the crown is placed and then whiten, you will have to replace the crown for it to match.

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

Can a Dental Implant Fix Her Triangled Teeth?

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I have a complicated case and I am not sure what to do. I have a baby canine tooth that has finally succumbed to decay. That tooth never fell out because my teeth shifted a bit when I was a child after a dentist pulled a baby molar. Now my canine tooth came in but in front of my first and second bicuspids. They’ve formed a sort of triangle. Not only is it embarrassing, but it is nearly impossible to keep thoroughly clean, though I am as diligent as I can be with it. My dentist feels it is too far away and the root system too tangled to use orthodontics to get it in the right place. I do have to remove the baby canine and I just want to have a normal and hopefully attractive smile.

Kelly

Dear Kelly,

dental implant diagram

I would think most dentists, who love their field, would be thrilled to work on a case as complicated as yours. It is possible your dentist feels in over his head with this one. Every dentist goes into the profession with different goals. He may just love being a good bread and butter family dentist and like keeping people’s teeth healthy but not get into all the complicated cosmetic stuff. That’s okay, we need good family dentists.

The only problem for you right now is you need someone with experience in cosmetics. There are a few ways to handle this, but it would take someone looking at your specific bite and x-rays to give you a definitive answer. Here are some possibilities, though.

Options for Fixing This

First, you could extract the baby and adult canine teeth, then use Invisalign to get the opening the right size, along with giving the other teeth proper alignment, and then have a dental implant placed in the area where your canine goes.

Another possibility, if the canine can’t be moved, is to extract it, then have your first bicuspid shaped to look like a canine in the front. That has been done many times with good results.

The key for you, however, it to make sure the dentist you see has the training, experience, and artistry you need to give you a beautiful finished product. I would make sure you look at their smile gallery, which is a sort of brag book for dentists, to see what type of results they get. Then, if they’re good, trust their instinct on the best way to handle this situation.

When Baby Molars are Extracted

I don’t know if you are currently a parent, but I want to tell you how you can avoid this situation with your children. Whoever your pediatric dentist was made a critical error. Baby molars need to stay in place until a child is at least 12 years old. Otherwise, you risk the teeth shifting, which leads to crowding and a complicated bite such as you are facing now.

There are times, however, that a molar cannot be saved. When that is the case, it is imperative the dentist puts a space maintainer in the area in order to keep the teeth in proper alignment. It sounds like your childhood dentist neglected that. Make sure whatever pediatric dentist you have for your children, doesn’t make the same mistake.

I know finding the right dentist will give you a smile you are proud of.
This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

Fixing a Tooth Gap

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I have a medium-sized tooth gap. My dentist is suggesting we do Lumineers, but I am on kind of a tight budget at the moment. Would I better off getting braces? I’m not too keen on that idea because I’m in my early 30s, but I am ready to get rid of this gap.

Leslie

Dear Leslie,

I’m glad you wrote. I am not going to recommend you go with Lumineers. It is a rather large overtreatment for your situation. The good news is, you can fix this without ugly metal braces. You have two good choices here.

Option One: Dental Bonding

before and after dental bonding

In most cases, dental bonding is the solution. It uses a composite bonding to close up the space. In the picture above, you see it used to repair a chipped tooth. This is not something any dentist can do. You will need to go to an experienced cosmetic dentist, especially since it has to be done freehand. I am not going to recommend you use your dentist for this. My guess is he suggested Lumineers because he doesn’t know how to do dental bonding. The Lumineers brand is often marketed to dentists who are inexperienced with cosmetic dentistry as being easy to place. That is likely why he suggested it. If he does this, you won’t like the results.

One thing to note. While the color can be made to match your teeth perfectly, the color is permanent. If you decide to whiten your teeth in a year, your natural teeth will whiten but your bonding will not. Because of that, I often suggest if you plan on whitening your teeth to do so before you have the bonding done. This will save you money in the long run.

Option Two: Invisalign

Invisalign Aligners

If the only thing you want to fix about your tooth alignment is the gap, then dental bonding is the way to go. It is faster and cheaper than the option I’m giving you now. However, if there are other things about your bite that need to be realigned, it will be worth it to get Invisalign. These are sometimes called invisible braces. That is because they use clear aligners to straighten your teeth. There are no wires or brackets either. No one will even know you have orthodontics on.

Either one of these will work for you and will be a better and less expensive option than your dentist is suggesting.
This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.